Walker M, Fulcher G R, Marsiaj H, Orskov H, Alberti K G
Department of Medicine, University of Newcastle upon Tyne, UK.
Scand J Clin Lab Invest. 1991 Nov;51(7):605-13. doi: 10.1080/00365519109104571.
Ketone bodies and non-esterified fatty acids (NEFA) inhibit insulin stimulated glucose uptake in muscle in-vitro. In man the infusion of ketone bodies lowers plasma NEFA levels thus confounding the interpretation of individual effects. The aim of this study was to examine the effect of ketone bodies on insulin mediated forearm glucose metabolism independent of the changes in the plasma NEFA levels. Seven healthy men received sodium 3-hydroxybutyrate (15 mumol kg-1 min-1) or sodium bicarbonate (control) for 240 min. Heparin (0.2 U kg-1 min-1) and insulin (0.01 U kg-1 h-1) were infused for 90 min (pre-clamp), followed by insulin alone (0.025 U kg-1 h-1) and euglycaemia was maintained (clamp). Plasma NEFA levels and rates of forearm NEFA uptake (+23 +/- 14 and +49 +/- 21 [mean +/- SEM] nmol 100 ml forearm [FA]-1 min-1) were comparable during the pre-clamp periods, and were suppressed equally during hyperinsulinaemia. Sodium 3-hydroxybutyrate infusion raised the blood ketone body levels from 70 +/- 4 mumol/l to a plateau of 450 +/- 30 mumol/l, while control levels declined from baseline (ketone body vs control; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
酮体和非酯化脂肪酸（NEFA）在体外可抑制胰岛素刺激的肌肉对葡萄糖的摄取。在人体中，输注酮体会降低血浆NEFA水平，从而混淆个体效应的解释。本研究的目的是在不考虑血浆NEFA水平变化的情况下，研究酮体对胰岛素介导的前臂葡萄糖代谢的影响。七名健康男性接受3-羟基丁酸钠（15μmol·kg⁻¹·min⁻¹）或碳酸氢钠（对照）输注240分钟。肝素（0.2U·kg⁻¹·min⁻¹）和胰岛素（0.01U·kg⁻¹·h⁻¹）输注90分钟（钳夹前期），随后单独输注胰岛素（0.025U·kg⁻¹·h⁻¹）并维持血糖正常（钳夹期）。钳夹前期血浆NEFA水平和前臂NEFA摄取率（+23±14和+49±21[平均值±标准误]nmol·100ml前臂[脂肪酸]⁻¹·min⁻¹）相当，在高胰岛素血症期间均被同等程度抑制。输注3-羟基丁酸钠使血酮体水平从70±4μmol/L升至450±30μmol/L的平台期，而对照水平从基线下降（酮体与对照；P<0.001）。（摘要截断于250字）
