Göschke H
Metabolism. 1977 Oct;26(10):1147-53. doi: 10.1016/0026-0495(77)90042-7.
Oral glucose tolerance tests were performed on 14 lean and 14 obese nondiabetic subjects before and after a 6-day fast. In addition, insulin tolerance tests were performed on 8 lean and 8 obese subjects before and after starvation. Both in lean and obese subjects glucose tolerance deteriorated during starvation, but much more so in the lean population. During fasting, insulin elevation after a glucose load was significantly delayed in lean subjects but not in the obese. Circulating levels of factors known to affect glucose tolerance, such as glucagon, growth hormone, free fatty acids, and ketone bodies were higher in fasting lean than in fasting obese individuals. In normals fasting resulted in a significant decrease of the blood glucose response to insulin injection, whereas in fasting obese subjects glucose response was unchanged. The results obtained suggest that the effect of fasting on insulin release and insulin sensitivity was more pronounced in lean than in obese subjects, which resulted in greater deterioration of glucose tolerance in the lean population.
对14名体重正常的非糖尿病受试者和14名肥胖的非糖尿病受试者在禁食6天前后进行了口服葡萄糖耐量试验。此外，对8名体重正常的受试者和8名肥胖受试者在饥饿前后进行了胰岛素耐量试验。在体重正常和肥胖的受试者中，饥饿期间葡萄糖耐量均下降，但在体重正常人群中下降得更为明显。在禁食期间，体重正常的受试者在给予葡萄糖负荷后胰岛素升高明显延迟，而肥胖受试者则没有。已知影响葡萄糖耐量的因素，如胰高血糖素、生长激素、游离脂肪酸和酮体的循环水平，禁食的体重正常个体高于禁食的肥胖个体。在正常情况下，禁食导致对胰岛素注射的血糖反应显著降低，而在禁食的肥胖受试者中，葡萄糖反应没有变化。所获得的结果表明，禁食对胰岛素释放和胰岛素敏感性的影响在体重正常的受试者中比在肥胖受试者中更为明显，这导致体重正常人群的葡萄糖耐量恶化更严重。
