Bowes S B, Benn J J, Scobie I N, Umpleby A M, Lowy C, Sönksen P H
Division of Medicine, United Medical School, Guy's Hospital, London, UK.
Clin Endocrinol (Oxf). 1991 Apr;34(4):311-6. doi: 10.1111/j.1365-2265.1991.tb03772.x.
Glucose intolerance, sometimes severe enough to cause frank diabetes mellitus, is a frequent feature of Cushing's syndrome. The primary cause of the hyperglycaemia, whether due to glucose over-production or under-utilization, remains unresolved. We therefore measured glucose turnover using an intravenous bolus of 3-3H glucose in 14 normoglycaemic patients with Cushing's syndrome and 14 control subjects. Seven of the patients with Cushing's syndrome were also restudied post-operatively. Plasma glucose concentrations were similar in all three groups whereas glucose metabolic clearance rate (MCR) (1.80 +/- 0.06 ml/min/kg) and glucose turnover rate (9.09 +/- 0.36 mumol/min/kg) were significantly reduced in patients with Cushing's syndrome compared to normal subjects (2.21 +/- 0.1; P less than 0.001; 10.90 +/- 0.50; P less than 0.01) and rose post-operatively to normal values (2.35 +/- 0.14 ml/min/kg; 11.07 +/- 0.48 mumol/min/kg). We conclude from these results that the hyperglycaemia sometimes found in Cushing's syndrome may be primarily due to decreased utilization rather than increased glucose production.
葡萄糖耐量异常，有时严重到足以导致显性糖尿病，是库欣综合征的常见特征。高血糖的主要原因，无论是由于葡萄糖生成过多还是利用不足，仍未得到解决。因此，我们对14例血糖正常的库欣综合征患者和14例对照者静脉注射3-3H葡萄糖后测量了葡萄糖周转率。其中7例库欣综合征患者术后也进行了再次研究。三组的血浆葡萄糖浓度相似，但与正常受试者相比，库欣综合征患者的葡萄糖代谢清除率（MCR）（1.80±0.06 ml/min/kg）和葡萄糖周转率（9.09±0.36 μmol/min/kg）显著降低（2.21±0.1；P<0.001；10.90±0.50；P<0.01），术后升至正常水平（2.35±0.14 ml/min/kg；11.07±0.48 μmol/min/kg）。从这些结果我们得出结论，库欣综合征中有时发现的高血糖可能主要是由于利用率降低而非葡萄糖生成增加。
