Shah Pankaj, Basu Ananda, Rizza Robert
Mayo Clinic and Foundation, 200 First Street SW, Room 5-194 Joseph, Rochester, MN 55905, USA.
Curr Diab Rep. 2003 Jun;3(3):214-8. doi: 10.1007/s11892-003-0066-1.
In vitro studies have established that free fatty acids (FFAs) are important regulators of hepatic glucose metabolism. FFAs can increase hepatic glucose release by increasing the amount and activity of glucose-6-phosphatase and multiple gluconeogenic enzymes. Elevated FFAs can also potentially decrease hepatic glucose uptake by decreasing hepatic glucokinase activity. In vivo studies in both animals and humans have shown a close correlation between changes in plasma FFAs and endogenous glucose production (EGP). Intervention studies have established that changes in plasma FFAs are accompanied by changes in the relative contribution of gluconeogenesis and glycogenolysis to EGP. The effects of a change in FFAs on EGP itself are more evident when compensatory changes in insulin secretion are prevented or when insulin secretion is impaired (eg, diabetes mellitus). The effects of elevated FFAs on splanchnic glucose uptake are less clear, in that they appear to have no effect in nondiabetic humans and may impair uptake in people with type 2 diabetes.
体外研究已证实，游离脂肪酸（FFA）是肝脏葡萄糖代谢的重要调节因子。FFA可通过增加葡萄糖-6-磷酸酶及多种糖异生酶的量和活性来增加肝脏葡萄糖释放。升高的FFA还可能通过降低肝脏葡萄糖激酶活性来减少肝脏葡萄糖摄取。动物和人类的体内研究均显示，血浆FFA变化与内源性葡萄糖生成（EGP）之间存在密切关联。干预研究已证实，血浆FFA的变化伴随着糖异生和糖原分解对EGP相对贡献的变化。当胰岛素分泌的代偿性变化被阻止或胰岛素分泌受损（如糖尿病）时，FFA变化对EGP本身的影响更为明显。FFA升高对内脏葡萄糖摄取的影响尚不清楚，因为它们在非糖尿病患者中似乎没有影响，而在2型糖尿病患者中可能会损害葡萄糖摄取。
