Forearm Glucose Uptake During the Oral Glucose Tolerance Test in Normal Subjects
Forearm Glucose Uptake During the Oral Glucose Tolerance Test in Normal Subjects
复制标题
正常受试者口服葡萄糖耐量试验期间前臂葡萄糖摄取量
作者：
R. A. Jackson;N. Peters;U. Advani;G. Perry;J. Rogers;W. Brough;T. Pilkington
总前臂葡萄糖利用率（FGU）测定在100克。口服葡萄糖耐量试验（GTT）在25名正常志愿者。此外，在13名受试者中研究了前臂胰岛素、生长激素和乳酸盐的伴随平衡。摄入葡萄糖后3小时内FGU的增量为74 mg/kg。100毫升前臂;可以计算出，增加的外周葡萄糖利用占100克葡萄糖的42%。负载和GTT期间约58克。额外的葡萄糖到达外周循环。葡萄糖负荷后，混合静脉血（MY）中的血清胰岛素浓度急剧上升，而生长激素水平降低。对13名受试者的额外观察表明，在30~150分钟之间，MV胰岛素水平显著低于相应的动脉化静脉（AV）浓度，表明在此期间胰岛素被前臂组织持续清除。在生长激素水平中未检测到显著的AV-MV差异。血浆乳酸浓度在葡萄糖负荷后立即上升，在60分钟时达到峰值，此后下降。初始升高与前臂的乳酸摄取和随后的乳酸释放下降相关，表明外周乳酸代谢对乳酸反应曲线的形状几乎没有影响。这表明乳酸浓度的早期上升是肝脏乳酸产生增加的结果，乳酸峰的时间和高度反映了口服葡萄糖负荷后肝葡萄糖利用增强的模式。我们的研究结果表明，处置100克。口服葡萄糖负荷主要由肝葡萄糖保存而不是外周摄取来解释，因此，前者是口服葡萄糖耐量曲线形状的主要决定因素。
Total forearm glucose utilization (FGU) was determined during 100 gm. oral glucose tolerance tests (GTT) in twenty-five normal volunteers. In addition, the concomitant balance of insulin, growth hormone, and lactate across the forearm was studied in thirteen subjects. The increment in FGU during the three hours following glucose ingestion amounted to 74 mg./100 ml. forearm; it may be calculated that increased peripheral glucose utilization accounted for the disposal of 42 per cent of the 100 gm. load and that during the GTT some 58 gm. of extra glucose reached the peripheral circulation. Serum insulin concentrations in mixed venous (MY) blood rose steeply after glucose loading, while growth hormone levels were reduced. Additional observations in thirteen subjects showed that MV insulin levels remained significantly lower than corresponding arterialized venous (AV) concentrations between thirty and 150 minutes, suggesting that insulin was being continually removed bythe forearm tissues during this time. Significant AV-MV differences were not detected in growth hormone levels. Plasma lactate concentrations rose immediately after glucose loading, reaching a peak at sixty minutes and declining thereafter. The initial elevation was associated with lactate uptake by the forearm and the subsequent fall with lactate release, suggesting that peripheral lactate metabolism has little or no influence on the shape of the lactate response curve. It is suggested thatthis early rise in lactate concentrations is the result of increased hepatic lactate production and that the timing and height of the lactate peak reflect the pattern of enhanced hepatic glucoseutilization after oral glucose loading. Our results suggest that the disposition of a 100 gm. oral glucose load is accounted for mainly by hepatic glucose conservation rather than peripheral uptake and, therefore, that the former is the major determinant of the shape of the oral glucose tolerance curve.