McCullough F S, Tzagournis M, Greenberger N J, Linscheer W G
Gut. 1971 Feb;12(2):134-8. doi: 10.1136/gut.12.2.134.
Oral medium-chain triglycerides were given to 10 normal volunteers, 12 cirrhotics (group I) without and 28 cirrhotics (group II) with abnormal portal systemic communications (ascites, splenomegaly, oesophageal varices, or surgically-created portacaval shunts). After 30 ml of medium-chain triglyceride oil there was no appreciable change in serum glucose levels in any of the three groups nor in serum insulin levels in the normals and in cirrhotics in group I. However, there was a significant increase in serum insulin levels in the cirrhotic patients in group II. It is suggested that the rise in serum insulin levels after medium-chain triglycerides noted in the cirrhotics with shunts is due to shunting of insulin-containing portal blood around the liver (anatomical shunts) and to a diminished hepatic cell mass capable of extracting insulin (functional shunt). This differential response of serum insulin levels to medium-chain triglycerides may prove to be of value in detecting the presence of abnormal portal systemic communications in cirrhotic patients.
对10名正常志愿者、12名无门体分流异常的肝硬化患者（第一组）以及28名有门体分流异常（腹水、脾肿大、食管静脉曲张或外科门腔分流术）的肝硬化患者（第二组）给予口服中链甘油三酯。给予30毫升中链甘油三酯油后，三组中的任何一组血清葡萄糖水平均无明显变化，正常人和第一组肝硬化患者的血清胰岛素水平也无明显变化。然而，第二组肝硬化患者的血清胰岛素水平显著升高。提示分流性肝硬化患者中链甘油三酯后血清胰岛素水平升高是由于含胰岛素的门静脉血绕过肝脏分流（解剖分流）以及肝细胞摄取胰岛素的能力降低（功能性分流）。血清胰岛素水平对中链甘油三酯的这种差异反应可能在检测肝硬化患者门体分流异常的存在方面具有价值。
