Ferrannini E, Katz L D, Glickman M G, Defronzo R A
Metabolism Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
Clin Physiol. 1990 Nov;10(6):527-38. doi: 10.1111/j.1475-097x.1990.tb00444.x.
The influence of intravenous plus oral glucose administration on splanchnic glucose handling was examined in healthy young individuals by combining the hepatic vein catheterization technique with the double glucose tracer method. After 1 h of steady state hyperglycaemia (11.7 mM) induced by intravenous glucose alone (hyperglycaemic clamp technique), subjects ingested 89 +/- 1 g of glucose, and the hyperglycaemic plateau was maintained for the subsequent 4 h by adjusting the exogenous glucose infusion rate. Over the 4-h absorptive period, only 51 +/- 4 g of oral glucose (i.e. 58 +/- 4% of the ingested load) appeared in the systemic circulation, while 193 +/- 15 g (1.072 +/- 0.83 mol) of glucose had to be infused exogenously to sustain the hyperglycaemia. Endogenous glucose production was suppressed by over 60%. Net splanchnic glucose balance switched from a positive value (i.e. net uptake) of 5.06 +/- 2.56 mumol min-1 kg-1 with intravenous glucose alone (0-60 min) to a negative one (i.e. net output) of 12.50 +/- 2.44 mumol min-1 kg-1 during 4 h (60-300 min) of intravenous + oral glucose. The mean rate of splanchnic glucose uptake was estimated to be 6.39 +/- 4.67 mumol min-1 kg-1 with intravenous glucose alone, and 8.83 +/- 4.28 mumol min-1 kg-1 with intravenous + oral glucose. In either case, the large majority (80-90%) of the glucose appearing in the systemic circulation was disposed of by extrasplanchnic tissues. These results indicate that pre-existing hyperglycaemia and/or hyperinsulinaemia inhibit gastrointestinal glucose absorption, and that oral glucose administration does not result in a major redistribution of intravenous glucose between splanchnic and extrasplanchnic tissues.
通过将肝静脉插管技术与双葡萄糖示踪法相结合，在健康年轻个体中研究了静脉输注加口服葡萄糖对内脏葡萄糖处理的影响。在仅通过静脉输注葡萄糖诱导1小时稳态高血糖（11.7 mM）（高血糖钳夹技术）后，受试者摄入89±1 g葡萄糖，并通过调整外源性葡萄糖输注速率在随后4小时维持高血糖平台期。在4小时的吸收期内，仅51±4 g口服葡萄糖（即摄入负荷的58±4%）出现在体循环中，而必须外源性输注193±15 g（1.072±0.83 mol）葡萄糖以维持高血糖。内源性葡萄糖生成被抑制超过60%。内脏葡萄糖净平衡从仅静脉输注葡萄糖时（0 - 60分钟）的5.06±2.56 μmol min⁻¹ kg⁻¹正值（即净摄取）转变为静脉输注加口服葡萄糖期间4小时（60 - 300分钟）的12.50±2.44 μmol min⁻¹ kg⁻¹负值（即净输出）。仅静脉输注葡萄糖时内脏葡萄糖摄取平均速率估计为6.39±4.67 μmol min⁻¹ kg⁻¹，静脉输注加口服葡萄糖时为8.83±4.28 μmol min⁻¹ kg⁻¹。在任何一种情况下，出现在体循环中的葡萄糖绝大多数（80 - 90%）由内脏外组织处理。这些结果表明，预先存在的高血糖和/或高胰岛素血症会抑制胃肠道葡萄糖吸收，并且口服葡萄糖不会导致静脉输注葡萄糖在内脏和内脏外组织之间发生重大重新分布。
