van Doormaal J J, Muskiet F A, Martini I A, Doorenbos H
Department of Internal Medicine, Faculty of Medicine, State University of Groningen, The Netherlands.
Metabolism. 1987 Dec;36(12):1132-40. doi: 10.1016/0026-0495(87)90239-3.
Twelve normal men received twice their estimated basal energy requirement by a carbohydrate solution via a nasogastric catheter during 48 hours, followed by a seven-hour fast. Subsequently, in nine of them 0.5 mg epinephrine was given subcutaneously under ongoing fasting. During hyperalimentation, serum triglycerides, phospholipids, total and free cholesterol, phospholipids/free cholesterol ratio, and plasma free fatty acids decreased, whereas the percentage of free cholesterol increased. During fasting and subsequent epinephrine administration triglycerides and free fatty acids rose without reaching basal levels. Plasma and red blood cell (RBC) fatty acid composition already changed from two hours after the start of the feeding. Most markedly, a steady decrease in RBC 18:2c, omega 6, amounting to more than 17% of the basal value at the end of the observation period was found. Neither in plasma, nor in RBC a concomitant appearance of 20:3c, omega 9 was seen. In RBC, the relative amounts of the saturated fatty acids increased, whereas those of monounsaturated and polyunsaturated fatty acids decreased. RBC content of total fatty acids decreased and that of cholesterol increased. The ratios 16:1c, omega 7/16:0 and 18:3c, omega 6/18:2c, omega 6 in plasma, and 20:3c, omega 6/18:2c, omega 6 in plasma and RBC increased, whereas those of 18:1c, omega 7/16:1c, omega 7 and 20:3c, omega 6/18:3c, omega 6 in plasma decreased. After 48 hours feeding serum glutamic pyruvic transaminase and glutamic oxaloacetic transaminase levels were moderately increased and rose further during fasting. Thus, continuous enteral hyperalimentation by carbohydrates alone rapidly induces profound changes in serum-, plasma-, and RBC lipid compositions and serum parameters of hepatic function.(ABSTRACT TRUNCATED AT 250 WORDS)
12名正常男性通过鼻胃管在48小时内接受了两倍于其估计基础能量需求的碳水化合物溶液,随后禁食7小时。随后,其中9人在持续禁食状态下皮下注射了0.5毫克肾上腺素。在胃肠外营养期间,血清甘油三酯、磷脂、总胆固醇和游离胆固醇、磷脂/游离胆固醇比值以及血浆游离脂肪酸均下降,而游离胆固醇的百分比增加。在禁食及随后的肾上腺素给药期间,甘油三酯和游离脂肪酸上升,但未达到基础水平。从喂食开始两小时后,血浆和红细胞(RBC)脂肪酸组成就已发生变化。最明显的是,红细胞18:2c,ω6持续下降,在观察期结束时降至基础值的17%以上。在血浆和红细胞中均未观察到20:3c,ω9的同时出现。在红细胞中,饱和脂肪酸的相对含量增加,而单不饱和脂肪酸和多不饱和脂肪酸的相对含量下降。红细胞总脂肪酸含量下降,胆固醇含量增加。血浆中16:1c,ω7/16:0和18:3c,ω6/18:2c,ω6的比值,以及血浆和红细胞中20:3c,ω6/18:2c,ω6的比值增加,而血浆中18:1c,ω7/16:1c,ω7和20:3c,ω6/18:3c,ω6的比值下降。喂食48小时后,血清谷丙转氨酶和谷草转氨酶水平适度升高,并在禁食期间进一步上升。因此,仅通过碳水化合物进行持续肠内高营养会迅速引起血清、血浆和红细胞脂质组成以及肝功能血清参数的深刻变化。(摘要截选至250词)