SPLANCHNIC AND MUSCLE METABOLISM DURING EXERCISE IN NIDDM PATIENTS
SPLANCHNIC AND MUSCLE METABOLISM DURING EXERCISE IN NIDDM PATIENTS
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DOI：
10.1152/ajpendo.1995.269.3.e583
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发表时间：
1995-09-01
影响因子：
5.1
通讯作者：
WAHREN, J
中科院分区：
文献类型：
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作者：
MARTIN, IK;KATZ, A;WAHREN, J
为了解非胰岛素依赖型糖尿病(NIDDM)患者运动时内脏和肌肉代谢的特点，对8例男性非肥胖者和7例健康对照组(CON)进行了40min的60%最大摄氧量的踏车运动。分别于安静时和运动后即刻取股四头肌活检标本。运动结束时，NIDDM患者的动脉血糖浓度下降了10%(P<；0.01)，而CON患者的动脉血糖浓度上升了21%(P<；0.05)。NIDDM患者腿部葡萄糖摄取量从安静时的0.19+/-0.06 mm o l/min增加到运动结束时的2.25+/-0.61 mm o l/min，CON组从0.13+/-0.05 m o l/m in增加到1.17+/-0.34 m ol/m in。NIDDM组内脏葡萄糖排出量从0.52+/-0.06增加到2.37+/-0.26 mmol/min，CON组从0.79+/-0.12增加到2.44+/-0.38 mmol/min。NIDDM患者运动时的腿部乳酸排出量是前者的两倍。两组安静时肌肉乳酸和糖原含量相似，而NIDDM组运动后乳酸(19.5+/-1.7)和糖原(154+/-35)明显高于对照组(12.7+/-5.9 mmol/kg干重)和糖原(251+/-41 mmol葡萄糖单位/kg干重)。NIDDM组运动时全身呼吸交换比率较高(0.84+/-0.02比0.78+/-0.02，P<；0.05)。运动引起的其他肌肉代谢物的变化在NIDDM和CON中是相似的。这些数据表明，非肥胖型NIDDM患者运动时血糖下降是由于外周葡萄糖利用率的提高，而不是内脏葡萄糖输出量的减弱。
To characterize splanchnic and muscle metabolism during exercise in non-insulin-dependent diabetes mellitus (NIDDM), eight male nonobese patients and seven healthy control subjects (CON) were studied during 40 min of bicycle exercise at 60% of maximal oxygen uptake. Biopsies were obtained from the quadriceps femoris muscle at rest and immediately after exercise. Arterial glucose concentration in NIDDM had declined by 10% (P < 0.01) at the end of exercise, whereas in CON it had risen by 21% (P < 0.05). Leg glucose uptake rose from 0.19 +/- 0.06 mmol/min at rest to 2.25 +/- 0.61 mmol/min at the end of exercise in NIDDM and from 0.13 +/- 0.05 to 1.17 +/- 0.34 mmol/min in CON. Splanchnic glucose output increased from 0.52 +/- 0.06 to 2.37 +/- 0.26 mmol/min in NIDDM and from 0.79 +/- 0.12 to 2.44 +/- 0.38 mmol/min in CON. Leg lactate output during exercise was twofold higher in NIDDM. Muscle contents of lactate and glycogen were similar in both groups at rest, whereas after exercise lactate tended to be higher (19.5 +/- 1.7 vs. 12.7 +/- 5.9 mmol/kg dry wt) and glycogen lower (154 +/- 35 vs. 251 +/- 41 mmol glucosyl units/kg dry wt) in NIDDM. Whole body respiratory exchange ratio during exercise was higher in NIDDM (0.84 +/- 0.02 vs. 0.78 +/- 0.02, P < 0.05). Exercise-induced changes in other muscle metabolites were similar in NIDDM and CON. These data indicate that the decline in blood glucose during exercise in nonobese NIDDM is due to enhanced peripheral glucose utilization rather than to an attenuated increase in splanchnic glucose output.