TRUNCAL VAGOTOMY ABOLISHES THE SOMATOSTATIN RESPONSE TO INSULIN-INDUCED HYPOGLYCEMIA IN MAN

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Abstract
The mechanism whereby insulin-induced hypoglycemia stimulates release of immunoreactive somatostatin(SRIF-LI) into the peripheral circulation in man is unknown. We have measured the plasma SRIF-LI response to insulin-induced hypoglycemia in 16 healthy subjects and five subjects with prior truncal vagotomy. Mean nadir of plasma glucose was similar in the two groups (37±5 and 34±2 mg/dl in the control group). Hypoglycemia induced a brisk rise in plasma pancreatic polypeptide (hPP) concentrations in healthy subjects (maximum concentration 1563±245 pg/ml) whereas in none of the postvagotomy subjects was there a significant change in hPP concentrations, indicative of completeness of the truncal vagotomy. In healthy subjects SRIF-LI concentrations rose from a basal of 168±19 pg/ml to a maximum of 254±30 at 39±4 minutes (p<0.005) with an incremental area of 2.8±1 na · min/ml above Fasal. In vagotomized subjects, the mean basal SRIF-LI concentration of 166±22 pg/ml was not significantly different from that in healthy subjects. After insulin injection, SRIF-LI concentration fell with a net decrement of −3.2±1 ng · min/ml below the basal. It is concluded that the SRIF-LI response to insulin-induced hypoglycemia is cTependent upon vagal integrity. Section of the vagus unmasks a suppressive effect of insulin action or its metabolic or hormonal consequences on the concentration of SRIF-LI in plasma.

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