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胃肠外高营养对血清脂蛋白以及对脂肪组织和骨骼肌脂蛋白脂肪酶活性的影响。

Effect of parenteral hyperalimentation on serum lipoproteins and on lipoprotein lipase activity of adipose tissue and skeletal muscle.

作者信息

Taskinen M R, Tulikoura I, Nikkilä E A, Ehnholm C

出版信息

Eur J Clin Invest. 1981 Aug;11(4):317-23. doi: 10.1111/j.1365-2362.1981.tb02123.x.

Abstract

This study reports on the effects of parenteral nutrition with glucose along or in combination with Intralipid on heparin-releasable lipoprotein lipase (LPL) activity of adipose tissue and skeletal muscle and on serum lipoproteins. Thirteen patients with postoperative hypercatabolism and nine patients with caloric malnutrition were studied. The average adipose tissue LPL activity increased 5-fold during 4-day glucose infusion (P less than 0.001) and 7.4-fold during Intralipid plus glucose infusion (P less than 0.001). In contrast, no change occurred in the LPL activity of skeletal muscle. Glucose infusion caused a significant increase in VLDL and LDL triglyceride concentrations and the Intralipid plus glucose infusion was followed by a rise in LDL and HDL triglyceride concentrations. HDL cholesterol decreased by 26% (P less than 0.01) during glucose and by 19% (P less than 0.05) during Intralipid plus glucose. Apoprotein A I was very low already at the start of parenteral alimentation and it did not change during either nutrition. The HDL cholesterol and apoprotein A I and A II levels were each positively correlated with adipose tissue LPL activity before parenteral nutrition but not after it.

摘要

本研究报告了单独使用葡萄糖或葡萄糖与英脱利匹特联合进行肠外营养对脂肪组织和骨骼肌中肝素可释放脂蛋白脂肪酶(LPL)活性以及血清脂蛋白的影响。对13例术后高分解代谢患者和9例热量营养不良患者进行了研究。在为期4天的葡萄糖输注期间,脂肪组织LPL活性平均增加了5倍(P<0.001),在英脱利匹特加葡萄糖输注期间增加了7.4倍(P<0.001)。相比之下,骨骼肌的LPL活性没有变化。葡萄糖输注导致极低密度脂蛋白(VLDL)和低密度脂蛋白(LDL)甘油三酯浓度显著增加,英脱利匹特加葡萄糖输注后,LDL和高密度脂蛋白(HDL)甘油三酯浓度升高。葡萄糖输注期间高密度脂蛋白胆固醇降低了26%(P<0.01),英脱利匹特加葡萄糖输注期间降低了19%(P<0.05)。在肠外营养开始时载脂蛋白A I就已经很低,并且在两种营养方式期间均未发生变化。肠外营养前,HDL胆固醇、载脂蛋白A I和A II水平均与脂肪组织LPL活性呈正相关,但肠外营养后则无相关性。

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