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R. PHILIP EATON, NEAL FRIEDMAN, RICHARD C. ALLEN, DAVID S. SCHADE, Insulin Removal in Man: In Vivo Evidence for a Receptor-Mediated Process, The Journal of Clinical Endocrinology & Metabolism, Volume 58, Issue 3, 1 March 1984, Pages 555–559, https://doi.org/10.1210/jcem-58-3-555
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Abstract
To evaluate the in vivo participation of insulin receptors in both hepatic and extrahepatic removal of insulin, compartmental kinetic analysis of insulin behavior was performed in a patient with blocked receptors due to endogenous antiinsulin receptor antibodies. Using the standard three-compartment simulation of insulin behavior, the responses to both a 5-U injection of exogenous insulin and a 4.2-U secretion of endogenous insulin subsequent to tolbutamide injection were examined. In response to both exogenous and endogenous insulin, hepatic removal of insulin was reduced to less than 18% of the insulin exposure (normal, 40–60%). The metabolic clearance of insulin was reduced from the normal level of 520 ml/min to less than 120 ml/min, consistent with a reduction in receptormediated removal of insulin from the blood. These studies propose quantitative parameters for insulin receptor function in hepatic and extrahepatic removal of insulin in man.