mThe pancreas secretes:

Digestive enzymes
Four hormones
żInsulin
żGlucagon
żSomatostatin
żPancreatic polypeptide
m Insulin
and glucagon are involved
in CARBOHYDRATE
METABOLISM
m Somatostatin is involved in
LOCAL REGULATION OF
INSULIN AND GLUCAGON
SECRETION
m Pancreatic polypeptide affects
GASTROINTESTINAL
SECRETION
m Contains 36 amino acids
m Produced by the F cells of the pancreas
m Secretion is INCREASED during:
High-protein diet
Fasting
Exercise
Acute hypoglycemia
m Secretion is DECREASED by
somatostatin and intravenous infusion
of glucose
m Function: UNKNOWN
m A protein secreted by the ȕ cells of
the islets of Langerhans
m Has been isolated and crystallized
m Crystalline insulin
Contains a small amount of ZINC
m Small amounts of CHROMIUM are
needed for the synthesis of insulin
m Amount of chromium in the body
decreases with age
m It increases the rate of
oxidation of glucose
m Facilitates the conversion of
glucose to glycogen in the
liver and muscles
m Increases the synthesis of
fatty acids, protein, and RNA
m Decreases blood sugar to its
normal fasting level
m HYPERGLYCEMIA
If the islets of Langerhans are
underactive or degenerated = little or no
insulin is produced
Associated with diabetes mellitus
m DIABETES MELLITUS
Blood sugar level is increased
Glucose appears in urine
Ketone bodies are formed accompanied
by acidosis
m Insulin can NOT cure diabetes
m Itis NOT taken ORALLY
m Given by subcutaneous injection
must be given 2 or 3 times a day
to a patient with diabetes mellitus
m PROTAMINE ZINC INSULIN
Insulin is combined with protamin
Utilized much more slowly
Effective for more than 24 hrs.
One injection daily
m HYPOGLYCEMIA
Blood sugar level falls far below its normal
fasting value
Symptoms:
ż Dizziness
ż Nervousness
ż Blurring of vision
ż Unconsciousness
This state is called INSULIN SHOCK
Relieved by administration of sugar
Also occurs when there is a tumor on the
islets of Langerhans
m Insulin
is degraded primarily in the
LIVER and KIDNEYS
Enzyme: glutathione insulin
transhyroxylase
m1 ml sterile solution contains 100
units of insulin
m 1 unit of insulin can reduce the blood
sugar level of a normal 2-kg RABBIT
after a 24-hr fast from 120 to 45 mg
per 100ml
m Certain
HYPOGLYCEMIC
SUBSTANCES lower the blood sugar
level
Effective in adult diabetes and NOT juvenile
diabetes
Function: stimulates the ȕ cells of the islets of
Langerhans to produce insulin
Examples:
ż Glyburide (Micronase)
ż Troglitazone (Rezulin)
ż Metformin (Glucophage)
Have many side effects
m Former name: HYPERGLYCEMIC
GLYCOGENOLYTIC FACTOR
(HGF)
m Gave the hyperglycemic effects
from CRUDE INSULIN
m Has been isolated and crystallized
m A polypeptide containing 29 amino
acids in a single chain
m Has a different arrangement of
amino acids than insulin
m Contains NO disulfide bridges
m Contains methionine and
tryptophan (absent in insulin)
m Does NOT contain cysteine,
proline, and isoleucine (present
in insulin)
m Formed in the j cells of the islets
of Langerhans
m Significant amounts also come
from the A cells in the stomach
and other parts of the GIT
m Causes an increase in the sugar
content of the blood
Stimulates PHOSPHORYLASE
ACTIVITY in the liver
m Increases the formation of cAMP
Activates phosphorylase
Increases the glucose content of the
blood
Causes hyperglycemia
m Stimulates the formation of glucose
from amino acids (gluconeogenesis)
m Increases the release of potassium
ions from the liver
m Increases the breakdown of lipids to
fatty acids and glycerol
mHas been used to treat:
Hypoglycemic effects due to
an overdose of insulin
Insulin shock
mUsed in the diagnostic test
for glycogen storage
disease
m THYROID GLAND
H-shaped
Consists of one lobe on each
side of the trachea with a piece
of tissue connecting the two
lobes
Weight: approximately 25 to 30 g
in adults
Filled with many small follicles that
contain COLLOID
ż Contains the thyroid gland¶s
hormones
The only endocrine gland in the
body that is capable of storing
appreciable amounts of hormones
Contains IODINE ñ necessary for
the proper functioning of the body
ż 2 forms of iodine in the body:
Iodide ions and thyroid hormones
m HORMONES of the thyroid gland:
Regulate the metabolism of the body
Affect the growth and development of
the body
m Methods for evaluating activity
old and indirect (replaced already)
ż Basal metabolic rate (BMR)
ż Protein-bound iodine (PBI)
ż Butanol-extractable iodine (BEI)
New, direct and stable
ż Radioimmunoassay methods
m COLLOID of the thyroid contains
THYROGLOBIN / THYROGLOBULIN
ż A glycoprotein
ż Liberates the principal thyroid
hormones; TRIIODOTHYRONINE (T3)
and THYROXINE (T4)
m T3 is the major active form of the
thyroid hormone and is 3 to 5 times
as biologically active as T4.
