van Thien H, Ackermans M T, Weverling G J, Dang Vinh T, Endert E, Kager P A, Sauerwein H P
Bao Loc General Hospital, Lamdong Province, Vietnam.
Neth J Med. 2004 Apr;62(4):129-33.
In healthy subjects after an overnight fast, glucose production is for approximately 50% derived from glycogenolysis. If the fast is prolonged, glucose production decreases due to a decline in glycogenolysis, while gluconeogenesis remains stable. In cerebral malaria, glucose production is completely derived from gluconeogenesis after an overnight fast. It is not known if glucose production also decreases during fasting when its only source is gluconeogenesis.
Glucose production was measured by infusion of [6,6-2H2]glucose in seven patients with cerebral malaria after prolonging a fast from 20.30 to 00.30 hours.
Glucose production decreased by approximately 10% (27.4 +/- 2.1 to 24.7 +/- 1.6 micromol/kg/min, p = 0.05), without changes in the plasma concentrations of glucoregulatory hormones, FFA or precursors.
In the patients with cerebral malaria, glucose production decreases during fasting due to a decrease in the rate of gluconeogenesis. These data suggest that the decrease in the rate of glucose production during short-term fasting is actively regulated and not simply due to shrinkage of glycogen content, as in the absence of glycogenolysis, glucose production decreases at the same rate as normally seen in healthy subjects whose glucose production is for approximately 50% derived from glycogen and in whom gluconeogenesis is stable.
在健康受试者过夜禁食后，葡萄糖生成约50%来自糖原分解。如果禁食时间延长，由于糖原分解减少，葡萄糖生成会下降，而糖异生则保持稳定。在脑型疟患者中，过夜禁食后葡萄糖生成完全来自糖异生。目前尚不清楚当葡萄糖生成的唯一来源是糖异生时，禁食期间葡萄糖生成是否也会减少。
在7例脑型疟患者中，通过输注[6,6-2H2]葡萄糖来测量禁食从20:30延长至00:30期间的葡萄糖生成。
葡萄糖生成下降了约10%（从27.4±2.1降至24.7±1.6微摩尔/千克/分钟，p = 0.05），而血糖调节激素、游离脂肪酸或前体的血浆浓度没有变化。
在脑型疟患者中，禁食期间葡萄糖生成减少是由于糖异生速率降低。这些数据表明，短期禁食期间葡萄糖生成速率的下降是受到主动调节的，而不仅仅是由于糖原含量减少，因为在没有糖原分解的情况下，葡萄糖生成以与健康受试者相同的速率下降，在健康受试者中，葡萄糖生成约50%来自糖原，且糖异生稳定。
