Karlsson A K, Attvall S, Jansson P A, Sullivan L, Lönnroth P
Department of Neurosurgery, University of Gothenburg, Sahlgrenska Hospital, Sweden.
Metabolism. 1995 Jan;44(1):52-8. doi: 10.1016/0026-0495(95)90289-9.
To evaluate insulin sensitivity and adipose tissue metabolism, seven spinal cord-injured (SCI) subjects (age, 43 +/- 6 years; body mass index, 22.8 +/- 1.4; mean +/- SE) and their seven siblings (age, 45 +/- 6 years; body mass index, 24.8 +/- 0.8) were studied using oral glucose (100-g) tolerance tests (OGTTs), euglycemic insulin clamps (insulin infusion, 1 mU/kg.min), and microdialysis of the subcutaneous tissue. Blood glucose and insulin after oral glucose were significantly increased in SCI subjects as compared with their siblings. During insulin clamping, plasma adrenaline increased significantly in controls, but not in SCI subjects. However, the rates of glucose production (2.02 +/- 0.36 v 1.59 +/- 0.09 mg/kg.min) and utilization (5.13 +/- 0.71 v 5.78 +/- 0.34) were similar in the two groups. Furthermore, interstitial subcutaneous glycerol and lactate concentrations before and after oral glucose were similar in the two groups, even in neurally decentralized tissue with broken connection between the central nervous system and peripheral sympathetic nerves. The data suggest that (1) well-mobilized SCI subjects show minor insulin resistance, and (2) sympathetic nervous activity has a minor influence on adipose tissue metabolism in the postabsorptive state, but may affect insulin sensitivity during euglycemic clamping.
为评估胰岛素敏感性和脂肪组织代谢，我们对7名脊髓损伤（SCI）受试者（年龄43±6岁；体重指数22.8±1.4；均值±标准误）及其7名兄弟姐妹（年龄45±6岁；体重指数24.8±0.8）进行了研究，采用口服葡萄糖（100克）耐量试验（OGTT）、正常血糖胰岛素钳夹试验（胰岛素输注，1 mU/kg·min）以及皮下组织微透析。与他们的兄弟姐妹相比，SCI受试者口服葡萄糖后的血糖和胰岛素显著升高。在胰岛素钳夹期间，对照组血浆肾上腺素显著升高，而SCI受试者则未升高。然而，两组的葡萄糖生成率（2.02±0.36对1.59±0.09毫克/千克·分钟）和利用率（5.13±0.71对5.78±0.34）相似。此外，两组口服葡萄糖前后的间质皮下甘油和乳酸浓度相似，即使在中枢神经系统与外周交感神经之间连接中断的神经分散组织中也是如此。数据表明：（1）活动良好的SCI受试者表现出轻微的胰岛素抵抗；（2）交感神经活动在吸收后状态对脂肪组织代谢影响较小，但在正常血糖钳夹期间可能影响胰岛素敏感性。
