Mechanisms of acute hyperinsulinemia after Kupffer cell phagocytosis

Blockade of hepatic Kupffer cells by prior phagocytosis of a variety of particulate materials caused acute hyperinsulinemia in glucose-stimulated fasted rats under pentobarbital anesthesia. At 4-h postblockade a 125-250% increase in peripheral plasma insulin levels occurred due to a combination of enhanced pancreatic insulin secretion and depressed hepatic insulin extraction. Enhanced pancreatic insulin secretion was confirmed by a 36-54% elevation of portal venous insulin levels. Depressed hepatic insulin extraction was indicated by a 37-47% reduction in insulin uptake by in situ perfused livers as well as alterations in portal-hepatic venous insulin differences and intravenous insulin tolerance tests in vivo. All parameters began to return toward control values at 24 and 48 h postblockade. Return was slow after inert carbon phagocytosis and rapid after degradable bacteria phagocytosis. Peripheral plasma insulin levels were very highly correlated with glucose clearance rates in all groups both control and experimental. Mechanisms are proposed to explain these findings based on the release of lysosomal enzymes and endogenous pyrogens by phagocytizing Kupffer cells as well as the presence of insulin receptors on hepatocytes and Kupffer cells.