Okuda Y, Kawai K, Yamashita K
Endocrinology. 1987 May;120(5):2152-7. doi: 10.1210/endo-120-5-2152.
The age-related changes in plasma ketone body levels and related substances such as carnitine and FFA of normal and streptozotocin diabetic rats, as well as its effects on glucagon-induced ketogenesis in isolated perfused rat livers, were examined in this study. The degree of increase of acetoacetate (AcAc) in adult rats (50-week-old) after a 36-h fasting period in both normal and diabetic rats was significantly smaller than that of young rats (8-week-old). Plasma total carnitine tended to decrease with aging. On the other hand, the plasma levels of FFA and glucagon in fasted adult rats were significantly higher than those in young rats. In parallel with the in vivo observation, the basal output of AcAc, but not 3-hydroxybutyrate, from adult rat livers was significantly smaller than that of the young normal and diabetic rats. The level of glucagon-stimulated AcAc output from the young rat liver was significantly higher than that from the adult rat liver in both the normal and diabetic rats. This study demonstrates that the hepatic unresponsiveness to glucagon in terms of its ketone body production by aging may be one of the major causes of hyperosmolar nonketotic coma in elderly people.
本研究检测了正常大鼠和链脲佐菌素诱导的糖尿病大鼠血浆酮体水平以及肉碱和游离脂肪酸(FFA)等相关物质的年龄相关性变化,及其对离体灌注大鼠肝脏中胰高血糖素诱导的酮体生成的影响。正常大鼠和糖尿病大鼠禁食36小时后,成年大鼠(50周龄)中乙酰乙酸(AcAc)的增加程度明显小于幼龄大鼠(8周龄)。血浆总肉碱水平倾向于随年龄增长而降低。另一方面,禁食成年大鼠的血浆FFA和胰高血糖素水平显著高于幼龄大鼠。与体内观察结果一致,成年大鼠肝脏中AcAc的基础产量(而非3-羟基丁酸)明显低于幼龄正常大鼠和糖尿病大鼠。在正常大鼠和糖尿病大鼠中,幼龄大鼠肝脏经胰高血糖素刺激后的AcAc产量水平显著高于成年大鼠肝脏。本研究表明,衰老导致肝脏对胰高血糖素在酮体生成方面反应迟钝可能是老年人高渗性非酮症昏迷的主要原因之一。