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Insulin secretion: difference between revisions

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Revision 13 — 11:19, 19 Feb 2025
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add the reference range with the assay it was established on
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29Amino acids, free fatty acids acting at FFAR1, and parasympathetic input all amplify. The [[Incretin effect|incretin effect]] — the excess of the oral over the intravenous insulin response — is the integrated ''in vivo'' expression of the hormonal amplifiers.{{r|campbell2013}}29Amino acids, free fatty acids acting at FFAR1, and parasympathetic input all amplify. The [[Incretin effect|incretin effect]] — the excess of the oral over the intravenous insulin response — is the integrated ''in vivo'' expression of the hormonal amplifiers.{{r|campbell2013}}
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+31== Pulsatility and measurement ==
+32Insulin is secreted in pulses of five to ten minutes' period, superimposed on the biphasic pattern. Pulsatility is degraded early in type 2 diabetes and in first-degree relatives of affected people. Because the liver extracts insulin in a pulse-dependent manner, degraded pulsatility alters hepatic insulin exposure disproportionately to any change in mean concentration.{{r|rorsman2013}}
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+34Secretion is measured indirectly. Peripheral insulin concentration understates secretion because of first-pass hepatic extraction, so [[C-peptide]] — co-secreted equimolar with insulin and not extracted by the liver — is the preferred analyte for quantifying secretory rate. Deconvolution of C-peptide kinetics gives a secretion profile; simpler indices such as HOMA-B and the insulinogenic index are cruder but require only a fasting or a two-point sample.
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31== References ==36== References ==
32{{reflist}}37{{reflist}}