TOTAL-BODY AND MYOCARDIAL SUBSTRATE OXIDATION IN CONGESTIVE-HEART-FAILURE
TOTAL-BODY AND MYOCARDIAL SUBSTRATE OXIDATION IN CONGESTIVE-HEART-FAILURE
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DOI：
10.1016/0026-0495(94)90241-0
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发表时间：
1994-02-01
影响因子：
9.8
通讯作者：
DONOFRIO, F
中科院分区：
文献类型：
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作者：
PAOLISSO, G;GAMBARDELLA, A;DONOFRIO, F
充血性心力衰竭是一种与血浆去甲肾上腺素水平升高相关的疾病，已被证明会损害葡萄糖处理。在本研究中，10 名患有充血性心力衰竭的患者和 10 名年龄和体重指数匹配的健康受试者接受高胰岛素（胰岛素输注速率，0.5 mU/kg·min−1）葡萄糖钳夹，同时进行 3 H-葡萄糖输注和间接量热法，分别测定葡萄糖周转参数和底物氧化。在另一天，还进行了基础局部（心肌）间接量热测定。我们的数据表明，在充血性心力衰竭中，空腹心肌葡萄糖氧化 (Gox) 受到抑制，同时脂质氧化 (Lox) 增加。在我们的患者中，还发现全身胰岛素刺激的葡萄糖代谢（31.0±0.5v20.3±0.4μmol/kg·min−1，P<.01）和非氧化葡萄糖代谢（18.9±1.1v11.0±0.5μmol/kg·min−1，P<.05）显着下降。后者的变化也与 Lox 同时超速有关 (0.4 ± 0.2v1.9 ± 0.2 μmol/kg · min−1,P< .02)，这与血浆游离脂肪酸 (FFA) 可用性的增强相关。
Congestive heart failure is a condition associated with increased plasma norepinephrine levels, which have been demonstrated to impair glucose handling. In the present study, 10 patients suffering from congestive heart failure and 10 healthy age- and body mass index-matched subjects were submitted to a hyperinsulinemic (insulin infusion rate, 0.5 mU/kg · min−1) glucose clamp, while simultaneousd-3H-glucose infusion and indirect calorimetry allowed for determination of glucose turnover parameters and substrate oxidation, respectively. On a separate day, basal local (myocardial) indirect calorimetry was also performed. Our data demonstrate that in congestive heart failure, fasting myocardial glucose oxidation (Gox) was inhibited with a simultaneous increase in lipid oxidation (Lox). In our patients, a significant decrease in total-body insulin-stimulated glucose metabolism (31.0 ± 0.5v20.3 ± 0.4 μmol/kg · min−1,P< .01) and nonoxidative glucose metabolism (18.9 ± 1.1v11.0 ± 0.5 μmol/kg · min−1,P< .05) was also found. Such latter changes were also associated with a simultaneous overdrive of Lox (0.4 ± 0.2v1.9 ± 0.2 μmol/kg · min−1,P< .02) that was correlated with an enhanced availability of plasma free fatty acids (FFAs).