Klein S, Peters E J, Shangraw R E, Wolfe R R
Department of Internal Medicine, University of Texas Medical Branch, Galveston 77550.
Crit Care Med. 1991 Jun;19(6):776-9. doi: 10.1097/00003246-199106000-00008.
To measure whole-body lipolysis and fatty acid re-esterification in critically ill patients.
The rates of appearance of glycerol and palmitic acid in blood plasma were measured by infusing stable isotope tracers [2H5]glycerol and [1-13C]palmitic acid, respectively. Energy expenditure was measured by indirect calorimetry.
Medical ICU of The University of Texas Medical Branch Hospital, a university-based referral center.
Five uninjured critically ill patients. Four patients were hospitalized because of respiratory insufficiency and one because of myocardial infarction. Three patients died during their hospitalization.
Metabolic studies were performed in each patient after an overnight (12-hr) fast.
Mean +/- SE glycerol and fatty acid rates of appearance were 4.5 +/- 1.0 and 11.5 +/- 0.8 mumol/kg.min, respectively. The ratio of fatty acid to glycerol rate of appearance was 2.9 +/- 0.5. Resting energy expenditure was 132 +/- 6% of predicted.
An accelerated rate of lipolysis is part of the metabolic response to severe stress, regardless of its etiology. Because the rate of fatty acid release far exceeded energy requirements, fatty acids that were not oxidized as fuel were re-esterified to triglyceride, presumably in the liver.
测量危重症患者的全身脂肪分解及脂肪酸再酯化情况。
分别通过输注稳定同位素示踪剂[2H5]甘油和[1-13C]棕榈酸来测量血浆中甘油和棕榈酸的出现率。通过间接测热法测量能量消耗。
德克萨斯大学医学分校医院的医学重症监护病房，一所大学附属医院。
5例未受伤的危重症患者。4例因呼吸功能不全住院，1例因心肌梗死住院。3例患者在住院期间死亡。
每位患者在禁食过夜（12小时）后进行代谢研究。
甘油和脂肪酸的平均出现率（±标准误）分别为4.5±1.0和11.5±0.8μmol/kg·min。脂肪酸与甘油出现率的比值为2.9±0.5。静息能量消耗为预测值的132±6%。
脂肪分解加速是严重应激代谢反应的一部分，无论其病因如何。由于脂肪酸释放速率远远超过能量需求，未作为燃料被氧化的脂肪酸大概在肝脏中被重新酯化为甘油三酯。
