The effect of carbohydrate intake on the lipolytic rate in depleted patients.
The effect of carbohydrate intake on the lipolytic rate in depleted patients.
复制标题
碳水化合物摄入量对耗竭患者脂肪分解率的影响。
DOI：
10.1016/0026-0495(80)90042-6
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发表时间：
1980
期刊：
影响因子：
--
通讯作者：
J. Kinney
中科院分区：
文献类型：
--
作者：
Y. Carpentier;J. Askanazi;D. Elwyn;F. Gump;J. Nordenström;J. Kinney
对6例需要全肠外营养的营养衰竭外科患者，评估了静脉碳水化合物摄入对甘油周转和脂肪代谢的影响。给出了两种饮食方案。两种饮食中的氮摄入量是相同的。根据不同的葡萄糖摄入量调整的卡路里摄入量，提供了测量的静息能量消耗的72%或128%。在开始全肠外营养前和每种饮食4天后再次给予5%葡萄糖溶液期间，测量甘油转换率。甘油周转率与血浆浓度密切相关。然而，部分周转率仅为正常值的三分之二，表明清除能力降低可能是由于肝脏血流量减少。随着葡萄糖摄入量的增加，甘油周转率、血浆游离脂肪酸浓度和脂肪氧化率逐渐下降。与这些结果相比，以前对受伤和败血症患者的研究显示：甘油周转、FFA浓度和脂肪氧化的值较高；甘油周转和浓度之间的相关性较差；高糖摄入时脂肪生成受到抑制；去甲肾上腺素的排泄率较高。结果提示，在严重损伤时，逆调节激素可几乎完全阻断胰岛素对激素敏感脂肪酶的作用，但对胰岛素刺激FFA酯化和抑制酮体合成的影响较小。
The effect of intravenous carbohydrate intake on glycerol turnover and fat metabolism was estimated in six nutritionally depleted surgical patients requiring total parenteral nutrition. Two diets were given. Nitrogen intake was the same in both diets. The calorie intake, adjusted by varying glucose intake, provided either 72% or 128% of the measured resting energy expenditure. Glycerol turnover was measured during administration of 5% dextrose solutions before starting total parenteral nutrition, and again after 4 days on each diet. Turnover rates of glycerol were closely correlated with plasma concentrations. However, fractional turnover rates were only two-thirds of normal values, indicating decreased clearance possibly due to decreased hepatic blood flow. Glycerol turnover, plasma free fatty acid concentrations, and the rate of fat oxidation declined progressively with increased glucose intake. When compared with these results, previous studies of injured and septic patients showed: higher values for glycerol turnover, FFA concentrations, and fat oxidation; poor correlation between glycerol turnover and concentration; inhibition of lipogenesis at high glucose intake; and high rates of norepinephrine excretion. The data suggest that in severe injury, counter regulatory hormones may almost completely block the effects of insulin on hormone sensitive lipase but have less influence on insulin stimulation of FFA esterification and inhibition of ketone body synthesis.