The Role of Intramyocellular Lipids during Hypoglycemia in Patients with Intensively Treated Type 1 Diabetes
| العنوان: | The Role of Intramyocellular Lipids during Hypoglycemia in Patients with Intensively Treated Type 1 Diabetes |
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| المؤلفون: | Elisabeth Bernroider, Michael Roden, Christian Anderwald, Attila Brehm, Martin Krššák, Gerald I. Shulman, Gary W. Cline, Zlatko Trajanoski |
| المصدر: | The Journal of Clinical Endocrinology & Metabolism. 90:5559-5565 |
| بيانات النشر: | The Endocrine Society, 2005. |
| سنة النشر: | 2005 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Glycerol, Male, medicine.medical_specialty, Epinephrine, Hydrocortisone, Lipolysis, Microdialysis, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Context (language use), Fatty Acids, Nonesterified, Hypoglycemia, Biochemistry, Endocrinology, Diabetes mellitus, Internal medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Intramyocellular lipids, Infusions, Intravenous, Muscle, Skeletal, Muscle Cells, Type 1 diabetes, business.industry, Biochemistry (medical), Glucagon, Lipid Metabolism, medicine.disease, Kinetics, Diabetes Mellitus, Type 1, Glucose, Hemoglobin A, Adipose Tissue, business, Body mass index |
| الوصف: | Endocrine defensive mechanisms provide for energy supply during hypoglycemia. Intramyocellular lipids (IMCL) were recently shown to contribute to energy supply during exercise.The objective of this study was to assess the contribution of IMCL compared with lipolysis and endogenous glucose production (EGP) to insulin-mediated hypoglycemia counterregulation in patients with type 1 diabetes mellitus (T1DM).This was a prospective explorative study performed in a university research facility.Six well-controlled T1DM (age, 29 +/- 4 yr; body mass index, 23.4 +/- 1.0 kg/m2; hemoglobin A1c, 6.3 +/- 0.1%) and six nondiabetic humans (controls; age, 28 +/- 2 yr; body mass index, 23.4 +/- 1.0 kg/m2; hemoglobin A1c, 5.1 +/- 0.1%) were studied.We performed 240-min hypoglycemic (approximately 3 mM)-hyperinsulinemic (0.8 mU/kg x min) clamps on separate days to measure: 1) systemic lipolysis ([2H5]glycerol turnover), EGP ([6,6-(2)H2]glucose), and local lipolysis in abdominal s.c. adipose tissue and gastrocnemius muscle (microdialysis); and 2) IMCL (by 1H nuclear magnetic resonance spectroscopy) in soleus and tibialis anterior muscle.The main outcome measures were changes in IMCL during prolonged hypoglycemia.At baseline, EGP, glycerol turnover, and IMCL were not different between the groups. During hypoglycemia, hormonal counterregulation was blunted in T1DM (peak: glucagon, 68 +/- 4 vs. 170 +/- 37 pg/ml; cortisol, 16 +/- 2 vs. 24 +/- 2 microg/dl; epinephrine, 274 +/- 84 vs. 597 +/- 212 pg/ml; all P0.05 vs. control). T1DM had approximately 50% lower EGP (4.6 +/- 0.6 vs. 10.9 +/- 0.5 micromol/kg x min; P0.005), but approximately 40% higher glycerol turnover (374 +/- 21 vs. 272 +/- 19 micromol/kg x min; P0.01). Glycerol concentrations in muscle (T1DM, 302 +/- 22 control, 346 +/- 17 micromol/liter) and adipose tissue (264 +/- 25 vs. 318 +/- 25 micromol/liter) did not differ between groups. IMCL in soleus and tibialis anterior muscle did not change from baseline during hypoglycemia.In well-controlled T1DM, impaired hypoglycemia counterregulation is associated with decreased glucose production and augmented whole body lipolysis, which cannot be explained by either hydrolysis of muscle triglycerides or increased abdominal s.c. adipose tissue lipolysis. |
| تدمد: | 1945-7197 0021-972X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::951ded1df5cb24ff09b3b692048e286cTest https://doi.org/10.1210/jc.2004-1756Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....951ded1df5cb24ff09b3b692048e286c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19457197 0021972X |
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