CLINICAL STUDIES ON PLASMA GLUCAGON RESPONSE TO INTRAVENOUS ADMINISTRATION OF ARGININE IN PATIENTS WITH OBSTRUCTIVE JAUNDICE

Abstract

Endocrine function of the pancreas in patients with obstructive jaundice was studied on the basis of plasma glucagon response to intravenous administration of arginine.
Immunoreactive glucagon (IRG) levels were determined by radioimmunoassay using the specific antisera, G-8, of Ito.
In severely jaundiced patients, whose serum bilirubin levels exceeded 20mg/dl, plasma IRG response to arginine was apparently deteriorated. However, it showed significant recovery after the biliary decompression.
When plasma IRG response was correlated with the bilirubin decreasing rate "b", it well maintained within the normal range in patients with the most favorable decreasing rate (the group I; B<-0.09, the peak IRG level=338.9±54.6pg/ml). In the group II, it was significantly deteriorated (-0.09_??_b<-0.05, the peak IRG level=120.2±19.2pg/ml), but recovered markedly after the biliary drainage. In the group III and IV (b_??_-0.05), the peak IRG level never exceeded 200pg/ml and this severe impairment of plasma IRG response persisted long even after the biliary drainage.
These results suggest that endocrine function of the pancreas is significantly impaired in patients with obstructive jaundice and the degree of this change correlates well to the bilirubin decreasing rate "b", which seems to reflect the grade of the surgical risk in patients with obstructive jaundice.