Steiner G, Morita S, Vranic M
Diabetes. 1980 Nov;29(11):899-905. doi: 10.2337/diab.29.11.899.
Glucose kinetics were studied in a group of nonobese humans with endogenous hypertriglyceridemia before, during, and after an infusion of graded increments of glucagon. The tracer methods employed permitted glucose turnover to be quantitated under non-steady state conditions. The rates of glucose production, disappearance, and fractional disappearance were related to the range of glucagon and insulin levels in each individual. The findings in hypertriglyceridemics were compared with those in lean normals of the same relative body weight and the same extracellular fluid volume per kg, as reflected by their apparent glucose space. Glucose production and serum insulin were each positively correlated to plasma glucagon concentrations in both hypertriglyceridemics and normals. Thus, with respect to these parameters, the hypertriglyceridemics were not resistant to glucagon. During the glucagon infusion, the glucose concentration rose more in the hypertriglyceridemics than in ther normals because of a reduced total rate of glucose disappearance in the hypertriglyceridemics. In the normals the fractional disappearance rate of glucose was positively related to serum levels of insulin, whereas in the hypertriglyceridemics it was lower than normal and did not change in relation to insulin concentration. This demonstrated that, at least with respect to glucose utilization, lean hypertriglyceridemics can be resistant to insulin even in the absence of obesity.
在一组内源性高甘油三酯血症的非肥胖人群中，在输注逐渐增加剂量的胰高血糖素之前、期间和之后，研究了葡萄糖动力学。所采用的示踪方法能够在非稳态条件下对葡萄糖周转率进行定量。葡萄糖生成、消失和分数消失的速率与每个个体中胰高血糖素和胰岛素水平的范围相关。将高甘油三酯血症患者的研究结果与具有相同相对体重和相同每千克细胞外液量（由其表观葡萄糖空间反映）的瘦正常个体的结果进行比较。在高甘油三酯血症患者和正常个体中，葡萄糖生成和血清胰岛素均与血浆胰高血糖素浓度呈正相关。因此，就这些参数而言，高甘油三酯血症患者对胰高血糖素并不抵抗。在输注胰高血糖素期间，高甘油三酯血症患者的葡萄糖浓度升高幅度大于正常个体，这是因为高甘油三酯血症患者的葡萄糖总消失率降低。在正常个体中，葡萄糖的分数消失率与血清胰岛素水平呈正相关，而在高甘油三酯血症患者中，该比率低于正常水平，且与胰岛素浓度无关。这表明，至少在葡萄糖利用方面，即使没有肥胖，瘦的高甘油三酯血症患者也可能对胰岛素抵抗。
