Owen O E, Felig P, Morgan A P, Wahren J, Cahill G F
J Clin Invest. 1969 Mar;48(3):574-83. doi: 10.1172/JCI106016.
This study quantifies the concentrations of circulating insulin, growth hormone, glucose, free fatty acids, glycerol, beta-hydroxybutyrate, acetoacetate, and alpha amino nitrogen in 11 obese subjects during prolonged starvation. The sites and estimated rates of gluconeogenesis and ketogenesis after 5-6 wk of fasting were investigated in five of the subjects. Blood glucose and insulin concentrations fell acutely during the 1st 3 days of fasting, and alpha amino nitrogen after 17 days. The concentration of free fatty acids, beta-hydroxybutyrate, and acetoacetate did not reach a plateau until after 17 days. Estimated glucose production at 5-6 wk of starvation is reduced to approximately 86 g/24 hr. Of this amount the liver contributes about one-half and the kidney the remainder. Approximately all of the lactate, pyruvate, glycerol, and amino acid carbons which are removed by liver and kidney are converted into glucose, as evidenced by substrate balances across these organs.
本研究对11名肥胖受试者在长期饥饿期间循环胰岛素、生长激素、葡萄糖、游离脂肪酸、甘油、β-羟基丁酸、乙酰乙酸和α-氨基氮的浓度进行了量化。对其中5名受试者在禁食5-6周后糖异生和生酮的部位及估计速率进行了研究。禁食的前3天血糖和胰岛素浓度急剧下降，17天后α-氨基氮下降。游离脂肪酸、β-羟基丁酸和乙酰乙酸的浓度直到17天后才达到平台期。饥饿5-6周时估计的葡萄糖生成量减少至约86克/24小时。其中肝脏约贡献一半，其余由肾脏贡献。肝脏和肾脏清除的几乎所有乳酸、丙酮酸、甘油和氨基酸碳都转化为葡萄糖，这通过这些器官的底物平衡得到证明。
