Hayakawa J, Shibata T, Tsuburaya A, Motohashi H, Sairenji M, Kobayashi O, Usuda Y
Department of Anesthesia, Kanagawa Cancer Center Hospital, Yokohama.
Masui. 1995 Jul;44(7):976-80.
We evaluated the effect of aging on portal blood immunoreactive insulin concentration, AKBR, and keton body concentration (acetoacetate + beta-hydroxybutyrate) after glucose infusion (25 g glucose in an hour) in patients undergoing gastrectomy. Twenty-seven patients studied were elderly (above 65 years) and twenty-eight were younger (below 60 years). There was no significant difference in portal blood immunoreactive insulin concentration after glucose infusion between the two groups of patients. In elderly patients, however, AKBR was significantly lower and keton body concentration was significantly higher than those in younger patients, and these imply that suppression of ketogenesis and activation of hepatic mitochondrial function due to insulin may be reduced in elderly patients. These findings suggest that, during gastrectomy, pancreatic insulin secretion may not be impaired in elderly patients, but insulin action may be attenuated with aging.
我们评估了年龄对接受胃切除术患者葡萄糖输注（一小时内输注25克葡萄糖）后门静脉血中免疫反应性胰岛素浓度、AKBR（肝线粒体呼吸活性）和酮体浓度（乙酰乙酸+β-羟基丁酸）的影响。研究的27名患者为老年人（65岁以上），28名患者为年轻人（60岁以下）。两组患者葡萄糖输注后门静脉血中免疫反应性胰岛素浓度无显著差异。然而，老年患者的AKBR显著低于年轻患者，酮体浓度显著高于年轻患者，这意味着老年患者中胰岛素对生酮作用的抑制和肝线粒体功能的激活作用可能减弱。这些发现表明，在胃切除术中，老年患者的胰腺胰岛素分泌可能未受损，但胰岛素作用可能随年龄增长而减弱。
