Jequier E
Institute of Physiology, University of Lausanne, Faculty of Medicine, CH-1005 Lausanne, Switzerland.
Clin Nutr. 1986 Nov;5(4):181-6. doi: 10.1016/0261-5614(86)90022-1.
Recent data on the thermic effect of nutrients are presented. When given intravenously (i.v.), glucose (+ insulin) induces an increase of energy expenditure (EE) of 7% of energy infused, whereas lipid (Intralipid) infusion stimulates EE by 3% of energy infused. The stimulation of EE due to amino acid infusion in depleted patients is 30-40% of the energy infused as amino acids. Glucose induced thermogenesis includes an 'obligatory thermogenesis' which accounts for the energy cost of storing the nutrient and a 'facultative thermogenesis' which is mainly due to a stimulation of sympathetic activity; the latter is suppressed by propranolol infusion. Comparison of nutrient induced thermogenesis during continuous administration of nutrients between the enteral and parenteral routes reveal similar responses. This shows that the energy costs of digestion and absorption of nutrients is low in comparison with the cost of nutrient storage. However, when given by the enteral route, the net efficiency of energy utilisation is also dependent on the co-efficient of nutrients absorption. Oral administration of nutrients (bolus) induces a larger thermogenic response than continuous enteral administration, due to a larger nutrient storage for the former. It is therefore advisable to allow for the thermic effect of nutrients when assessing the efficiency of energy utilisation in patients.
本文介绍了近期关于营养素热效应的数据。静脉注射（i.v.）葡萄糖（+胰岛素）会使能量消耗（EE）增加，增加幅度为输注能量的7%，而输注脂质（英脱利匹特）会使EE增加，增加幅度为输注能量的3%。在营养缺乏的患者中，输注氨基酸引起的EE刺激为输注氨基酸能量的30 - 40%。葡萄糖诱导的产热包括“ obligatory thermogenesis”（用于储存营养素的能量消耗）和“facultative thermogenesis”（主要由于交感神经活动的刺激）；后者可被普萘洛尔输注所抑制。比较肠内和肠外途径持续给予营养素期间营养素诱导的产热，发现反应相似。这表明与营养素储存成本相比，营养素消化和吸收的能量成本较低。然而，通过肠内途径给予时，能量利用的净效率也取决于营养素的吸收系数。口服营养素（推注）比持续肠内给药引起更大的产热反应，因为前者的营养素储存量更大。因此，在评估患者能量利用效率时，考虑营养素的热效应是明智的。