m Mono- and diiodothyronine are
formed but quickly deiodinated in the
bloodstream
m CALCITONIN
(THYROCALCITONIN)
Produced in the C cells in the
thyroid gland
Regulates calcium ions in the blood
Prevents calcium ion concentration
from rising above the required level
Pure calcitonin
ż 1st isolated in 1968; structure was
determined shortly thereafter
This is a polypeptide containing a
single chain of 32 amino acids
Produces its effect by inhibiting the
release of calcium ions, from the bone
to the blood
Its release is stimulated by high levels
of Ca2+ in the blood
MEDULLARY THYROID CARCINOMA
ż A disorder of the C cells of the
thyroid
ż Causes an abnormally high
production of calcitonin
m HYPOTHYROIDISM
A condition in which the thyroid gland
does not manufacture sufficient thyroxine
for the body¶s needs
Usually caused by a lack of iodine in the
diet
May also be due to a disease of the
thyroid gland or to its congenital absence
Symptoms:
ż Sluggishness
ż Weight gain
ż Slower heartbeat
ż Reduced metabolic rate
ż Loss of appetite
Remedy: use iodized salt; use of
synthetic thyroid hormones
m CRETINISM
The thyroid gland is absent or fails to
develop in an infant
CRETIN
ż Name of the individual with this condition
ż Has greatly retarded growth (physically
and mentally)
ż Usually abnormal dwarves with coarse
hair and thick dry skin
ż Obese with protruding abdomens
ż Underdeveloped mentally and sexually
Remedy: give thyroid hormones
If thyroid gland atrophies after an
individual reaches adulthood:
ż Same symptoms of cretinism appear
ż but Individual remains adult in size
ż MYXEDEMA
Development of thick, coarse, dry skin
Cured by admission of thyroxine
People are sluggish, have lower pulse
and metabolic rate and lower body
temperature and are frequently anemic.
They are also very sensitive to cold.
m SIMPLE GOITER
aka COLLOID GOITER or ENDEMIC
GOITER
A condition in which the thyroid gland
enlarges
Due to lack of iodine in the diet
The decreased production of thyroid
hormones causes an increased production
of TSH, which overstimulates the thyroid
gland
Accompanied by a definite increase in the
amount of colloid material in the thyroid
gland
Neck size increases
m HASHIMOTO¶S DISEASE
A type of hypothyroidism in which all
aspects of the thyroid function may
be impaired
Caused by an attack on the thyroid
gland by the body¶s own immune
system
m HYPERTHYROIDISM
Occurs when the thyroid gland
produces excess thyroxine
Symptoms:
ż Increased metabolic rate
ż Bulging of the eyes (exophthalmos)
ż Nervousness
ż Loss of weight
ż Rapid, irregular hearbeat
ż Elevated body temperature
Also called GRAVE¶S DISEASE,
BASEDOW¶S DISEASE or
EXOPHTHALMIC GOITER
May also be due to a tumor in the thyroid
gland (TOXIC ADENOMA or PLUMMER¶S
DISEASE)
Control or cure:
ż Surgical removal of part of the thyroid
gland
ż Oral administration of radioactive iodine
ż Use of antithyroid drugs
Hypertrophy of the endocrine glands ñ
toxic adenomas with a malignant
potential if not treated promptly.
m There are 4 small parathyroid
glands attached to the thyroid
gland
m Reddish brown in humans
m Total weight: 0.05 to 0.3 g
m Early experimental
Thyroidectomies (removal of the
thyroid glands) inadvertently
removed the parathyroid glands,
causing the death of animals
m Parathyroid hormone:
Influences the metabolism of
calcium and phosphorus in the body
A polypeptide chain with 84 amino
acids
CANNOT be stored in the
parathyroid gland
Synthesized and secreted
continuously
m Administration
of VIT. A
decreases parathyroid hormone
mHYPOPARATHYROIDISM
Caused by the surgical
removal of the parathyroid
glands
Symptoms:
żMuscular weakness
żIrritability
żTetany
There is a decrease in the calcium
content of the BLOOD PLASMA
Death ñ due to convulsions
Calcium content in URINE
decreases
Phosphate content of the PLASMA
increases
Treatment: (relieve the symptoms)
ż Vitamin D
ż Calcium salts
ż Or both
m HYPERPARATHYROIDISM
An increase in the production of
hormones by the parathyroid glands
Usually caused by a tumor of those
glands (parathyroid adenoma)
Symptoms:
ż Decalcification of bones
ż Deformation and fractures of the bones
ż Nausea
ż Polyuria
Deposits of calcium occur in soft tissues
Renal stones frequently occur
Calcium content of the BLOOD
PLASMA is high and the
phosphate content is low
Extra calcium in the blood is
obtained from the bones
Urine calcium, phosphate and
cAMP are increased
Treatment:
ż Surgical removal of the tumor
of the parathyroid glands