Glucagon stimulation test (GST) is often employed to assess the insulin reserve of the pancreatic beta cells in diabetic subjects. The clinical significance of the increment of plasma glucose (Δglucose) by exogenous glucagon during GST has not been elucidated. We investigated the relationship between Δglucose and clinical parameters including the liver and renal function in type 2 diabetic subjects, since we hypothesized that Δglucose is associated with the liver and renal function reflecting the capacity for gluconeogenesis in the organs. A total of 209 subjects with type 2 diabetes who underwent GST during admission were included in this cross-sectional study. We defined the difference between plasma glucose at fasting and 6 min after intravenous injection of 1 mg glucagon as Δglucose. We assessed correlations between Δglucose and clinical parameters such as diabetic duration, BMI, HbA1c, beta cell function, serum free fatty acids (FFA) which is known to stimulate gluconeogenesis, liver function, the indices of liver function, renal function, and urinary albumin excretion (UAE). In correlation analysis, Δglucose positively correlated to FFA and estimated glomerular filtration rate (eGFR), but inversely to serum creatinine and cystatin C, although Δglucose showed no correlation with both liver function and the indices of residual liver function. Multiple regression analysis revealed that Δglucose was an independent determinant for the eGFR after 1 year, equally BMI, HbA1c, serum lipids, and UAE, which are known as the predictors for the development of chronic kidney disease. Our results suggest that Δglucose during GST might be related to gluconeogenesis in the kidney and could be the determinant of future renal function in type 2 diabetes.

中文翻译：

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外源胰高血糖素使血浆葡萄糖增加与2型糖尿病的当前和未来肾功能有关：来自胰高血糖素刺激试验的回顾性研究

胰高血糖素刺激试验（GST）通常用于评估糖尿病受试者中胰岛β细胞的胰岛素储备。尚不清楚GST期间外源胰高血糖素使血浆葡萄糖（Δ葡萄糖）增加的临床意义。由于我们假设Δ葡萄糖与反映器官中糖异生能力的肝和肾功能有关，因此我们研究了2型糖尿病患者中Δ葡萄糖与临床参数之间的关系，包括肝和肾功能。这项横断面研究共纳入了209名入院期间接受GST的2型糖尿病患者。我们定义了空腹血糖和静脉注射1 mg胰高血糖素后6分钟的血浆葡萄糖之间的差异作为Δ葡萄糖。我们评估了Δ葡萄糖与糖尿病持续时间，BMI，HbA1c，β细胞功能，血清游离脂肪酸（FFA）等临床参数之间的相关性，已知该脂肪酸可刺激糖原异生，肝功能，肝功能，肾功能和尿白蛋白指数排泄物（阿联酋）。在相关分析中，尽管Δ葡萄糖与肝功能和残余肝功能指标均无相关性，但Δ葡萄糖与FFA和估计的肾小球滤过率（eGFR）呈正相关，与血清肌酐和半胱氨酸蛋白酶抑制剂C呈负相关。多元回归分析显示，Δ葡萄糖是1年后eGFR的独立决定因素，而BMI，HbA1c，血脂和阿联酋均被认为是eGFR的独立决定因素，这些均被称为慢性肾脏病发展的预测因子。