Stifel F B, Lufkin E G, Hagler L, Greene H L, Taunton O D, Wrensch M, Miller C L, Herman R H
Am J Clin Nutr. 1976 Sep;29(9):989-96. doi: 10.1093/ajcn/29.9.989.
The adaptive responses of gastrointestinal enzymes, glucose tolerance, and plasma insulin to diet, folic acid, and insulin of five obese adult-onset diabetic patients were studied before and after a 30-day fast. Their data were compared to the adaptive responses of gastrointestinal enzymes to diet, folic acid, and insulin of 15 normal male volunteer subjects, ages 18 to 24. Each group during each testing period received a carbohydrate diet (50% calories as carbohydrate consisting of 1/2 glucose and 1/2 fructose) and a noncarbohydrate diet (70% of calories as corn oil and 30% as sodium caseinate) each without and with folic acid (5 mg three times per day). The effect of insulin was studied only on the carbohydrate diet plus folic acid. Our data demonstrate that obese adult-onset diabetic patients have an impaired adaptive response of jejunal carbohydrate-metabolizing enzyme activities (hexokinase, pyruvate kinase, fructose-1-6-diphosphate aldolase, fructosediphosphatase) to dietary carbohydrate, oral folic acid, and insulin when compared to normal subjects and nondiabetic obese patients. Following a 30-day fast, the obese diabetic patients showed an improvement in glucose tolerance, hyperinsulinemia, and the adaptive response of the jejunal carbohydrate-metabolizing enzyme activities to dietary carbohydrate, folic acid, and insulin. The greatest improvement in the adaptive response of the jejunal enzyme activities occurred on the carbohydrate diet.
对5名成年起病型肥胖糖尿病患者在禁食30天前后，其胃肠道酶、葡萄糖耐量及血浆胰岛素对饮食、叶酸和胰岛素的适应性反应进行了研究。将他们的数据与15名年龄在18至24岁的正常男性志愿者受试者胃肠道酶对饮食、叶酸和胰岛素的适应性反应进行比较。在每个测试期间，每组受试者分别接受碳水化合物饮食（50%热量来自碳水化合物，其中一半为葡萄糖，一半为果糖）和非碳水化合物饮食（70%热量来自玉米油，30%来自酪蛋白酸钠），每种饮食均分为添加叶酸（每日3次，每次5毫克）和未添加叶酸的情况。仅在碳水化合物饮食加叶酸的情况下研究胰岛素的作用。我们的数据表明，与正常受试者和非糖尿病肥胖患者相比，成年起病型肥胖糖尿病患者空肠碳水化合物代谢酶活性（己糖激酶、丙酮酸激酶、果糖-1,6-二磷酸醛缩酶、果糖二磷酸酶）对饮食碳水化合物、口服叶酸和胰岛素的适应性反应受损。禁食30天后，肥胖糖尿病患者的葡萄糖耐量、高胰岛素血症以及空肠碳水化合物代谢酶活性对饮食碳水化合物、叶酸和胰岛素的适应性反应均有所改善。空肠酶活性适应性反应的最大改善出现在碳水化合物饮食时。
