Freyse Ernst-Joachim, Giessmann Thomas, Petzke Klaus Jürgen, Knospe Siegfried, Engel Georg, Heinke Peter, Metges Cornelia C, Siegmund Werner
Institut für Diabetes "Gerhardt Katsch" Karlsburg, Germany.
Am J Physiol Endocrinol Metab. 2003 Jul;285(1):E54-62. doi: 10.1152/ajpendo.00324.2002.
Increased synthesis rate of fibrinogen, an independent risk factor for cardiovascular disease, was recently reported in obese insulin-resistant female adolescents with chronic elevated nonesterified fatty acids (NEFA). It is unknown whether a short-term change of NEFA concentrations controls hepatic fibrinogen synthesis. Therefore, 10 healthy male volunteers (24.5 +/- 3.3 yr, body mass index 23.5 +/- 2.9 kg/m2) were investigated in random order under basal and elevated NEFA for 8 h. Leucine metabolism, the fractional synthesis rates (FSR) of plasma fibrinogen, and endogenous urea production rates were measured during primed, continuous infusion of [1-13C]leucine and [15N2]urea, respectively. Plasma alpha-[13C]ketoisocaproic acid and [15N2]urea enrichment values were measured with GC-MS. Plasma fibrinogen was isolated with the beta-alanine method, and fibrinogen-related [13C]leucine enrichment was analyzed by GC-CIRMS. Lipofundin infusion and subcutaneous heparin tripled NEFA and triglycerides in the tests. Plasma glucose, circulating insulin, human C-peptide, and plasma glucagon were not changed by the study procedure. Fibrinogen FSR were significantly lower in tests with NEFA elevation (18.44 +/- 4.67%) than in control tests (21.48 +/- 4.32%; P < 0.05). Plasma fibrinogen concentrations measured were not significantly different (NEFA test subjects: 1.85 +/- 0.33, controls: 1.97 +/- 0.54 g/l). Parameters of leucine metabolism, such as leucine rate of appearance, leucine oxidation, and nonoxidative leucine disposal, were not influenced by NEFA elevation, and endogenous urea production remained unchanged. NEFA contributes to short-term regulation of fibrinogen FSR in healthy volunteers under unchanged hormonal status, leucine metabolism, and overall amino acid catabolism. Its contribution might be of relevance at least after fat-rich meals, counteracting by reduction of FSR the blood viscosity increase implied by hyperlipidemia.
近期有报道称,在患有慢性非酯化脂肪酸(NEFA)升高的肥胖胰岛素抵抗女性青少年中,纤维蛋白原合成速率增加,这是心血管疾病的一个独立危险因素。目前尚不清楚NEFA浓度的短期变化是否会控制肝脏纤维蛋白原的合成。因此,对10名健康男性志愿者(24.5±3.3岁,体重指数23.5±2.9kg/m2)进行了研究,他们在基础NEFA水平和升高的NEFA水平下随机接受8小时的观察。分别在初注、持续输注[¹-¹³C]亮氨酸和[¹⁵N₂]尿素期间,测量亮氨酸代谢、血浆纤维蛋白原的分数合成率(FSR)和内源性尿素生成率。用气相色谱-质谱联用仪(GC-MS)测量血浆α-[¹³C]酮异己酸和[¹⁵N₂]尿素的富集值。采用β-丙氨酸法分离血浆纤维蛋白原,并用气相色谱-燃烧同位素比值质谱仪(GC-CIRMS)分析纤维蛋白原相关的[¹³C]亮氨酸富集情况。在试验中,输注Lipofundin和皮下注射肝素使NEFA和甘油三酯增加了两倍。研究过程未改变血浆葡萄糖、循环胰岛素、人C肽和血浆胰高血糖素水平。NEFA升高试验中的纤维蛋白原FSR(18.44±4.67%)显著低于对照试验(21.48±4.32%;P<0.05)。所测血浆纤维蛋白原浓度无显著差异(NEFA试验对象:1.85±0.33,对照组:1.97±0.54g/l)。亮氨酸代谢参数,如亮氨酸出现率、亮氨酸氧化和非氧化亮氨酸处理,不受NEFA升高的影响,内源性尿素生成保持不变。在激素状态、亮氨酸代谢和整体氨基酸分解代谢不变的情况下,NEFA有助于健康志愿者对纤维蛋白原FSR的短期调节。其作用可能至少在进食富含脂肪的食物后具有相关性,通过降低FSR来抵消高脂血症所导致的血液粘度增加。