BED-REST-INDUCED INSULIN RESISTANCE OCCURS PRIMARILY IN MUSCLE
BED-REST-INDUCED INSULIN RESISTANCE OCCURS PRIMARILY IN MUSCLE
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DOI：
10.1016/0026-0495(88)90018-2
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发表时间：
1988-08-01
影响因子：
9.8
通讯作者：
WOLFE, RR
中科院分区：
文献类型：
--
作者：
STUART, CA;SHANGRAW, RE;WOLFE, RR
对创伤受害者和严重疾病患者的治疗可能会通过严重限制体力活动而导致他们的代谢紊乱。我们试图量化的影响，绝对卧床休息单独胰岛素调节葡萄糖代谢的6名健康受试者。6 - 7天的严格卧床休息导致口服葡萄糖耐量中度恶化，空腹血浆胰岛素浓度和胰岛素对口服葡萄糖挑战的反应增加了40%以上。正常血糖胰岛素钳夹研究表明，胰岛素刺激全身葡萄糖利用产生了抵抗。这种变化的特征在于胰岛素剂量-反应曲线的快速移动（发生50%最大刺激时的胰岛素浓度为45 ± 0.01）。3（SE）μ U/mL，基线期为78 ± 0. 8 μ U/mL，P <0.01），葡萄糖摄取速率的最大反应几乎没有改变（基线15.4 ± 0.01）。1.4 mg/kg.分钟和卧床休息14.0 .+-. 1.3 mg/kg.分钟）。与全身葡萄糖利用对胰岛素敏感性的变化相反，胰岛素对肝脏葡萄糖输出的抑制在卧床休息7天后没有变化。胰岛素与循环单核细胞的结合不受卧床休息的影响。这些研究表明，卧床休息仅7天所要求的有限体力活动与胰岛素对葡萄糖代谢作用的实质性抵抗有关。此外，数据表明，这些影响主要发生在骨骼肌中，胰岛素对肝脏的作用几乎没有变化。
Treatment of trauma victims and patients with severe illness may contribute to their metabolic derangements by severely restricting physical activity. We sought to quantitate the impact of absolute bed rest alone on insulin regulation of glucose metabolism in six healthy subjects. Six to seven days of strict bed rest resulted in moderate deterioration in oral glucose tolerance and increased both fasting plasma insulin concentration and the insulin response to an oral glucose challenge by more than 40%. Euglycemic insulin clamp studies demonstrated the development of resistance to insulin''s stimulation of whole-body glucose utilization. This change was characterized by a rightward shift of the insulin dose-response curve (insulin concentration at which 50% of maximal stimulation occurred was 45 .+-. 3 (SE) .mu.U/mL in the base line period and 78 .+-. 8 .mu.U/mL after seven days of bed rest, P < .01) with little alteration in the maximal response in the rate of glucose uptake (baseline 15.4 .+-. 1.4 mg/kg .cntdot. min and bed rest 14.0 .+-. 1.3 mg/kg .cntdot. min). In contrast to the shift of sensitivity of whole-body glucose utilization to insulin, suppression of hepatic glucose output by insulin was unchanged by seven days of bed rest. Insulin binding to circulating mononuclear cells was not changed by bed rest. These studies demonstrate that the limited physical activity dictated by bed rest for as little as seven days is associated with substantial resistance to insulin''s effects on glucose metabolism. Further, the data suggest that these effects occur primarily in skeletal muscle with little change in insulin action on the liver.