The objective of the study is to investigate how exogenously administered glucagon affects hepatic lipid, glucose and protein metabolism as well as appetite, food intake and resting energy expenditure.
Most research has focused on the role of the pancreatic hormone, insulin, and insulin signalling (or lack of) in the development of NAFLD. However, increasing evidence suggest that the other major gluco-regulatory pancreatic hormone glucagon is also implicated in lipid metabolism and recent human data from studies investigating the effect of glucagon receptor antagonism suggest that glucagon signalling may be essential for maintaining a fat-free liver. This, combined with observations of increased degree of hepatic steatosis in patients after total pancreatectomy, who are devoid of pancreatic glucagon and typically are lean and peripherally insulin sensitive, suggests that glucagon may play a hitherto unrecognised role in the pathophysiology of NAFLD. The hypothesis of the study is that exogenously delivered glucagon will drive hepatic metabolism in a lipolytic direction and increase resting energy expenditure without affecting appetite and food intake. The acute effects of exogeneous glucagon infusion on hepatic lipid metabolism will be evaluated in patients after total pancreatectomy (no endogenous pancreatic hormones), in patients with type 1 diabetes (no endogenous insulin production) and in healthy controls (preserved endogenous pancreatic hormones).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
DOUBLE
Enrollment
27
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen
Hellerup, Denmark
Hepatic lipid metabolism
evaluated using isotopic labelled tracer kinetics: lipolysis, ketogenesis, very low-density lipoprotein (VLDL) secretion and free fatty acid (FFA) re-esterification rate
Time frame: -120,-30,-15,0,30,60,90,120,135,150 minutes
Changes in plasma concentration of lipids
Total cholesterol, VLDL, LDL, HDL, FFA
Time frame: 0, 60,150 minutes
Changes in plasma concentration of amino acids
Time frame: 0, 60, 120, 150 minutes
Changes in plasma concentration of fibroblast growth factor 21 (FGF-21)
Time frame: -120,0,150 minutes
Endogenous glucose production
Measured by glucose tracer
Time frame: -120,-30,-15,0,30,60,90,120,135,150 minutes
Changes in resting energy expenditure and oxidation rate
Measured by indirect calorimetry
Time frame: 0, 150 minutes
Food intake
Ad libitum meal
Time frame: 30 minutes (150-180) minutes
Changes in appetite sensation
Visual analogue scale
Time frame: 0,30,60,90,120,150 minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.