Prando R, Cheli V, Buzzo P, Melga P, Ansaldi E, Accoto S
Cattedra di Malattie del Ricambio, Università di Genova, Italy.
Acta Diabetol Lat. 1988 Jul-Sep;25(3):247-56. doi: 10.1007/BF02624820.
The aim of this study was to evaluate the relationships between blood lactate and plasma glucose, insulin (IRI) and C-peptide (IRCP) during the first hour of an oral glucose load (OGTT, 100 g). Twelve controls, sixteen non-insulin-dependent (NIDDM) and four insulin-dependent (IDDM) diabetic subjects were studied. A significant increase in blood lactate was observed at 15 min in normal subjects, whereas there was a delayed increase at 45 min in NIDDM subjects, in the presence of IRCP increments of 0.31 nmol/l. In order to have a minimum significant lactate increment, the threshold value of peripheral IRCP increment was about 0.30 nmol/l. In IDDM subjects, despite considerable hyperglycemia, blood lactate concentration remained unchanged throughout the test. In normal and NIDDM subjects there was a significant negative correlation between delta lactate and delta glucose (r = -0.89, p less than 0.001) and a significant positive correlation between delta lactate and delta IRCP (r = 0.78, p less than 0.001). In conclusion, hyperglycemia itself and the lack of increase in insulin secretion do not affect blood lactate increase during OGTT; blood concentration of this metabolite depends mainly on an early insulin secretion apt to enhance tissue glucose uptake and to inhibit gluconeogenesis.
本研究旨在评估口服葡萄糖负荷试验（OGTT，100g）第1小时内血乳酸与血浆葡萄糖、胰岛素（IRI）和C肽（IRCP）之间的关系。研究了12名对照者、16名非胰岛素依赖型（NIDDM）和4名胰岛素依赖型（IDDM）糖尿病患者。正常受试者在15分钟时血乳酸显著升高，而NIDDM患者在45分钟时出现延迟升高，此时IRCP升高0.31nmol/l。为了使乳酸有最小的显著升高，外周IRCP升高的阈值约为0.30nmol/l。在IDDM患者中，尽管血糖显著升高，但在整个试验过程中血乳酸浓度保持不变。在正常和NIDDM受试者中，乳酸变化量与葡萄糖变化量之间存在显著负相关（r = -0.89，p < 0.001），乳酸变化量与IRCP变化量之间存在显著正相关（r = 0.78，p < 0.001）。总之，高血糖本身以及胰岛素分泌缺乏并不影响OGTT期间血乳酸升高；这种代谢产物的血浓度主要取决于早期胰岛素分泌，该分泌易于增强组织对葡萄糖的摄取并抑制糖异生。
