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人体葡萄糖代谢:对静脉输注葡萄糖的反应

Glucose metabolism in man: responses to intravenous glucose infusion.

作者信息

Wolfe R R, Allsop J R, Burke J F

出版信息

Metabolism. 1979 Mar;28(3):210-20. doi: 10.1016/0026-0495(79)90066-0.

Abstract

We have determined the effect of unlabeled glucose infusions, with and without added insulin, on glucose metabolism in normal male volunteers by means of the simultaneous primed-constant infusion of 6-3H and U-13C-glucose. Glucose kinetics were measured after 90 min of infusion. When steady state had been reached, endogenous glucose production (2.53 +/- .058 mg/kg . min, X +/- SEM) was suppressed at all rates of exogenous glucose tested (1, 2, and 4 mg/kg . min). The absolute degree of suppression was most marked (75%) at the highest rate of infusion, but the greatest degree of suppression, relative to infusion rate, was at the lowest infusion rate. The control of plasma glucose concentration during the glucose infusion was achieved primarily through regulation of endogenous Ra. The rate of uptake of glucose only increased during the 4 mg/kg . min infusion, even though there were significant elevations in the plasma glucose and insulin concentrations during the 2 mg/kg . min infusion as well. The glucose clearance rate increased only when sufficient insulin was infused with the 4 mg/kg . min glucose infusion to control the hyperglycemia that developed if no insulin was administered. Approximately 43% of the infused glucose was directly oxidized when the infusion rate was 1 or 2 mg/kg . min. That value fell to 32% when the infusion rate was increased to 4 mg/kg . min, regardless of whether insulin was infused or not.

摘要

我们通过同时一次性注射和持续注射6-³H和U-¹³C标记的葡萄糖,测定了在有无添加胰岛素的情况下,未标记葡萄糖输注对正常男性志愿者葡萄糖代谢的影响。输注90分钟后测量葡萄糖动力学。达到稳态后,在所测试的所有外源性葡萄糖输注速率(1、2和4mg/kg·min)下,内源性葡萄糖生成(2.53±0.058mg/kg·min,X±SEM)均受到抑制。抑制的绝对程度在最高输注速率时最为显著(75%),但相对于输注速率而言,最大抑制程度出现在最低输注速率时。葡萄糖输注期间血浆葡萄糖浓度的控制主要通过调节内源性葡萄糖生成率(Ra)来实现。仅在4mg/kg·min输注期间葡萄糖摄取率增加,尽管在2mg/kg·min输注期间血浆葡萄糖和胰岛素浓度也有显著升高。仅当以4mg/kg·min的葡萄糖输注速率同时输注足够的胰岛素以控制不注射胰岛素时出现的高血糖时,葡萄糖清除率才会增加。当输注速率为1或2mg/kg·min时,约43%的输注葡萄糖被直接氧化。当输注速率增加到4mg/kg·min时,该值降至32%,无论是否输注胰岛素。

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