Morioka S, Kanai K, Kako M, Nakajima T, Yoshimi T, Masaka M, Sudo K, Kanno T
Gastroenterol Jpn. 1983 Dec;18(6):553-9. doi: 10.1007/BF02774696.
An amino acid solution enriched in branched chain amino acids (BCAA) was administered to cirrhotic patients with encephalopathy and serial determinations of serum glucose, IRI and IRG were performed. Slight decrease of serum glucose was observed when only BCAA was given. On the other hand, when BCAA was infused with glucose, the serum glucose level decreased significantly after infusion (-77.5 +/- 26.2 mg/dl, p less than 0.01) and two cases of hypoglycemic shock were observed. Although both serum insulin and glucagon increased in these cases, the IRI/IRG molar ratio which was 8.9 at the start of infusion increased to 20.6 at the end of infusion. It was suggested that administration of BCAA with glucose caused hypoglycemia in cirrhotics with encephalopathy, possibly by synergistic action of BCAA and glucose on serum insulin level.
给患有肝性脑病的肝硬化患者输注富含支链氨基酸（BCAA）的氨基酸溶液，并对血清葡萄糖、胰岛素释放指数（IRI）和胰岛素抵抗指数（IRG）进行系列测定。仅给予BCAA时，观察到血清葡萄糖略有下降。另一方面，当BCAA与葡萄糖一起输注时，输注后血清葡萄糖水平显著下降（-77.5±26.2mg/dl，p<0.01），并观察到2例低血糖休克。虽然这些病例中血清胰岛素和胰高血糖素均升高，但输注开始时为8.9的IRI/IRG摩尔比在输注结束时升至20.6。提示BCAA与葡萄糖一起给药可导致患有肝性脑病的肝硬化患者发生低血糖，可能是由于BCAA和葡萄糖对血清胰岛素水平的协同作用。
