Del Prato S, Enzi G, Vigili de Kreutzenberg S, Lisato G, Riccio A, Maifreni L, Iori E, Zurlo F, Sergi G, Tiengo A
Unit of Metabolic Diseases, University of Padova, Italy.
Diabetologia. 1990 Apr;33(4):228-36. doi: 10.1007/BF00404801.
Eight obese patients and 12 normal individuals underwent a euglycaemic insulin clamp (20 and 40 mU m2-1.min-1) along with continuous infusion of 3-3H-glucose and 1-14C-palmitate and indirect calorimetry. Basal plasma glucose concentration (4.7 +/- 0.3 vs 4.4 +/- 0.2 mmol/l) was similar in the two groups, whereas hepatic glucose production was slightly higher in obese individuals (1.11 +/- 0.06 vs 0.84 +/- 0.05 mmol/min) in spite of higher plasma insulin levels (17 +/- 2 vs 6 +/- 1 mU/l; p less than 0.01). Insulin inhibition of hepatic glucose production was impaired in obese subjects. Glucose disposal by lean body mass was markedly reduced both at baseline (11.7 +/- 1.1 vs 15.6 +/- 0.6 mumol.kg-1.min-1; p less than 0.05) and during clamp (15.0 +/- 1.1 vs 34.4 +/- 2.8 and 26.7 +/- 3.9 vs 62.2 +/- 2.8 mumol.kg-1.min-1; p less than 0.01) Oxidative (12.2 +/- 1.1 vs 17.8 +/- 1 and 16.1 +/- 1.1 vs 51.1 +/- 1.7 mumol.kg-1.min-1; p less than 0.05-0.002) and non-oxidative glucose metabolism (3.9 +/- 1.1 vs 15.0 +/- 2.8 and 12.8 +/- 3.3 vs 38.2 +/- 2.2 mumol.kg-1.min-1; p less than 0.01-0.001) were impaired. Basal plasma concentrations of non-esterified fatty acids (635 +/- 75 vs 510 +/- 71 mumol/l) and blood glycerol (129 +/- 17 vs 56 +/- 5 mumol/l; p less than 0.01) were increased in obese patients.(ABSTRACT TRUNCATED AT 250 WORDS)
8名肥胖患者和12名正常个体接受了正常血糖胰岛素钳夹试验（20和40 mU m²⁻¹·min⁻¹），同时持续输注3-³H-葡萄糖和1-¹⁴C-棕榈酸，并进行间接测热法。两组的基础血浆葡萄糖浓度相似（4.7±0.3 vs 4.4±0.2 mmol/l），然而，尽管肥胖个体的血浆胰岛素水平较高（17±2 vs 6±1 mU/l；p<0.01），但其肝脏葡萄糖生成略高（1.11±0.06 vs 0.84±0.05 mmol/min）。肥胖受试者中胰岛素对肝脏葡萄糖生成的抑制作用受损。瘦体重的葡萄糖处置在基线时（11.7±1.1 vs 15.6±0.6 μmol·kg⁻¹·min⁻¹；p<0.05）和钳夹期间（15.0±1.1 vs 34.4±2.8以及26.7±3.9 vs 62.2±2.8 μmol·kg⁻¹·min⁻¹；p<0.01）均显著降低。氧化（12.2±1.1 vs 17.8±1以及16.1±1.1 vs 51.1±1.7 μmol·kg⁻¹·min⁻¹；p<0.05 - 0.002）和非氧化葡萄糖代谢（3.9±1.1 vs 15.0±2.8以及12.8±3.3 vs 38.2±2.2 μmol·kg⁻¹·min⁻¹；p<0.01 - 0.001）均受损。肥胖患者的基础血浆非酯化脂肪酸浓度（635±75 vs 510±71 μmol/l）和血甘油浓度（129±17 vs 56±5 μmol/l；p<0.01）升高。（摘要截选至250词）
