Schlienger J L, Imler M, Stahl J
Diabetologia. 1975 Oct;11(5):439-43. doi: 10.1007/BF00429913.
In order to explain the abnormalities of glucose metabolism previously observed in patients with blood ammonia elevation, the effect of a transitory hyperammonemia on I.V. glucose tolerance was investigated in rats. An I.V. glucose tolerance test was performed in 3 groups of 15 rats 60 min after the beginning of a 95 min infusion of either a 2 ml isotonic NaCl solution (control group) or ammonium acetate solutions at low (0.50 mumol/kg/min. NH4+) or high doses (1.70 mumol/kg/min NH4+). The "high" NH4+ infusion produced an increase of blood ammonia to levels near 1000 mug/100 ml, a significant decrease in the K coefficient for glucose disappearance (2.53 X 10(-2) +/- 0.20 compared to 4.92 X 10(-2) +/- 0.13 in control group) and a suppression of the radioimmunological plasma insulin (I.R.I.) response to glucose. With the "low" NH4+ infusion the hyperammonemia was less pronounced (200-300) mug/100 ml), but the decrease in K(3.02 X 10(-2) +/- 0.15) and in the first phase of I.R.I. release remained significant. The decrease in glucose disappearance rate could be accounted for by the proportional decrease in insulin secretion. Thus glucose intolerance induced by ammonium acetate infusions may be due to a direct effect of NH4 + on the pancreas. These abnormalities in glucose metabolism depend on the quantity of infused ammonium.
为了解释先前在血氨升高患者中观察到的糖代谢异常，研究了短暂性高氨血症对大鼠静脉注射葡萄糖耐量的影响。在三组各15只大鼠中进行静脉注射葡萄糖耐量试验，在开始输注95分钟后60分钟，分别输注2ml等渗氯化钠溶液（对照组）或低剂量（0.50μmol/kg/min NH4+）或高剂量（1.70μmol/kg/min NH4+）的醋酸铵溶液。“高”剂量NH4+输注使血氨水平升高至接近1000μg/100ml，葡萄糖消失的K系数显著降低（2.53×10(-2)±0.20，而对照组为4.92×10(-2)±0.13），并抑制了血浆胰岛素（IRI）对葡萄糖的放射免疫反应。“低”剂量NH4+输注时，高氨血症不太明显（200 - 300μg/100ml），但K值降低（3.02×10(-2)±0.15）以及IRI释放的第一阶段仍有显著下降。葡萄糖消失率的降低可由胰岛素分泌的相应减少来解释。因此，醋酸铵输注诱导的葡萄糖不耐受可能是由于NH4 +对胰腺的直接作用。这些糖代谢异常取决于输注铵的量。
