Boden G, Shimoyama R, Savage R C, Owen O E
Diabetes. 1985 May;34(5):498-503. doi: 10.2337/diab.34.5.498.
Total body carbohydrate (CHO) and fat oxidation rates, plasma glucose, free fatty acid, and insulin concentrations were determined in two patients with the type B syndrome of severe insulin resistance and in normal controls in response to insulin infusions (1-100 mU/kg/min) and to a test meal. In addition, insulin was infused at higher rates (10-1000 mU/kg/min) in one of the two patients while plasma glucose concentrations were clamped first at 195 and later at 244 mg/dl. During the postabsorptive state, resting metabolic rates (RMR) were 914 and 979 cal/min/1.73 m2 in the two patients (controls: 1018 +/- 85 cal/min/1.73 m2). Patients met 85% and 83% of their caloric requirements by oxidizing fat (controls: 63 +/- 7%). Protein oxidation accounted for 15% and 13% (controls: 14 +/- 3%) of energy requirements and CHO oxidation for 0% and 0%, respectively, in both patients (controls: 23 +/- 5%). Infusion of insulin at a rate of 10 mU/kg/min raised plasma insulin concentrations from 1400 and 440 microU/ml to 6000 and 2500 microU/ml, respectively, in patients 1 and 2 (controls: from 4 +/- 0.3 to 1288 +/- 50 microU/ml), but had no effects on rates of CHO, fat, or protein oxidation in either patient. By comparison, the rate of CHO oxidation in controls rose about sixfold from 40 +/- 8 to 234 +/- 12 mg/min/1.73 m2. Infusion of 1000 mU/kg/min in combination with an increase in plasma glucose from 195 +/- 1.1 to 244 +/- 1.9 mg/dl in patient 1, however, raised CHO oxidation from 0 to 36 mg/min/1.73 m2 and lowered fat oxidation from 105 to 69 mg/min/1.73 m2.(ABSTRACT TRUNCATED AT 250 WORDS)
测定了两名患有严重胰岛素抵抗B型综合征的患者以及正常对照者在静脉输注胰岛素（1 - 100 mU/kg/分钟）和进食试验餐时的全身碳水化合物（CHO）和脂肪氧化率、血浆葡萄糖、游离脂肪酸及胰岛素浓度。此外，对其中一名患者以更高的速率（10 - 1000 mU/kg/分钟）输注胰岛素，同时先将血浆葡萄糖浓度钳定在195 mg/dl，随后钳定在244 mg/dl。在空腹状态下，两名患者的静息代谢率（RMR）分别为914和979 cal/分钟/1.73 m²（对照组：1018 ± 85 cal/分钟/1.73 m²）。患者通过氧化脂肪满足其85%和83%的热量需求（对照组：63 ± 7%）。蛋白质氧化分别占能量需求的15%和13%（对照组：14 ± 3%），两名患者的CHO氧化均为0%（对照组：23 ± 5%）。以10 mU/kg/分钟的速率输注胰岛素，患者1和患者2的血浆胰岛素浓度分别从1400和440 μU/ml升高至6000和2500 μU/ml（对照组：从4 ± 0.3升高至1288 ± 50 μU/ml），但对两名患者的CHO、脂肪或蛋白质氧化率均无影响。相比之下，对照组的CHO氧化率从40 ± 8 mg/分钟/1.73 m²升高约6倍至234 ± 12 mg/分钟/1.73 m²。然而，在患者1中，以1000 mU/kg/分钟的速率输注胰岛素并将血浆葡萄糖从195 ± 1.1 mg/dl升高至244 ± 1.9 mg/dl，使CHO氧化从0升高至36 mg/分钟/1.73 m²，并使脂肪氧化从105降低至69 mg/分钟/1.73 m²。（摘要截选至250字）
