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[不同剂量葡萄糖及葡萄糖替代品输注的副作用比较]

[Comparison of side effects of infusion of glucose and glucose substitutes at different doses].

作者信息

Förster H, Boecker S, Zagel D

出版信息

Z Ernahrungswiss. 1978 Dec;17(4):224-39. doi: 10.1007/BF02019385.

Abstract

Glucose, fructose, sorbitol or xylitol were infused for four hours at different dose levels to metabolically healthy volunteers. The metabolic effects of the so-called glucose substitutes were compared to that of glucose. Even at very high doses (2.0 g/kg bodyweight per hour) of infusion of glucose or fructose a steady state was attained. This, however, was not the case with xylitol or sorbitol at lower doses (i.e. 0.5 g/kg bodyweight per hour), where no steady state was reached. The blood glucose concentration is not influenced by any of the glucose substitutes. During infusion of very high doses of fructose a small increase in serum insulin level is found, however, without any alteration in blood glucose concentration. Glucose as well as glucose substitutes cause an immediate suppression of free fatty acid concentrations in serum. In case of glucose there is a manifold increase in fatty acid concentration after the infusion is terminated. On the other hand, the free fatty acid concentration remains low even several hours following termination of the high-dosed fructose infusion. Theoretically one would expect an increase in triglyceride concentration, at least at the high dosed carbohydrate infusions. In contrast to this theoretical expectation, in the case of glucose and of xylitol a significant reduction of triglyceride concentration in serum was observed. Fructose and sorbitol did not exhibit this effect. Glucose and fructose are well utilized in metabolically healthy subjects. The maximum turnover rates for both polyols are lower. Unlike glucose, the glucose substitutes obviously do not cause any serious disturbation in hormonal regulations. Only in the case of glucose, counterregulation is seen following the termination of the infusion.

摘要

将葡萄糖、果糖、山梨醇或木糖醇以不同剂量水平输注给代谢健康的志愿者4小时。将这些所谓的葡萄糖替代品的代谢效应与葡萄糖的代谢效应进行比较。即使以非常高的剂量(每小时2.0克/千克体重)输注葡萄糖或果糖,也能达到稳态。然而,对于较低剂量(即每小时0.5克/千克体重)的木糖醇或山梨醇,情况并非如此,未达到稳态。血糖浓度不受任何葡萄糖替代品的影响。在输注非常高剂量的果糖期间,血清胰岛素水平有小幅升高,然而,血糖浓度没有任何变化。葡萄糖以及葡萄糖替代品会立即抑制血清中游离脂肪酸的浓度。对于葡萄糖,输注终止后脂肪酸浓度会有多种增加。另一方面,高剂量果糖输注终止后数小时,游离脂肪酸浓度仍保持较低水平。理论上,至少在高剂量碳水化合物输注时,人们会预期甘油三酯浓度会升高。与这种理论预期相反,在葡萄糖和木糖醇的情况下,观察到血清中甘油三酯浓度显著降低。果糖和山梨醇没有表现出这种效应。葡萄糖和果糖在代谢健康的受试者中得到很好的利用。两种多元醇的最大周转率较低。与葡萄糖不同,葡萄糖替代品显然不会对激素调节造成任何严重干扰。只有在葡萄糖的情况下,输注终止后会出现反调节。

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