Franssila-Kallunki A, Rissanen A, Ekstrand A, Ollus A, Groop L
Fourth Department of Medicine, Helsinki University Central Hospital, Finland.
Am J Clin Nutr. 1992 Jul;56(1 Suppl):247S-248S. doi: 10.1093/ajcn/56.1.247S.
Weight reduction improves glucose utilization, but it is not known whether this occurs primarily through the oxidative or nonoxidative pathways of glucose metabolism. We studied this question in 12 obese subjects [whose body mass index (BMI) was 33.4 +/- 1.1 kg/m2)] before and after 6 wk on a very-low-calorie diet of 1680 kJ/d with the euglycemic insulin clamp technique in combination with indirect calorimetry. The mean body weight decreased from 105.3 +/- 4.6 to 94.1 +/- 4.0 kg (P less than 0.001). This was mainly due to a reduction in fat mass from 47.2 +/- 3.6 to 37.7 +/- 3.0 kg (P less than 0.001), whereas lean body mass decreased only slightly (from 58.0 +/- 2.0 to 56.4 +/- 1.8 kg). The basal energy expenditure decreased with weight loss by 10.7%. This was associated with a reduced rate of lipid oxidation (P less than 0.05). Weight loss increased glucose utilization by 26%, primarily by enhancing insulin-stimulated glucose oxidation (P less than 0.05), whereas the effect on nonoxidative glucose metabolism was less pronounced (P greater than 0.05). Substantial weight loss increases glucose utilization by enhancing glucose oxidation.
体重减轻可改善葡萄糖利用，但尚不清楚这主要是通过葡萄糖代谢的氧化途径还是非氧化途径实现的。我们采用正常血糖胰岛素钳夹技术并结合间接测热法，对12名肥胖受试者（体重指数[BMI]为33.4±1.1kg/m2）在接受为期6周、每日能量为1680kJ的极低热量饮食前后进行了研究。平均体重从105.3±4.6kg降至94.1±4.0kg（P<0.001）。这主要是由于脂肪量从47.2±3.6kg减少至37.7±3.0kg（P<0.001），而瘦体重仅略有下降（从58.0±2.0kg降至56.4±1.8kg）。基础能量消耗随着体重减轻而下降了10.7%。这与脂质氧化速率降低相关（P<0.05）。体重减轻使葡萄糖利用增加了26%，主要是通过增强胰岛素刺激的葡萄糖氧化实现的（P<0.05），而对非氧化葡萄糖代谢的影响则不那么明显（P>0.05）。大量体重减轻通过增强葡萄糖氧化来增加葡萄糖利用。
