Arnold W C, Holliday M A
Kidney Int. 1979 Aug;16(2):124-9. doi: 10.1038/ki.1979.113.
Peripheral tissue resistance to insulin-mediated glucose uptake occurs in uremia. A similar resistance also may exist to insulin-mediated amino acid uptake. The present study examined the effect of insulin on the uptake or distribution ratios (DR) of alpha-aminoisobutyric acid (AIBA) attained in the tissues of rats made acutely uremic by bilateral nephrectomy. Both uremic and control rats concentrated equally AIBA in the gastrocnemius muscle in the absence of insulin (DR = 2.82 +/- 0.39 in controls, 2.52 +/- 0.40 in uremics). Compared to control rats, the diaphragm and liver of uremic rats, in the absence of insulin, had higher concentrations of AIBA. Insulin had the expected effect of increasing the uptake in the gastrocnemius, diaphragm, and liver of control rats but had no effect on uptake in the gastrocnemius muscle of uremic rats (DR = 5.82 +/- 0.78 in controls, 3.07 +/- 0.60 in uremics). The effect of insulin on the distribution ratio of AIBA in diaphragm and liver or uremic rats was less than it was in control rats. Uremia is associated with inhibition of insulin-mediated amino acid uptake as well as peripheral resistance to glucose utilization.
尿毒症患者存在外周组织对胰岛素介导的葡萄糖摄取的抵抗。对胰岛素介导的氨基酸摄取可能也存在类似的抵抗。本研究检测了胰岛素对双侧肾切除所致急性尿毒症大鼠组织中α-氨基异丁酸（AIBA）摄取或分布比率（DR）的影响。在无胰岛素情况下，尿毒症大鼠和对照大鼠的腓肠肌对AIBA的浓集程度相同（对照大鼠的DR = 2.82±0.39，尿毒症大鼠的DR = 2.52±0.40）。与对照大鼠相比，在无胰岛素情况下，尿毒症大鼠的膈肌和肝脏中AIBA浓度更高。胰岛素可使对照大鼠的腓肠肌、膈肌和肝脏对AIBA的摄取增加，但对尿毒症大鼠的腓肠肌摄取无影响（对照大鼠的DR = 5.82±0.78，尿毒症大鼠的DR = 3.07±0.60）。胰岛素对尿毒症大鼠膈肌和肝脏中AIBA分布比率的影响小于对照大鼠。尿毒症与胰岛素介导的氨基酸摄取受抑制以及外周对葡萄糖利用的抵抗有关。
