The diabetic heart utilizes ketone bodies as an energy source
The diabetic heart utilizes ketone bodies as an energy source
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DOI：
10.1016/j.metabol.2017.08.005
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发表时间：
2017-12-01
影响因子：
9.8
通讯作者：
Yasue, Hirofumi
中科院分区：
文献类型：
--
作者：
Mizuno, Yuji;Harada, Eisaku;Yasue, Hirofumi
背景糖尿病心脏的特征在于胰岛素不能增加葡萄糖摄取，并且在动物模型中越来越依赖于游离脂肪酸（FFA）作为燃料来源。然而，目前尚不清楚心脏能量代谢是如何在人类糖尿病心脏改变。我们检测了糖尿病患者与非糖尿病患者心脏疾病行心导管检查的心脏燃料代谢。研究对象包括81例因心脏病接受心导管插入术的患者（男55例，女26例，平均年龄63.0 ± 10.0岁）。糖尿病组36例，非糖尿病组45例。于主动脉根部（Ao）和冠状窦（CS）同时采血，测定血浆游离脂肪酸（FFA）、葡萄糖、乳酸、丙酮酸、总酮体和β-羟丁酸的水平，并进行比较。与非糖尿病患者相比，糖尿病患者的心肌摄取葡萄糖、乳酸和丙酮酸减少，而总酮体、β-羟基丁酸和乙酰乙酸增加。但糖尿病患者心肌游离脂肪酸摄取与非糖尿病患者相比无显著性差异。与人类非糖尿病患者相比，糖尿病患者心脏对碳水化合物（葡萄糖、乳酸盐和丙酮酸盐）的摄取减少，而总酮体和β-羟基丁酸盐的摄取增加。因此，酮体被用作能量来源，部分替代人糖尿病心脏中的葡萄糖。(C)2017作者爱思唯尔公司出版
Background. Diabetic heart is characterized by failure of insulin to increase glucose uptake and increasingly relies on free fatty acids (FFAs) as a source of fuel in animal models. However, it is not well known how cardiac energy metabolism is altered in diabetic hearts in humans. We examined cardiac fuel metabolism in the diabetics as compared to non diabetics who underwent cardiac catheterization for heart diseases.Material and Methods. The study subjects comprised 81 patients (male 55, female 26, average age 63.0 +/- 10.0 years) who underwent the cardiac catheterization for heart diseases. Thirty-six patients were diagnosed as diabetics (diabetic group) and 45 as non diabetics (non-diabetic group). Blood samplings were done in both the aortic root (Ao) and coronary sinus (CS) simultaneously and the plasma levels of FFAs, glucose, lactate, pyruvate, total ketone bodies and beta-hydroxybutyrate were measured and compared between the two groups.Results. The myocardial uptake of glucose, lactate and pyruvate were decreased, whereas those of total ketone bodies, beta-hydroxybutyrate and acetoacetate were increased in the diabetics as compared to the non-diabetics. However, the myocardial uptakes of FFAs were not significantly increased in the diabetics as compared to the non-diabetics.Conclusions. Cardiac uptakes of carbohydrate (glucose, lactate and pyruvate) were decreased, whereas those of total ketone bodies and beta-hydroxybutyrate were increased in the diabetics as compared to the non-diabetics in humans. Ketone bodies therefore are utilized as an energy source partially replacing glucose in the human diabetic heart. (C) 2017 The Authors. Published by Elsevier Inc.