Molina R D, Carver T D, Hay W W
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania 15213-3180.
Pediatr Res. 1993 Nov;34(5):654-60. doi: 10.1203/00006450-199311000-00018.
Compared with fetuses near term, midgestation fetal sheep at about 75 d of gestation have higher weight-specific glucose uptake rates, higher plasma glucose concentrations, lower plasma insulin concentrations, higher red blood cell insulin receptor concentrations and affinity, and a lower proportion of body weight accounted for by potentially insulin-sensitive skeletal muscle. Based on these observations, we measured the net rate of glucose uptake by the fetus from the uteroplacenta under basal and hyperinsulinemic conditions in eight fetal sheep at 76 d of gestation and eight fetal sheep at 132 d of gestation (term approximately 150 d). Hyperinsulinemia (414 +/- 90 pM) in the 76-d fetal sheep decreased plasma glucose concentration by 0.20 +/- 0.03 mM (-13%, p < 0.01) and increased the net rate of glucose uptake (8.4 +/- 2.2 mumol/min/kg, +21.3%, p < 0.05) and glucose clearance (11.4 +/- 2.6 mL/min/kg, +39%, p < 0.01). In the 132-d fetuses, a comparable hyperinsulinemia (306 +/- 36 pM) decreased plasma glucose concentration (-0.31 +/- 0.02 mM, -26%, p < 0.05) and increased glucose clearance (16.7 +/- 1.8 mL/min/kg, +73.6%, p < 0.05) to a greater extent than in the 76-d fetuses (p < 0.05 and p < 0.01, respectively). Net glucose uptake rate increased significantly in the 132-d fetuses (6.7 +/- 1.1 mumol/min/kg, +27.5%, p < 0.05), but not differently from the 76-d fetuses (p = 0.21). These data define brisk and significant effects of insulin on glucose metabolism in fetal sheep, even as early as approximately 50% of gestation. The midgestation fetal sheep, particularly in relation to its larger fractional content of body water and smaller fractional content of insulin-sensitive tissues, demonstrates glucose metabolic responses to insulin at least as great as those that occur near term.
与足月胎儿相比,妊娠约75天的妊娠中期胎羊具有更高的体重特异性葡萄糖摄取率、更高的血浆葡萄糖浓度、更低的血浆胰岛素浓度、更高的红细胞胰岛素受体浓度和亲和力,以及由潜在胰岛素敏感骨骼肌占体重的比例更低。基于这些观察结果,我们测量了8只妊娠76天的胎羊和8只妊娠132天的胎羊(足月约150天)在基础和高胰岛素血症条件下从子宫胎盘摄取葡萄糖的净速率。76天胎羊的高胰岛素血症(414±90 pM)使血浆葡萄糖浓度降低了0.20±0.03 mM(-13%,p<0.01),并增加了葡萄糖摄取净速率(8.4±2.2 μmol/min/kg,+21.3%,p<0.05)和葡萄糖清除率(11.4±2.6 mL/min/kg,+39%,p<0.01)。在132天的胎儿中,类似的高胰岛素血症(306±36 pM)使血浆葡萄糖浓度降低(-0.31±0.02 mM,-26%,p<0.05),并使葡萄糖清除率增加(16.7±1.8 mL/min/kg,+73.6%,p<0.05),程度大于76天的胎儿(分别为p<0.05和p<0.01)。132天胎儿的葡萄糖摄取净速率显著增加(6.7±1.1 μmol/min/kg,+27.5%,p<0.05),但与76天胎儿相比无差异(p = 0.21)。这些数据表明胰岛素对胎羊葡萄糖代谢有明显且显著的影响,即使早在妊娠约50%时。妊娠中期的胎羊,特别是相对于其更大的身体水分含量分数和更小的胰岛素敏感组织分数含量,表现出对胰岛素的葡萄糖代谢反应至少与足月时一样大。