Girard J R, Cuendet G S, Marliss E B, Kervran A, Rieutort M, Assan R
J Clin Invest. 1973 Dec;52(12):3190-200. doi: 10.1172/JCI107519.
The metabolic response to the first fast experienced by all mammals has been studied in the newborn rat. Levels of fuels and hormones have been compared in the fetal and maternal circulations at term. Then, after cesarean section just before the normal time of birth, sequential changes in the same parameters were quantified during the first 16 h of the neonatal period. No caloric intake was permitted, and the newborns were maintained at 37 degrees C. Activities of three key hepatic enzymes involved in glucose production were estimated. Marked differences in maternal and fetal hormones and fuels were observed. Lower levels of glucose, free fatty acids, and glycerol but higher levels of lactate, alpha-amino nitrogen, alanine, and glutamine were present in the fetus. Pyruvate, glutamate, and ketone bodies were not significantly different. The combination of a strikingly higher fetal immunoreactive insulin and a slightly lower immunoreactive glucagon (pancreatic) resulted in a profound elevation in the insulin-to-glucagon ratio, a finding consistent with an organism in an anabolic state. The rat at birth presents a body composition with respect to fuels available for mobilization and conversion which is dominated by carbohydrate and protein, since little fat is present. However, at birth a transient period of hypoglycemia occurred, associated with a rapid fall in insulin and rise in glucagon, causing reversal of the insulin-to-glucagon relationship toward ratios such as were observed in the mother. After a lag period, hepatic activities of phosphorylase, glucose-6-phosphatase, and phosphoenolpyruvate carboxykinase increased. Concurrent with these enzyme changes, the blood glucose returned to levels at or above those of the fetus. Interestingly, the fall observed in levels of the gluconeogenic precursors, lactate and amino acids, preceded the rise in enzyme activities and restoration of blood glucose. After 4 h, however, hypoglycemia recurred, during a period of decreasing hepatic glycogen content and blood lactate, pyruvate, and glycerol levels but of stable or increasing amino acid concentrations. Hepatic gluconeogenesis in this phase of depleted glycogen stores was insufficient to maintain euglycemia. Substrates derived from fat showed early changes of smaller magnitude. The rise in free fatty acids which occurred was less than twofold the value at birth, though this rise persisted up to 6 h. Whereas glycerol rose transiently, acetoacetate did not change and beta-hydroxybutyrate concentration fell. Both ketone bodies showed a marked rise at 16 h. at a time of diminished free fatty acid levels. Plasma growth hormone, though higher in the fetal than the maternal circulation, showed no consistent change during the period of observation. The changes in levels of the endocrine pancreatic hormones at birth were appropriate in time, magnitude, and direction to be implicated as prime regulators of the metabolic response during the neonatal period in the rat.
在新生大鼠中研究了所有哺乳动物首次经历禁食时的代谢反应。足月时比较了胎儿和母体循环中的燃料和激素水平。然后,在正常出生时间前进行剖宫产,在新生儿期的前16小时内对相同参数的连续变化进行了量化。不允许摄入热量,新生儿维持在37摄氏度。估计了参与葡萄糖生成的三种关键肝酶的活性。观察到母体和胎儿激素及燃料存在明显差异。胎儿体内葡萄糖、游离脂肪酸和甘油水平较低,但乳酸、α-氨基氮、丙氨酸和谷氨酰胺水平较高。丙酮酸、谷氨酸和酮体无显著差异。胎儿免疫反应性胰岛素显著升高与免疫反应性胰高血糖素(胰腺)略低相结合,导致胰岛素与胰高血糖素比值大幅升高,这一发现与处于合成代谢状态的生物体一致。出生时大鼠的身体组成中,可用于动员和转化的燃料以碳水化合物和蛋白质为主,因为脂肪含量很少。然而,出生时出现了短暂的低血糖期,与胰岛素迅速下降和胰高血糖素升高有关,导致胰岛素与胰高血糖素的关系逆转,朝着在母体中观察到的比值变化。经过一段延迟期后,磷酸化酶、葡萄糖-6-磷酸酶和磷酸烯醇丙酮酸羧激酶的肝活性增加。与这些酶变化同时发生的是,血糖恢复到胎儿水平或以上。有趣的是,糖异生前体乳酸和氨基酸水平的下降先于酶活性的升高和血糖的恢复。然而,4小时后,低血糖再次出现,此时肝糖原含量、血乳酸、丙酮酸和甘油水平下降,但氨基酸浓度稳定或升高。在糖原储备耗尽的这个阶段,肝糖异生不足以维持血糖正常。来自脂肪的底物早期变化幅度较小。游离脂肪酸的升高不到出生时值的两倍,尽管这种升高持续到6小时。甘油短暂升高,乙酰乙酸不变,β-羟基丁酸浓度下降。两种酮体在16小时时均显著升高,此时游离脂肪酸水平降低。血浆生长激素虽然在胎儿循环中高于母体循环,但在观察期间没有一致的变化。出生时内分泌胰腺激素水平的变化在时间、幅度和方向上都适合作为大鼠新生儿期代谢反应的主要调节因子。