Boden G, Jadali F
Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania 19104.
Diabetes. 1991 Jun;40(6):686-92. doi: 10.2337/diab.40.6.686.
We investigated the effects of infusion of a 20% triglyceride emulsion plus heparin (LH) on carbohydrate (CHO) metabolism during basal insulin and glucose turnover conditions in normal male subjects. In study 1, LH or saline was infused at 0.5 and 1.5 ml/min for 2 h each. Plasma free fatty acids rose from approximately 0.4 to 0.8 mM with the low rate and to between 1.6 and 2.1 mM with the high rate. Similar increases occurred in plasma concentrations of glycerol, acetoacetate, and beta-hydroxybutyrate. LH infusions resulted in significant increases in C-peptide concentrations but had no effects on any of the other measured parameters of CHO metabolism. In study 2, LH or saline was infused as in study 1, but the compensatory insulin release was prevented by intravenous infusion of somatostatin and replacement of basal insulin and glucagon concentrations. This resulted in significant increases in plasma glucose (from 4.5 +/- 0.2 to 7.1 +/- 0.6 mM, P less than 0.001) and hepatic glucose output (from 9.0 +/- 1.5 to 11.3 +/- 1.4 mumol.kg-1.min-1, P less than 0.05) and a decrease in glucose clearance (from 2.32 +/- 0.13 to 1.44 +/- 0.11 ml.kg-1.min-1, P less than 0.05). We conclude that lipids can have adverse effects on CHO metabolism under basal conditions and that healthy individuals can compensate for these effects with additional secretion of insulin.
我们研究了在正常男性受试者基础胰岛素和葡萄糖代谢率条件下，输注20%甘油三酯乳剂加肝素（LH）对碳水化合物（CHO）代谢的影响。在研究1中，以0.5和1.5 ml/min的速度分别输注LH或生理盐水2小时。血浆游离脂肪酸在低输注速度时从约0.4 mM升至0.8 mM，在高输注速度时升至1.6至2.1 mM之间。甘油、乙酰乙酸和β-羟基丁酸的血浆浓度也有类似升高。输注LH导致C肽浓度显著升高，但对CHO代谢的任何其他测量参数均无影响。在研究2中，按研究1的方式输注LH或生理盐水，但通过静脉输注生长抑素并补充基础胰岛素和胰高血糖素浓度来阻止代偿性胰岛素释放。这导致血浆葡萄糖显著升高（从4.5±0.2 mM升至7.1±0.6 mM，P<0.001）和肝葡萄糖输出增加（从9.0±1.5至11.3±1.4 μmol·kg-1·min-1，P<0.05），同时葡萄糖清除率降低（从2.32±0.13降至1.44±0.11 ml·kg-1·min-1，P<0.05）。我们得出结论，在基础条件下，脂质可对CHO代谢产生不利影响，而健康个体可通过额外分泌胰岛素来补偿这些影响。
