Assomull V M, Vreman H J, Weiner M W
Proc Clin Dial Transplant Forum. 1979;9:73-9.
Concern has been expressed that the acetate (Ac) used in dialysate may stimulate lipid synthesis and accelerate atherosclerosis. Tolchin, et al(10) calculated the fractional generation of bicarbonate from Ac, in order to estimate the amount of Ac entering the citric acid cycle. However, these calculations were based upon the assumption that the bicarbonate space was 60% of body weight. These investigators estimated that 91-93% of Ac was metabolized to bicarbonate; they suggested that 7-9% Ac may have been used for lipid synthesis. In the present experiments, 6 hemodialysis patients were infused with 2 mmoles Na bicarbonate/kg to measure directly the bicarbonate space for each patient. The bicarbonate space was 44 +/- 2% of body weight. On a separate day, the same patients were infused with 2 mmoles Na Ac/kg. Using the measured bicarbonate space, the calculated fractional generation of bicarbonate from Ac was 98 +/- 4%. Rabbit experiments were also performed with an atherogenic diet, supplemented with 10% Ac, 10% bicarbonate, or 10% glucose. After 8 mos of dietary treatment, there was no difference in serum triglycerides, cholesterol, or extent of atherosclerosis between groups. The human and animal experiments both provide evidence that Ac in dialysate does not stimulate lipid synthesis.
有人担心透析液中使用的醋酸盐（Ac）可能会刺激脂质合成并加速动脉粥样硬化。托尔钦等人（10）计算了从Ac生成碳酸氢盐的分数，以估计进入柠檬酸循环的Ac量。然而，这些计算是基于碳酸氢盐空间为体重的60%这一假设。这些研究者估计91 - 93%的Ac被代谢为碳酸氢盐；他们认为7 - 9%的Ac可能用于脂质合成。在本实验中，给6名血液透析患者输注2 mmol碳酸氢钠/千克体重，以直接测量每名患者的碳酸氢盐空间。碳酸氢盐空间为体重的44±2%。在另一天，给相同的患者输注2 mmol醋酸钠/千克体重。利用测得的碳酸氢盐空间，计算出从Ac生成碳酸氢盐的分数为98±4%。还用致动脉粥样硬化饮食对兔子进行了实验，饮食中添加10%的Ac、10%的碳酸氢盐或10%的葡萄糖。经过8个月的饮食治疗后，各组之间的血清甘油三酯、胆固醇或动脉粥样硬化程度没有差异。人体和动物实验均提供了证据，表明透析液中的Ac不会刺激脂质合成。
