Stingl H, Krssák M, Krebs M, Bischof M G, Nowotny P, Fürnsinn C, Shulman G I, Waldhäusl W, Roden M
Department of Internal Medicine III, University of Vienna Medical School, Austria.
Diabetologia. 2001 Jan;44(1):48-54. doi: 10.1007/s001250051579.
AIMS/HYPOTHESIS: Non-esterified fatty acids and glycerol could stimulate gluconeogenesis and also contribute to regulating hepatic glycogen stores. We examined their effect on liver glycogen breakdown in humans.
After an overnight fast healthy subjects participated in three protocols with lipid/heparin (plasma non-esterified fatty acids: 2.2 +/- 0.1 mol/l; plasma glycerol: 0.5 +/- 0.03 mol/l; n = 7), glycerol (0.4 +/- 0.1 mol/l; 1.5 +/- 0.2 mol/l; n = 5) and saline infusion (control; 0.5 +/- 0.1 mol/l; 0.2 +/- 0.02 mol/l; n = 7). Net rates of glycogen breakdown were calculated from the decrease of liver glycogen within 9 h using 13C nuclear magnetic resonance spectroscopy. Endogenous glucose production was measured with infusion of D-[6,6-2H2]glucose.
Endogenous glucose production decreased by about 25 % during lipid and saline infusion (p < 0.005) but not during glycerol infusion (p < 0.001 vs lipid, saline). An increase of plasma non-esterified fatty acids or glycerol reduced the net glycogen breakdown by about 84 % to 0.6 +/- 0.3 micromol x kg(-1) x min(-1) (p < 0.001 vs saline: 3.7 +/- 0.5 micromol x kg(-1) x min(-1)) and by about 46 % to 2.0 +/- 0.4 micromol x kg(-1) x min(-1) (p < 0.01 vs saline and lipid), respectively. Rates of gluconeogenesis increased to 11.5 +/- 0.8 micromol x kg(-1) x min(-1) (p < 0.01) and 12.8 +/- 1.0 micromol x kg(-1) min(-1) (p < 0.01 vs saline: 8.2 +/- 0.7 micromol x l(-1) x min(-1)), respectively.
CONCLUSION/INTERPRETATION: An increase of non-esterifled fatty acid leads to a pronounced inhibition of net hepatic glycogen breakdown and increases gluconeogenesis whereas glucose production does not differ from the control condition. We suggest that this effect is not due to increased availability of glycerol alone but rather to lipid-dependent control of hepatic glycogen stores.
目的/假设:非酯化脂肪酸和甘油可刺激糖异生,也有助于调节肝糖原储备。我们研究了它们对人体肝脏糖原分解的影响。
经过一夜禁食后,健康受试者参与了三项方案,分别为输注脂质/肝素(血浆非酯化脂肪酸:2.2±0.1毫摩尔/升;血浆甘油:0.5±0.03毫摩尔/升;n = 7)、甘油(0.4±0.1毫摩尔/升;1.5±0.2毫摩尔/升;n = 5)和生理盐水(对照组;0.5±0.1毫摩尔/升;0.2±0.02毫摩尔/升;n = 7)。使用13C核磁共振波谱法根据9小时内肝糖原的减少量计算糖原分解的净速率。通过输注D-[6,6-2H2]葡萄糖来测量内源性葡萄糖生成。
在输注脂质和生理盐水期间,内源性葡萄糖生成减少约25%(p < 0.005),但在输注甘油期间未减少(与脂质、生理盐水相比,p < 0.001)。血浆非酯化脂肪酸或甘油的增加使糖原分解净速率分别降低约84%至0.6±0.3微摩尔·千克-1·分钟-1(与生理盐水相比,p < 0.001:3.7±0.5微摩尔·千克-1·分钟-1)和约46%至2.0±0.4微摩尔·千克-1·分钟-1(与生理盐水和脂质相比,p < 0.01)。糖异生速率分别增加至11.5±0.8微摩尔·千克-1·分钟-1(p < 0.01)和12.8±1.0微摩尔·千克-1·分钟-1(与生理盐水相比,p < 0.01:8.2±0.7微摩尔·升-1·分钟-1)。
结论/解读:非酯化脂肪酸的增加导致肝脏糖原分解净速率明显受到抑制,并增加糖异生,而葡萄糖生成与对照条件无差异。我们认为这种效应并非仅由于甘油可用性增加,而是由于脂质对肝脏糖原储备的依赖性控制。