Wasserman D H, Johnson J L, Bupp J L, Lacy D B, Bracy D P
Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Am J Physiol. 1993 Jul;265(1 Pt 1):E51-60. doi: 10.1152/ajpendo.1993.265.1.E51.
To assess the mechanism of the accelerated gluconeogenesis in the insulin-deficient state, chronically catheterized (carotid artery, portal vein, hepatic vein, vena cava) normal (C; n = 9) and depancreatized (PX; n = 7) dogs were studied during rest (40 min) and moderate exercise (150 min). Tracers ([14C]alanine, [3H]glucose) and dye were infused to measure determinants of gluconeogenesis in the gut and liver. Arterial levels, net gut output, hepatic load, and net hepatic uptake of alanine were similar in C and PX at rest. During exercise, alanine levels fell in C but rose approximately 100% in PX. Exercise did not affect gut output or liver uptake of alanine in C but increased these variables by approximately 50 and 100% in PX due to an increase in hepatic alanine load. Arterial lactate was similar at rest in C and PX but rose fourfold more in PX with exercise. Net gut lactate output was fivefold greater in PX during rest and exercise. Net hepatic lactate uptake was present in PX at rest, whereas net output was evident in C. In response to exercise, hepatic lactate uptake was increased further in PX due to a rise in hepatic lactate load. Net hepatic lactate uptake was not evident until the end of exercise in C. Net hepatic glycerol uptake was elevated at rest in PX and during the initial 60 min of exercise due to an elevated hepatic load. In contrast to the high rates of gut lactate and alanine output in PX, gut glycerol output was not present. Gluconeogenesis from lactate and alanine was 5- to 10-fold higher in PX than C during rest and exercise. At rest, this resulted, in part, from a twofold greater intrahepatic gluconeogenic efficiency. During exercise, the greater conversion occurred even though efficiency was not consistently greater. In summary, gluconeogenesis from alanine, lactate, and glycerol in the insulin-deficient diabetic state 1) is exaggerated at rest, due to an increased capacity for hepatic lactate extraction, increased hepatic precursor loads, and a greater gluconeogenic efficiency; 2) is accelerated further by exercise due to added increments in hepatic precursor loads; and 3) is exaggerated partly because of a greater net gut alanine and lactate output.
为评估胰岛素缺乏状态下糖异生加速的机制,对长期插管(颈动脉、门静脉、肝静脉、腔静脉)的正常犬(C组;n = 9)和胰腺切除犬(PX组;n = 7)在静息状态(40分钟)和中等强度运动(150分钟)期间进行了研究。输注示踪剂([14C]丙氨酸、[3H]葡萄糖)和染料以测定肠道和肝脏中糖异生的决定因素。静息时,C组和PX组的动脉水平、肠道丙氨酸净输出量、肝脏丙氨酸负荷以及肝脏丙氨酸净摄取量相似。运动期间,C组的丙氨酸水平下降,而PX组的丙氨酸水平上升约100%。运动对C组的肠道丙氨酸输出量或肝脏丙氨酸摄取量无影响,但由于肝脏丙氨酸负荷增加,PX组的这些变量分别增加了约50%和100%。静息时,C组和PX组的动脉乳酸水平相似,但运动时PX组的动脉乳酸水平升高幅度是C组的四倍。静息和运动期间,PX组的肠道乳酸净输出量比C组大五倍。静息时,PX组存在肝脏乳酸净摄取,而C组则表现为乳酸净输出。运动时,由于肝脏乳酸负荷增加,PX组的肝脏乳酸摄取进一步增加。C组直到运动结束时才出现明显的肝脏乳酸净摄取。静息时以及运动最初60分钟内,PX组的肝脏甘油净摄取量因肝脏甘油负荷增加而升高。与PX组肠道高乳酸和丙氨酸输出率相反,PX组不存在肠道甘油输出。静息和运动期间,PX组由乳酸和丙氨酸生成葡萄糖的糖异生作用比C组高5至10倍。静息时,这部分是由于肝内糖异生效率提高了两倍。运动期间,尽管效率并非始终更高,但仍发生了更大程度的转化。总之,在胰岛素缺乏的糖尿病状态下,由丙氨酸、乳酸和甘油生成葡萄糖的糖异生作用:1)在静息时就被夸大,这是由于肝脏乳酸提取能力增加、肝脏前体负荷增加以及糖异生效率提高;2)运动时由于肝脏前体负荷进一步增加而加速;3)部分是由于肠道丙氨酸和乳酸净输出量增加而被夸大。