Newman W P, Brodows R G
Metabolism. 1983 Jun;32(6):590-6. doi: 10.1016/0026-0495(83)90029-x.
The effects of insulin on glucose utilization, lipolysis, and potassium and phosphate metabolism were studied during short-term fasting in six lean subjects using a sequential euglycemic glucose clamp technique (two additional subjects were used in 70 mU/m2/min clamp studies). The subjects were infused with insulin for four hours at four rates ranging from 6 to 442 mU/m2/min before and after a 48-hour fast. Insulin was infused for one hour at each rate in all experiments. Fasting markedly reduced glucose utilization at all insulin infusion rates. On the other hand, the decline in levels of free fatty acids that occurred at insulin concentrations of 30 microU/ml was virtually identical before and after fasting. After insulin was infused for four hours, serum phosphate had decreased in all subjects (P less than 0.001) and strongly correlated with glucose disposal rates (r = 0.76, P less than 0.005). The plasma potassium level also declined in all subjects but did not relate to fasting or glucose disposal. These studies demonstrate that starvation produces selective insulin resistance. The biologic effect of insulin on glucose utilization and plasma phosphate shifts is clearly diminished. Free fatty acid and potassium metabolism are unaffected by starvation.
采用连续正常血糖葡萄糖钳夹技术，对6名瘦受试者在短期禁食期间胰岛素对葡萄糖利用、脂肪分解以及钾和磷代谢的影响进行了研究（在70 mU/m2/min钳夹研究中还使用了另外2名受试者）。在48小时禁食前后，以6至442 mU/m2/min的四种速率对受试者输注胰岛素4小时。在所有实验中，每种速率的胰岛素均输注1小时。禁食显著降低了所有胰岛素输注速率下的葡萄糖利用率。另一方面，在胰岛素浓度为30微单位/毫升时，禁食前后游离脂肪酸水平的下降几乎相同。在输注胰岛素4小时后，所有受试者的血清磷酸盐均下降（P<0.001），且与葡萄糖处置率密切相关（r = 0.76，P<0.005）。所有受试者的血浆钾水平也下降，但与禁食或葡萄糖处置无关。这些研究表明，饥饿会产生选择性胰岛素抵抗。胰岛素对葡萄糖利用和血浆磷酸盐变化的生物学作用明显减弱。游离脂肪酸和钾代谢不受饥饿影响。
