Clore John N, Allred James, White Danielle, Li Jing, Stillman Julie
Division of Endocrinology and Metabolism, Virginia Commonwealth University, Richmond, VA, USA.
Metabolism. 2002 Nov;51(11):1471-7. doi: 10.1053/meta.2002.35202.
Hepatic insulin resistance and increased endogenous glucose production (EGP) are associated with increased plasma free fatty acids (FFA). However, the contribution of FFA composition to the regulation of EGP is not known. Six obese nondiabetic subjects and 6 patients with type 2 diabetes mellitus (DM2) were studied after an overnight and a 3-day fast. Plasma insulin concentrations after an overnight fast were similar in the DM2 and nondiabetic patients (88.8 +/- 26.4 v 57.6 +/- 12.6 pmol/L, not significant [NS]) despite increased plasma glucose (9.9 +/- 1.8 v 5.1 +/- 0.1 mmol/L, P <.01) and EGP (510.3 +/- 77.7 v 298.3 +/- 18.3 micromol x m(-2) x min(-1), P <.05) in the patients with DM2. Absolute rates of gluconeogenesis using the heavy water method were also increased in the patients with DM2 (346.8 +/- 74.9 v 198.8 +/- 16.4 micromol x m(-2). min(-1), P <.05). No differences were observed in plasma polyunsaturated fatty acids (PUFA) between the diabetic and nondiabetic subjects. However, total saturated fatty acid (SFA) concentrations (350 +/- 37.4 v 230.9 +/- 33.3 micromol/L, P <.02) were significantly increased in the diabetic subjects. Rates of EGP were correlated with total plasma FFA concentration (r =.71, P <.01) and the concentration of SFA (r =.71, P <.01), but not monounsaturated fatty acids or PUFA. Rates of gluconeogenesis were also correlated with plasma FFA (r =.64, P <.05) and SFA (r =.67, P <.05). We observed no relationship between EGP and either total FFA or fatty acid composition after a 3-day fast. We conclude that increases in EGP are associated with concentrations of plasma SFA after an overnight fast.
肝胰岛素抵抗和内源性葡萄糖生成（EGP）增加与血浆游离脂肪酸（FFA）升高有关。然而，FFA组成对EGP调节的作用尚不清楚。对6名肥胖非糖尿病受试者和6名2型糖尿病（DM2）患者进行了过夜禁食和3天禁食后的研究。尽管DM2患者的血浆葡萄糖（9.9±1.8对5.1±0.1 mmol/L，P<.01）和EGP（510.3±77.7对298.3±18.3 μmol·m⁻²·min⁻¹，P<.05）升高，但过夜禁食后DM2患者和非糖尿病患者的血浆胰岛素浓度相似（88.8±26.4对57.6±12.6 pmol/L，无显著差异[NS]）。使用重水法测定的糖异生绝对速率在DM2患者中也升高（346.8±74.9对198.8±16.4 μmol·m⁻²·min⁻¹，P<.05）。糖尿病患者和非糖尿病受试者之间的血浆多不饱和脂肪酸（PUFA）无差异。然而，糖尿病患者的总饱和脂肪酸（SFA）浓度（350±37.4对230.9±33.3 μmol/L，P<.02）显著升高。EGP速率与血浆总FFA浓度（r=.71，P<.01）和SFA浓度（r=.71，P<.01）相关，但与单不饱和脂肪酸或PUFA无关。糖异生速率也与血浆FFA（r=.64，P<.05）和SFA（r=.67，P<.05）相关。在3天禁食后，我们未观察到EGP与总FFA或脂肪酸组成之间的关系。我们得出结论，过夜禁食后EGP升高与血浆SFA浓度有关。
