Connolly Cynthia C, Aglione Lisa N, Smith Marta S, Lacy D Brooks, Moore Mary Courtney
Department of Molecular Physiology and Biophysics, Diabetes Research and Training Center, Vanderbilt University School of Medicine, Nashville, TN 37232-0615, USA.
Am J Physiol Endocrinol Metab. 2004 Jun;286(6):E909-15. doi: 10.1152/ajpendo.00143.2003. Epub 2004 Jan 28.
Our aim was to assess the magnitude of peripheral insulin resistance and whether changes in hepatic insulin action were evident in a canine model of late (3rd trimester) pregnancy. A 3-h hyperinsulinemic (5 mU.kg(-1).min(-1)) euglycemic clamp was conducted using conscious, 18-h-fasted pregnant (P; n = 6) and nonpregnant (NP; n = 6) female dogs in which catheters for intraportal insulin infusion and assessment of hepatic substrate balances were implanted approximately 17 days before experimentation. Arterial plasma insulin rose from 11 +/- 2 to 192 +/- 24 and 4 +/- 2 to 178 +/- 5 microU/ml in the 3rd h in NP and P, respectively. Glucagon fell equivalently in both groups. Basal net hepatic glucose output was lower in NP (1.9 +/- 0.1 vs. 2.4 +/- 0.2 mg.kg(-1).min(-1), P < 0.05). Hyperinsulinemia completely suppressed hepatic glucose release in both groups (-0.4 +/- 0.2 and -0.1 +/- 0.2 mg.kg(-1).min(-1) in NP and P, respectively). More exogenous glucose was required to maintain euglycemia in NP (15.2 +/- 1.3 vs. 11.5 +/- 1.1 mg.kg(-1).min(-1), P < 0.05). Nonesterified fatty acids fell similarly in both groups. Net hepatic gluconeogenic amino acid uptake with high insulin did not differ in NP and P. Peripheral insulin action is markedly impaired in this canine model of pregnancy, whereas hepatic glucose production is completely suppressed by high circulating insulin levels.
我们的目的是评估外周胰岛素抵抗的程度,以及在妊娠晚期(妊娠晚期)犬类模型中肝脏胰岛素作用是否有明显变化。对清醒的、禁食18小时的妊娠(P;n = 6)和非妊娠(NP;n = 6)雌性犬进行了3小时的高胰岛素血症(5 mU·kg⁻¹·min⁻¹)正常血糖钳夹实验,实验前约17天在这些犬体内植入了用于门静脉内输注胰岛素和评估肝脏底物平衡的导管。在第3小时,NP组和P组的动脉血浆胰岛素分别从11±2微U/ml升至192±24微U/ml和从4±2微U/ml升至178±5微U/ml。两组中胰高血糖素的下降程度相当。NP组的基础肝脏净葡萄糖输出较低(1.9±0.1 vs. 2.4±0.2 mg·kg⁻¹·min⁻¹,P < 0.05)。高胰岛素血症完全抑制了两组的肝脏葡萄糖释放(NP组和P组分别为-0.4±0.2和-0.1±0.2 mg·kg⁻¹·min⁻¹)。NP组需要更多的外源性葡萄糖来维持正常血糖(15.2±1.3 vs. 11.5±1.1 mg·kg⁻¹·min⁻¹,P < 0.05)。两组中非酯化脂肪酸的下降情况相似。高胰岛素水平下肝脏糖异生氨基酸的净摄取在NP组和P组中没有差异。在这个犬类妊娠模型中,外周胰岛素作用明显受损,而高循环胰岛素水平完全抑制了肝脏葡萄糖生成。