Schauder P, Matthaei D, Henning H V, Scheler F, Langenbeck U
Klin Wochenschr. 1981 Aug 3;59(15):845-9. doi: 10.1007/BF01721054.
The effect of an oral glucose tolerance test (oGTT) on serum levels of branched-chain keto acids (BCKA), i.e. alpha-keto-isocaproic acid (KICA), alpha-keto-isovaleric acid (KIVA) and alpha-keto-beta methyl-n-valeric acid (KMVA) as well as on serum insulin, C-peptide and blood glucose levels was determined in uremic patients and in healthy control subjects. In controls, blood levels of KICA, KMVA and KIVA declined significantly following oral administration of 100 glucose. In uremic patients no decline of KICA was observed. The fall of KMVA was diminished, while suppression of KIVA blood levels in response to the oGGT remained unimpaired. Although serum insulin and C-peptide levels in uremic patients were not significantly different from the controls before and throughout the oGTT, six out of eight displayed abnormal glucose tolerance. It is suggested that the response of blood BCKA levels to an oGTT is altered in uremia, an abnormality restricted primarily to KICA and possibly explained by insulin antagonism and/or by insufficient insulin secretion.
在尿毒症患者和健康对照受试者中，测定了口服葡萄糖耐量试验（oGTT）对血清支链酮酸（BCKA）水平的影响，即α-酮异己酸（KICA）、α-酮异戊酸（KIVA）和α-酮-β-甲基-n-戊酸（KMVA），以及对血清胰岛素、C肽和血糖水平的影响。在对照组中，口服100葡萄糖后，KICA、KMVA和KIVA的血药浓度显著下降。在尿毒症患者中，未观察到KICA下降。KMVA的下降幅度减小，而oGGT后KIVA血药浓度的抑制作用未受影响。虽然尿毒症患者的血清胰岛素和C肽水平在oGTT前及整个过程中与对照组无显著差异，但8例中有6例糖耐量异常。提示尿毒症患者血BCKA水平对oGTT的反应发生改变，这种异常主要局限于KICA，可能由胰岛素拮抗和/或胰岛素分泌不足引起。
