ADRENERGIC-MECHANISMS CONTRIBUTE TO THE LATE PHASE OF HYPOGLYCEMIC GLUCOSE COUNTERREGULATION IN HUMANS BY STIMULATING LIPOLYSIS
ADRENERGIC-MECHANISMS CONTRIBUTE TO THE LATE PHASE OF HYPOGLYCEMIC GLUCOSE COUNTERREGULATION IN HUMANS BY STIMULATING LIPOLYSIS
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DOI：
10.1172/jci115809
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发表时间：
1992-06-01
影响因子：
15.9
通讯作者：
BOLLI, GB
中科院分区：
文献类型：
--
作者：
FANELLI, CG;DEFEO, P;BOLLI, GB
在9名正常志愿者身上进行了三项研究，以评估儿茶酚胺介导的脂肪分解是否有助于抵消低血糖的调节。在这三个研究中，胰岛素静脉滴注8h(0.30mU·kg-1.min-1从0到180min，0.40mU·kg-1.min-1到480min)。在研究I(对照研究)中，只输注胰岛素；在研究II(儿茶酚胺的直接+间接效应)中，将心得安和酚妥拉明叠加到胰岛素中，并输入外源性葡萄糖，以复制与研究I相同的血糖(PG)浓度。研究III(儿茶酚胺的间接效应)与研究II相同，除了肝素(80min后0.2U·kg~(-1)·min~(-1))、10%Intralipid(160min后1ml.min~(-1))和与研究II的PG相匹配的可变葡萄糖。测定葡萄糖生成量(HGO)、葡萄糖利用率(RD)、[3-H-3]葡萄糖、葡萄糖氧化和脂肪氧化(LO)(间接量热法)。在所有三个研究中，PG从几乎相等的4.8降到几乎相等的2.9 mmol/L(P=研究之间的NS)，而血浆甘油和FFA在120分钟时降至最低点。随后，在研究I中，血浆甘油和FFA在480分钟时几乎相等地升高到75%，但在研究II中，它们仍然几乎相等--比研究I低40%，而在研究III中，它们与研究I一样反弹(P=NS)。研究组LO低于研究组(1.69±0.13 vs 3.53±0.19 mU·kg~(-1)·min~(-1)，P<0.05)，60~480分钟HGO亦低于研究组(7.48±0.57 vs 11.6±0.35 mU·kg~(-1)·min~(-1)，P<0.05)。
Three studies were performed on nine normal volunteers to assess whether catecholamine-mediated lipolysis contributes to counterregulation to hypoglycemia. In these three studies, insulin was intravenously infused for 8 h (0.30 mU.kg-1.min-1 from 0 to 180 min, and 0.40 mU.kg-1.min-1 until 480 min). In study I (control study), only insulin was infused; in study II (direct + indirect effects of catecholamines), propranolol and phentolamine were superimposed to insulin and exogenous glucose was infused to reproduce the same plasma glucose (PG) concentration of study I. Study III (indirect effect of catecholamines) was the same as study II, except heparin (0.2 U.kg-1.min-1 after 80 min), 10% Intralipid (1 ml.min-1 after 160 min) and variable glucose to match PG of study II, were also infused. Glucose production (HGO), glucose utilization (Rd) [3-H-3]glucose, and glucose oxidation and lipid oxidation (LO) (indirect calorimetry) were determined. In all three studies, PG decreased from almost-equal-to 4.8 to almost-equal-to 2.9 mmol/liter (P = NS between studies), and plasma glycerol and FFA decreased to a nadir at 120 min. Afterwards, in study I plasma glycerol and FFA increased by almost-equal-to 75% at 480 min, but in study II they remained almost-equal-to 40% lower than in study I, whereas in study III they rebounded as in study I (P = NS). In study II, LO was lower than in study I (1.69+/-0.13 vs. 3.53+/-0.19-mu-mol.kg-1.min-1, P < 0.05); HGO was also lower between 60 and 480 min (7.48+/-0.57 vs. 11.6+/-0.35-mu-mol.kg-1.min-1, P