Physiologic hyperinsulinemia stimulates lactate extraction by heart muscle in the conscious dog.
Physiologic hyperinsulinemia stimulates lactate extraction by heart muscle in the conscious dog.
复制标题
生理性高胰岛素血症会刺激有意识的狗心肌提取乳酸。
DOI：
10.1016/0026-0495(89)90049-8
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
Barrett,EJ
中科院分区：
文献类型：
--
作者：
Young,LH;Zaret,BL;Barrett,EJ
在8只正常吸收后清醒的狗中研究了生理性高胰岛素血症对心脏乳酸、葡萄糖和游离脂肪酸净平衡的影响。在获得心肌底物平衡的基础测量值后，使用高胰岛素正葡萄糖钳夹将动脉血浆胰岛素从8 ± 1 μU/mL增加至68 ± 14 μU/mL，同时血糖保持恒定（64 ± 1 mg/dL）。心肌乳酸摄取增加近4倍，从5.8 ± 1.8 μmol/min增加到22.4 ± 2.9 μmol/min（P<0.005）。尽管动脉乳酸浓度从0.46 ± 0.08 mmol/L小幅增加至0.79 ± 0.11 mmol/L（P<0.02），但乳酸提取分数从23% ± 7%增加至54% ± 2%（P<0.001），表明乳酸提取效率增加。正常血糖高胰岛素血症导致心肌葡萄糖摄取增加（6.7 ± 2.3至18.2 ± 3.7 μmol/min，P<0.05）。动脉游离脂肪酸浓度从1.06 ± 0.13降至0.35 ± 0.06 mmol/L（P<0.001），同时心肌摄取游离脂肪酸从18.5 ± 5.3降至5.8 ± 2.9 μmol/min（P<0.05）。这些结果表明，生理性高胰岛素血症增加乳酸以及葡萄糖摄取正常心肌。
The effect of physiologic hyperinsulinemia on the net balance of lactate, glucose, and free fatty acids across the heart was studied in eight normal postabsorptive conscious dogs. After obtaining basal measurements of myocardial substrate balance, arterial plasma insulin was increased from 8 ± 1 to 68 ± 14 μU/mL while blood glucose was maintained constant (64 ± 1 mg/dL) using the hyperinsulinemic euglycemic clamp. Myocardial lactate uptake increased nearly fourfold, from 5.8 ± 1.8 to 22.4 ± 2.9 μmol/min (P< .005). Despite a small increase in arterial lactate concentration from 0.46 ± 0.08 to 0.79 ± 0.11 mmol/L (P< .02), the lactate extraction fraction increased from 23% ± 7% to 54% ± 2% (P< .001) indicating an increased efficiency of lactate extraction. Euglycemic hyperinsulinemia led to a comparable increase in myocardial glucose uptake (6.7 ± 2.3 to 18.2 ± 3.7 μmol/min,P< .05). Arterial free fatty acid concentrations fell from 1.06 ± 0.13 to 0.35 ± 0.06 mmol/L (P< .001) with a concomitant decline in the myocardial uptake of free fatty acids from 18.5 ± 5.3 to 5.8 ± 2.9 μmol/min (P< .05). These results indicate that physiologic hyperinsulinemia increases lactate as well as glucose uptake in normal heart muscle.