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Blood glucagon
Last reviewed: 05.07.2025
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Reference values (norm) of glucagon concentration in blood plasma in adults are 20-100 pg/ml (RIA).
Glucagon is a polypeptide consisting of 29 amino acid residues. It has a short half-life (several minutes) and is a functional antagonist of insulin. Glucagon is mainly produced by α-cells of the pancreas, duodenum, but secretion by ectopic cells in the bronchi and kidneys is possible. The hormone affects carbohydrate and lipid metabolism in peripheral tissues. In diabetes mellitus, the combined action of these hormones is manifested by the fact that insulin deficiency is accompanied by an excess of glucagon, which, in fact, causes hyperglycemia. This is especially well demonstrated by the example of treating type 1 diabetes mellitus, that is, absolute insulin deficiency. In this case, hyperglycemia and metabolic acidosis develop very quickly, which can be prevented by prescribing somatostatin, which inhibits the synthesis and secretion of glucagon. After this, even in the complete absence of insulin, hyperglycemia does not exceed 9 mmol/l.
Along with somatostatin, glucagon secretion is suppressed by glucose, amino acids, fatty acids and ketone bodies.
A significant increase in the concentration of glucagon in the blood is a sign of glucagonoma - a tumor of the alpha cells of the islets of Langerhans. Glucagonoma accounts for 1-7% of all islet cell tumors of the pancreas; most often localized in its body or tail. Diagnosis of the disease is based on the detection of a very high concentration of glucagon in the blood plasma - above 500 pg / ml (can be in the range of 300-9000 pg / ml). Hypocholesterolemia and hypoalbuminemia, detected in almost all patients, are of diagnostic value. Additional information can be provided by the test of suppression of glucagon secretion after a glucose load. After an overnight fast, the patient's blood is initially taken from a vein to determine the concentration of glucose and glucagon. After this, the patient takes glucose orally at a dose of 1.75 g / kg. Repeated blood sampling is performed after 30, 60 and 120 minutes. Normally, at the moment of peak glucose concentration in the blood, a decrease in glucagon concentration to 15-50 pg/ml is observed. In patients with glucagonoma, there is no decrease in glucagon level in the blood (negative test). The absence of suppression of glucagon secretion during the test is also possible in patients after gastrectomy and with diabetes mellitus.
The concentration of glucagon in the blood plasma may increase in diabetes mellitus, pheochromocytoma, liver cirrhosis, Itsenko-Cushing's disease and syndrome, renal failure, pancreatitis, pancreatic trauma, and familial hyperglucagonemia. However, an increase in its content several times higher than normal is noted only in glucagon-secreting tumors.
Low blood glucagon levels may reflect a general decrease in pancreatic mass caused by inflammation, tumor, or pancreatectomy.
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