Nolan C J, Proietto J
University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Victoria, Australia.
Diabetologia. 1994 Oct;37(10):976-84. doi: 10.1007/BF00400460.
The aim of this study was to determine the extent to which a feto-placental glucose steal phenomenon contributes to the process of maternal metabolic adaptation to late pregnancy. Glucose metabolism was studied in virgin control, pregnant rats and virgin rats with a phlorizin-induced model of the feto-placental glucose steal phenomenon. Whole body glucose kinetics and glucose uptake into individual tissues were measured in anaesthetised rats basally and during hyperinsulinaemic euglycaemic clamps. The basal glucose metabolism of the pregnant rats was closely mimicked by the phlorizin-treated rats. Basal plasma glucose was 39% and 38% lower (p < 0.0001 for both); hepatic glucose production was 21% and 26% higher (p < 0.05 for both); and plasma glucose clearance was 109% and 104% higher (p < 0.0001 for both) in the pregnant and phlorizin-treated rats, respectively, compared to the control rats. Basal glucose uptake into peripheral tissues was lower in both the pregnant and phlorizin-treated compared to the control rats, being most evident in heart (p < 0.01 for both) and brown adipose tissue (p < 0.001 for both). In the clamp studies, impairment of glucose uptake into skeletal muscle was observed in both the pregnant and phlorizin-treated rats compared to the control rats. In conclusion, the feto-placental glucose steal phenomenon is a major contributing factor to postabsorptive glucose metabolism in late pregnancy. This phenomenon also contributes to the impairment of maternal insulin-stimulated peripheral glucose uptake.
本研究的目的是确定胎儿 - 胎盘葡萄糖窃取现象在多大程度上促成母体对妊娠晚期代谢适应的过程。在未孕对照大鼠、妊娠大鼠以及用根皮苷诱导胎儿 - 胎盘葡萄糖窃取现象模型的未孕大鼠中研究了葡萄糖代谢。在基础状态以及高胰岛素 - 正常血糖钳夹期间,对麻醉大鼠的全身葡萄糖动力学和各组织的葡萄糖摄取进行了测量。根皮苷处理的大鼠与妊娠大鼠的基础葡萄糖代谢情况极为相似。与对照大鼠相比,妊娠大鼠和根皮苷处理大鼠的基础血浆葡萄糖分别降低了39%和38%(两者均P < 0.0001);肝葡萄糖生成分别增加了21%和26%(两者均P < 0.05);血浆葡萄糖清除率分别提高了109%和104%(两者均P < 0.0001)。与对照大鼠相比,妊娠大鼠和根皮苷处理大鼠外周组织的基础葡萄糖摄取均较低,在心脏(两者均P < 0.01)和棕色脂肪组织(两者均P < 0.001)中最为明显。在钳夹研究中,与对照大鼠相比,妊娠大鼠和根皮苷处理大鼠的骨骼肌葡萄糖摄取均受到损害。总之,胎儿 - 胎盘葡萄糖窃取现象是妊娠晚期吸收后葡萄糖代谢的一个主要促成因素。这种现象也导致母体胰岛素刺激的外周葡萄糖摄取受损。