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门静脉肾上腺素能阻断并不抑制循环儿茶酚胺对肝脏的糖异生作用。

Portal adrenergic blockade does not inhibit the gluconeogenic effects of circulating catecholamines on the liver.

作者信息

Chu C A, Sindelar D K, Neal D W, Cherrington A D

机构信息

Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN 37232-0615, USA.

出版信息

Metabolism. 1997 Apr;46(4):458-65. doi: 10.1016/s0026-0495(97)90067-6.

Abstract

This study was undertaken to determine the impact of portal adrenergic blockade on the gluconeogenic effects of epinephrine (EPI) and norepinephrine (NE). Experiments were performed on 18-hour fasted conscious dogs and consisted of a 100-minute equilibration, a 40-minute basal, and two 90-minute test periods. A pancreatic clamp was used to fix insulin and glucagon levels at basal values. Propranolol (1 microgram/kg.min) and phentolamine (2 micrograms/kg.min) were infused intraportally during both test periods. Portal infusion of alpha- and beta-adrenergic blockers alone (first test period) slightly increased hepatic glucose production from 2.4 +/- 0.4 to 2.8 +/- 0.5 mg/kg.min (nonsignificant [NS]) NE (500 ng/kg.min) and EPI (180 ng/kg.min) were infused peripherally during the second test period. Arterial NE and EPI increased from 186 +/- 63 to 6,725 +/- 913 pg/mL and 76 +/- 25 to 2,674 +/- 344 pg/mL, respectively. Portal NE and EPI increased from 135 +/- 32 to 4,082 +/- 747 pg/mL and 28 +/- 8 to 1,114 +/- 174 pg/mL, respectively. Hepatic glucose production, the maximal gluconeogenic rate, and gluconeogenic efficiency increased from 2.8 +/- 0.5 to 3.8 +/- 0.4 mg/kg.min (P < .05), 0.7 +/- 0.3 to 2.1 +/- 0.6 mg/kg.min (P < .05), and 21% +/- 8% to 60% +/- 13% (P < .05), respectively, in response to catecholamine infusion. Net hepatic lactate balance changed from output (1.5 +/- 3.3 mumol/kg.min) to uptake (-11.0 +/- 3.8 mumol/kg.min, P < .05). Net hepatic glycerol uptake increased from -1.5 +/- 0.7 to -5.5 +/- 2.0 mumol/kg.min (P < .05). Net hepatic uptake of gluconeogenic amino acids did not change significantly. Similarly, hepatic glycogenolysis did not increase during catecholamine infusion. In conclusion, portal delivery of adrenergic blockers selectively inhibits the glycogenolytic effects of EPI and NE on the liver, but allows a marked gluconeogenic response to the catecholamines.

摘要

本研究旨在确定门静脉肾上腺素能阻断对肾上腺素(EPI)和去甲肾上腺素(NE)糖异生作用的影响。实验在禁食18小时的清醒犬身上进行,包括100分钟的平衡期、40分钟的基础期和两个90分钟的测试期。使用胰腺夹将胰岛素和胰高血糖素水平固定在基础值。在两个测试期内,均经门静脉输注普萘洛尔(1微克/千克·分钟)和酚妥拉明(2微克/千克·分钟)。在第一个测试期单独经门静脉输注α和β肾上腺素能阻滞剂,使肝脏葡萄糖生成量从2.4±0.4毫克/千克·分钟轻微增加至2.8±0.5毫克/千克·分钟(无统计学意义[NS])。在第二个测试期经外周输注NE(500纳克/千克·分钟)和EPI(180纳克/千克·分钟)。动脉血中NE和EPI分别从186±63皮克/毫升增加至6725±913皮克/毫升和76±25皮克/毫升增加至2674±344皮克/毫升。门静脉血中NE和EPI分别从135±32皮克/毫升增加至4082±747皮克/毫升和28±8皮克/毫升增加至1114±174皮克/毫升。在输注儿茶酚胺后,肝脏葡萄糖生成量、最大糖异生率和糖异生效率分别从2.8±0.5毫克/千克·分钟增加至3.8±0.4毫克/千克·分钟(P<.05)、0.7±0.3毫克/千克·分钟增加至2.1±0.6毫克/千克·分钟(P<.05)和21%±8%增加至60%±13%(P<.05)。肝脏乳酸净平衡从输出(1.5±3.3微摩尔/千克·分钟)转变为摄取(-11.0±3.8微摩尔/千克·分钟,P<.05)。肝脏甘油净摄取量从-1.5±0.7微摩尔/千克·分钟增加至-5.5±2.0微摩尔/千克·分钟(P<.05)。肝脏对糖异生氨基酸的净摄取无显著变化。同样,在输注儿茶酚胺期间肝脏糖原分解未增加。总之,经门静脉给予肾上腺素能阻滞剂可选择性抑制EPI和NE对肝脏的糖原分解作用,但允许对儿茶酚胺产生显著的糖异生反应。

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