Portal glucose infusion-glucose clamp measures hepatic influence on postprandial systemic glucose appearance as well as whole body glucose disposal.

American Journal of Physiology. Endocrinology and Metabolism
Dan ZhengRichard N Bergman

Abstract

The full impact of the liver, through both glucose production and uptake, on systemic glucose appearance cannot be readily studied in a classical glucose clamp because hepatic glucose metabolism is regulated not only by portal insulin and glucose levels but also portal glucose delivery (the portal signal). In the present study, we modified the classical glucose clamp by giving exogenous glucose through portal vein, the "portal glucose infusion (PoG)-glucose clamp", to determine the net hepatic effect on postprandial systemic glucose supply along with the measurement of whole body glucose disposal. By comparing systemic rate of glucose appearance (R(a)) with portal glucose infusion rate (PoG(inf)), we quantified "net hepatic glucose addition (NHGA)" in the place of endogenous glucose production determined in a regular clamp. When PoG-glucose clamps (n = 6) were performed in dogs at basal insulinemia and hyperglycemia ( approximately 150 mg/dl, portal and systemic), we measured consistently higher R(a) than PoG(inf) (4.2 +/- 0.6 vs. 2.9 +/- 0.6 mg x kg(-1) x min(-1) at steady state, P < 0.001) and thus positive NHGA at 1.3 +/- 0.1 mg x kg(-1) x min(-1), identifying net hepatic addition of glucose to portal exogenous glucose. In c...Continue Reading

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Citations

Dec 28, 2012·American Journal of Physiology. Endocrinology and Metabolism·Elisa FabbriniSamuel Klein
Mar 30, 2012·Diabetes Care·Darko StefanovskiRichard N Bergman
Feb 6, 2004·Journal of Dairy Science·C Schlumbohm, J Harmeyer
Sep 27, 2014·Best Practice & Research. Clinical Endocrinology & Metabolism·Gilles Mithieux
Aug 27, 2019·The Journal of Clinical Investigation·Peng ZhouBarbara B Kahn
Mar 12, 2020·Proceedings of the National Academy of Sciences of the United States of America·Thiago M BatistaRichard T Lee

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