Souba W W, Goldwater D L, Techtmeyer H, Mossberg K, Copeland E M
Department of Surgery, University of Florida School of Medicine, Gainesville.
JPEN J Parenter Enteral Nutr. 1988 Nov-Dec;12(6):550-4. doi: 10.1177/0148607188012006550.
The effects of an anabolic steroid (nandrolone decanoate, 5 mg/kg) on postoperative splanchnic fuel metabolism were studied in order to gain further understanding of the regulation of the altered gut/liver amino acid metabolism that occurs following catabolic illness. In addition to studying glutamine and alanine, which together transport 60% of whole blood amino acid nitrogen, we determined the fluxes of glutamate and glucose across the gastrointestinal tract and liver in 12 postoperative dogs. Substrate exchange (flux) was calculated by multiplying bloodflow by the arterial-venous concentration difference for each substrate. Arterial glutamine, glutamate, and alanine were significantly increased in dogs receiving the anabolic steroid (AS) compared to control animals (p less than 0.05). Intestinal bloodflow was unchanged, but gut glutamine uptake doubled in dogs receiving steroids (1.4 +/- 0.3 mumol/kg/min in controls vs 2.8 +/- 0.7 in AS, p less than 0.05). Simultaneously, gut alanine release was augmented by 100% in dogs receiving steroids (p less than 0.05). Control dogs demonstrated net glutamate release by the gut, while dogs treated with the anabolic steroid demonstrated glutamate balance (p less than 0.05). Liver bloodflow remained unchanged in AS dogs, but hepatic alanine uptake nearly tripled (p less than 0.01) and hepatic glucose production increased by 60% (p less than 0.05). Anabolic steroids appear to support postoperative splanchnic fuel metabolism by increasing blood amino acid levels, enhancing gut/liver amino acid uptake and processing, and augmenting hepatic gluconeogenesis.
为了进一步了解分解代谢性疾病后肠道/肝脏氨基酸代谢改变的调节机制,研究了一种合成代谢类固醇(癸酸诺龙,5毫克/千克)对术后内脏燃料代谢的影响。除了研究共同运输全血氨基酸氮60%的谷氨酰胺和丙氨酸外,我们还测定了12只术后犬胃肠道和肝脏中谷氨酸和葡萄糖的通量。通过将血流量乘以每种底物的动静脉浓度差来计算底物交换(通量)。与对照动物相比,接受合成代谢类固醇(AS)的犬动脉谷氨酰胺、谷氨酸和丙氨酸显著增加(p<0.05)。肠道血流量未改变,但接受类固醇的犬肠道谷氨酰胺摄取量增加了一倍(对照组为1.4±0.3微摩尔/千克/分钟,AS组为2.8±0.7,p<0.05)。同时,接受类固醇的犬肠道丙氨酸释放增加了100%(p<0.05)。对照犬的肠道表现为谷氨酸净释放,而接受合成代谢类固醇治疗的犬表现为谷氨酸平衡(p<0.05)。AS组犬的肝脏血流量保持不变,但肝脏丙氨酸摄取量几乎增加了两倍(p<0.01),肝脏葡萄糖生成增加了60%(p<0.05)。合成代谢类固醇似乎通过提高血液氨基酸水平、增强肠道/肝脏氨基酸摄取和加工以及增强肝脏糖异生来支持术后内脏燃料代谢。