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在新近发生链脲佐菌素诱导糖尿病的大鼠中,高血糖是由葡萄糖生成过多而非胰岛素抵抗引起的。

Excessive glucose production, rather than insulin resistance, accounts for hyperglycaemia in recent-onset streptozotocin-diabetic rats.

作者信息

Burcelin R, Eddouks M, Maury J, Kande J, Assan R, Girard J

机构信息

Service de Diabétologie Hôpital Bichat, Paris, France.

出版信息

Diabetologia. 1995 Mar;38(3):283-90. doi: 10.1007/BF00400632.

Abstract

Glucose production and utilization and activities of key enzymes involved in liver and muscle glucose metabolism were studied in post-absorptive streptozotocin-diabetic rats after 12 h of severe hyperglycaemia (17.5 +/- 0.5 mmol/l) and insulinopenia (5 +/- 1 microU/ml). Basal glucose production was increased: 36.6 +/- 3.0 mg.kg.min-1, vs 24.4 +/- 2.5 in controls (p < 0.05); liver glycogen concentration was decreased by 40% (p < 0.05); liver phosphoenolpyruvate carboxykinase and glucose-6-phosphatase activities were increased by 375 and 156%, respectively (p < 0.001 and < 0.01). During a euglycaemic clamp at a plasma insulin level of 200 microU/ml, glucose production was totally suppressed in controls, but persisted at 20% of basal in diabetic rats. In these rats, glucose production was suppressed at a plasma insulin level of 2500 microU/ml. Basal whole body glucose utilization rate, 2-deoxy-1-[3H]-D-glucose ([3H]-2DG) uptake by muscles and muscle glycogen concentrations were similar in both groups, as well as total and active forms of pyruvate dehydrogenase and glycogen synthase activities. During the euglycaemic clamp, the total body glucose utilization rates and [3H]-2DG uptake by muscles were similar in control and diabetic rats at a plasma insulin level of 200 microU/ml, but lower in diabetic rats at a plasma insulin level of 2500 microU/ml. We conclude 1) in recent-onset severely insulinopenic rats, an excessive glucose production via gluconeogenesis prevailed, mainly accounting for the concomitant hyperglycaemia. This excess glucose output cannot be attributed to liver insulin resistance: the gluconeogenic pathway is physiologically less sensitive than glycogenolysis to the inhibition by insulin.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在严重高血糖(17.5±0.5 mmol/l)和胰岛素缺乏(5±1 μU/ml)12小时后的吸收后链脲佐菌素诱导的糖尿病大鼠中,研究了肝脏和肌肉葡萄糖代谢中涉及的葡萄糖生成与利用以及关键酶的活性。基础葡萄糖生成增加:36.6±3.0 mg·kg·min⁻¹,而对照组为24.4±2.5(p<0.05);肝脏糖原浓度降低40%(p<0.05);肝脏磷酸烯醇式丙酮酸羧激酶和葡萄糖-6-磷酸酶活性分别增加375%和156%(p<0.001和<0.01)。在血浆胰岛素水平为200 μU/ml的正常血糖钳夹期间,对照组的葡萄糖生成被完全抑制,但糖尿病大鼠的葡萄糖生成仍维持在基础水平的20%。在这些大鼠中,血浆胰岛素水平为2500 μU/ml时葡萄糖生成被抑制。两组的基础全身葡萄糖利用率、肌肉对2-脱氧-1-[³H]-D-葡萄糖([³H]-2DG)的摄取以及肌肉糖原浓度相似,丙酮酸脱氢酶和糖原合酶的总活性和活性形式也相似。在正常血糖钳夹期间,血浆胰岛素水平为200 μU/ml时,对照组和糖尿病大鼠的全身葡萄糖利用率以及肌肉对[³H]-2DG的摄取相似,但血浆胰岛素水平为2500 μU/ml时糖尿病大鼠的较低。我们得出结论:1)在近期发病的严重胰岛素缺乏大鼠中,通过糖异生的过量葡萄糖生成占主导,主要导致了伴随的高血糖。这种过量的葡萄糖输出不能归因于肝脏胰岛素抵抗:糖异生途径在生理上对胰岛素抑制的敏感性低于糖原分解。(摘要截短于250字)

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