Aspects of secretion and actions of amylin: interplay between amylin and other hormones.

Amylin is a second beta-cell hormone, co-localized and co-secreted with insulin in response to nutrient stimuli. Amylin is released in a pulsatile pattern similar to insulin. It is mostly expressed in pancreatic islet cells but smaller amounts are present elsewhere, e.g. in the central nervous system. Apparently amylin (and amylin analogues) has actions capable of modifying glucose homeostasis. It suppresses arginine-stimulated and postprandial glucagon secretion, inhibits insulin secretion and slows gastric emptying. Furthermore, amylin seems to be a satiety agent. In vitro and in vivo studies in animals have demonstrated that amylin may induce insulin resistance. However, it exerts no effect on insulin sensitivity in humans. The literature on the possible actions of amylin/amylin analogues on secretion of growth hormone (GH) is limited. Hypothetically, amylin treatment could be of relevance to improve glycemic control in diabetes mellitus. Muticenter trials with an amylin analogue are ongoing and results are being awaited with interest.