Pancreatic polypeptide responses to hypoglycemia in chronic autonomic failure

The Journal of Clinical Endocrinology and Metabolism
R J PolinskyI J Kopin

Abstract

Pancreatic polypeptide (PP) and catecholamine responses to insulin-induced hypoglycemia have been measured in 15 patients with neurogenic orthostatic hypotension. Eight of the patients had idiopathic orthostatic hypotension, and 7 had multiple system atrophy, a condition characterized by the presence of central nervous system lesions in addition to the orthostatic hypotension common to both diseases. Eleven healthy subjects exhibited rapid and substantial elevations in plasma epinephrine, norepinephrine, and PP concentrations in response to insulin hypoglycemia. In contrast, patients with neurogenic orthostatic hypotension exhibited impaired catecholamine and PP responses to insulin hypoglycemia. There was no correlation between the catecholamine and PP responses in either the normal subjects or the patients, suggesting that PP release during hypoglycemia is independent of the sympathoadrenal medullary response. As PP release in response to insulin hypoglycemia is abolished by truncal vagotomy and unaffected by splanchnic nerve section, our results suggest that patients with chronic autonomic failure may have a diffuse autonomic dysfunction involving the parasympathetic as well as the sympathetic nervous system.

Citations

Feb 1, 1995·Digestive Diseases and Sciences·B GlasbrennerP Malfertheiner
Oct 1, 1983·Journal of the Autonomic Nervous System·T W Schwartz
Nov 1, 1995·Diabetes Research and Clinical Practice·B GlasbrennerG Adler
Jul 20, 2002·Journal of the Neurological Sciences·Samir M ParikhDavid Robertson
Jan 1, 1988·Journal of Neurology, Neurosurgery, and Psychiatry·R J PolinskyI J Kopin
Nov 9, 2001·CNS Drugs·G K Wenning, S Braune
Apr 1, 1983·Acta Neurologica Scandinavica·J Hilsted

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