Selberg O, Weimann A, Meyer H J, Canzler H, Müller M J
Abteilung Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover.
Infusionstherapie. 1991 Apr;18(2):80-4.
Tumor-caused weight loss is frequently associated with a high rate of lipolysis and fat oxidation. In order to differentiate the effect of weight-loss from the tumour-dependent regulation of fat metabolism, we studied weight-stable and well nourished patients (ideal body weight 109 +/- 4% (+/- SEM), body mass index 25.1 +/- 0.9 kg/m2). Parameters of lipolysis (glycerol-, fatty acid concentrations) and the calorimetric determined fat oxidation rate of five male tumor patients were examined before and during an euglycaemic insulinclamp (0.2 mU insulin/kg/min). Concomitant with a high rate of lipolysis (glycerol concentration 112 +/- 20 mumol/l, free fatty acid concentration 0.72 +/- 0.13 mmol/l) and fat oxidation (60% of energy expenditure) there was a low normal insulin level (5.9 +/- 0.5 mU/l). Insulin reduced lipolysis and fat oxidation and stimulated glucose oxidation. Weight-stable tumor patients have a high basal rate of lipolysis and fat oxidation; yet the insulin dependent regulation of the fat metabolism is intact, as we have already shown for weight-losing cancer patients.
肿瘤导致的体重减轻通常与高比例的脂肪分解和脂肪氧化有关。为了区分体重减轻的影响与肿瘤对脂肪代谢的依赖性调节,我们研究了体重稳定且营养良好的患者(理想体重为109±4%(±标准误),体重指数为25.1±0.9kg/m²)。在正常血糖胰岛素钳夹试验(0.2mU胰岛素/kg/分钟)之前和期间,检测了5名男性肿瘤患者的脂肪分解参数(甘油、脂肪酸浓度)以及通过量热法测定的脂肪氧化率。伴随着高比例的脂肪分解(甘油浓度为112±20μmol/l,游离脂肪酸浓度为0.72±0.13mmol/l)和脂肪氧化(占能量消耗的60%),胰岛素水平处于低正常范围(5.9±0.5mU/l)。胰岛素减少了脂肪分解和脂肪氧化,并刺激了葡萄糖氧化。体重稳定的肿瘤患者具有较高的基础脂肪分解率和脂肪氧化率;然而,正如我们之前对体重减轻的癌症患者所表明的那样,脂肪代谢的胰岛素依赖性调节是完整的。