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W W Lacy

Publications and source records attributed to W W Lacy.

At least 19 recordsLinked to original sources

Effects of insulin on glucagon-stimulated glucose production in the conscious dog.

The relative importance of insulin and glucagon as primary regulators of glucose metabolism in vivo was assessed in 18-hour fasted conscious dogs. Glucose turnover was determined using [3-3H]glucose and gluconeogenesis was assessed using tracer ([14C]alanine) and A-V difference techniques during a 40-minute control period and a 3-hour period during which various hormonal perturbations were brought about. During the infusion of somatostatin and basal intraportal replacement amounts of insulin and glucagon for the entire study, the plasma glucose concentration (109 +/- 5 mg/dL), glucose production (3.24 +/- 0.30 mg/kg/min), and glucose utilization (3.17 +/- 0.32 mg/kg/min) remained unchanged. When the glucagon infusion rate was increased fourfold at the end of the control period, the plasma glucose level increased from 107 +/- 4 to 225 +/- 23 mg/dL by 1 hour and remained elevated. Glucose production increased from 3.14 +/- 0.29 to 7.66 +/- 0.51 mg/kg/min by 15 minutes and decreased to 4.23 +/- 0.35 mg/kg/min by 3 hours. Glucose utilization rose from a basal value of 3.20 +/- 0.26 to 5.46 +/- 0.27 mg/kg/min by 3 hours. When a fourfold increase in the insulin infusion rate was brought about at the end of the control period, glucose production decreased from 2.83 +/- 0.20 to 1.16 +/- 0.57 mg/kg/min by 1 hour, after which it increased slightly (1.62 +/- 0.81 mg/kg/min). Glucose utilization increased from 2.92 +/- 0.30 to 8.12 +/- 1.12 mg/kg/min by 3 hours. Euglycemia was maintained by glucose infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine↗

Effect of alanine concentration independent of changes in insulin and glucagon on alanine and glucose homeostasis in the conscious dog.

The effect of an alanine load per se on hepatic alanine balance and hepatic glucose production is unclear. To examine this question, alanine was infused into six postabsorptive dogs at a rate of 6 mumol/kg-min, while maintaining insulin and glucagon levels using the pancreatic clamp technique. The arterial alanine concentration rose from a basal level of 227 +/- 16 mumol/L to 497 +/- 40 mumol/L during alanine infusion (P less than .01). The net hepatic fractional extraction of alanine remained unchanged, while hepatic alanine uptake increased from 3.0 +/- 0.3 to 6.0 +/- 0.4 mumol/kg-min (P less than .01). Conversion of alanine into glucose increased 87% to 2.7 +/- 0.3 mumol/kg-min during alanine infusion (P less than .01) while gluconeogenic efficiency remained essentially unchanged. Despite the increased gluconeogenic rate, the total rate of glucose production was unchanged. These data suggest that an increase in the alanine load to the liver causes a proportional increase in net hepatic alanine uptake and the gluconeogenic rate, but that in an overnight fasted animal this increase is insufficient to significantly increase glucose production.

Alanine↗

Similar dose responsiveness of hepatic glycogenolysis and gluconeogenesis to glucagon in vivo.

This study was undertaken to determine whether the dose-dependent effect of glucagon on gluconeogenesis parallels its effect on hepatic glycogenolysis in conscious overnight-fasted dogs. Endogenous insulin and glucagon secretion were inhibited by somatostatin (0.8 micrograms X kg-1 X min-1), and intraportal replacement infusions of insulin (213 +/- 28 microU X kg-1 X min-1) and glucagon (0.65 ng X kg-1 X min-1) were given to maintain basal hormone concentrations for 2 h (12 +/- 2 microU/ml and 108 +/- 23 pg/ml, respectively). The glucagon infusion was then increased 2-, 4-, 8-, or 12-fold for 3 h, whereas the rate of insulin infusion was left unchanged. Glucose production (GP) was determined with 3-[3H]glucose, and gluconeogenesis (GNG) was assessed with tracer (U-[14C]alanine conversion to [14C]glucose) and arteriovenous difference (hepatic fractional extraction of alanine, FEA) techniques. Increases in plasma glucagon of 53 +/- 8, 199 +/- 48, 402 +/- 28, and 697 +/- 149 pg/ml resulted in initial (15-30 min) increases in GP of 1.1 +/- 0.4 (N = 4), 4.9 +/- 0.5 (N = 4), 6.5 +/- 0.6 (N = 6), and 7.7 +/- 1.4 (N = 4) mg X kg-1 X min-1, respectively; increases in GNG (approximately 3 h) of 48 +/- 19, 151 +/- 50, 161 +/- 25, and 157 +/- 7%, respectively; and increases in FEA (3 h) of 0.14 +/- 0.07, 0.37 +/- 0.05, 0.42 +/- 0.04, and 0.40 +/- 0.17, respectively. In conclusion, GNG and glycogenolysis were similarly sensitive to stimulation by glucagon in vivo, and the dose-response curves were markedly parallel.

Alanine↗

Role of glutamine in adaptations in nitrogen metabolism during fasting.

The present study examines the effect of glutamine infusion on the interorgan fluxes of glutamine, alanine, urea, and ammonia with progressive fasting. Experiments were carried out in two groups of conscious dogs with catheters previously implanted in an artery and in the hepatic, portal, and renal veins. Group I (n = 12) was fasted for 24 h, and group II (n = 10) was fasted for 96 h. On the day of the study, seven animals of group I and five of group II received a constant infusion of glutamine (3.0 mumol . kg-1 . min-1) for 1 h, and the rest (controls) received saline. Four-day fasting produced ketosis with a compensated metabolic acidosis. The demand for glutamine by the kidneys and gut increased, and the liver switched from net glutamine utilization to that of net production. The kidneys (33%) and gut (230%) increased their production of ammonia, while their release of alanine decreased. The estimated efflux of glutamine by skeletal muscle, however, did not change. All of the infused glutamine was cleared by the splanchnic and renal tissues. In group I, there was increased gut production of alanine, which was matched by increased hepatic alanine uptake and urea production. No such changes were observed in Group II. There was, however, an increase in hepatic uptake of ammonia. Finally, glutamine infusion did not alter glutamine or alanine output by skeletal muscle in group I, while it decreased efflux of alanine but not that of glutamine in group II. The data emphasize the complex interdependence of the liver, gut, kidneys, and skeletal muscle in nitrogen sparing.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine↗

Relative importance of first- and second-phase insulin secretion in glucose homeostasis in conscious dog. II. Effects on gluconeogenesis.

The normal pancreatic response to an exogenous glucagon infusion is a biphasic release of insulin. In our study the ability of each component of insulin release to counter the effects of the glucagon on gluconeogenesis and alanine metabolism was assessed by mimicking first- and/or second-phase insulin release with infusions of somatostatin and intraportal insulin. When a fourfold increase in glucagon was brought about in the presence of fixed basal insulin release, there was a large increase in overall glucose production and gluconeogenesis. The increase in the conversion of [14C]alanine into [14C]glucose (169 +/- 42%, P less than .05) was accompanied by an increase in the fractional extraction of alanine by the liver (FEA 0.32 +/- 0.06 to 0.66 +/- 0.10, P less than .05) and net hepatic alanine uptake (NHAU 2.97 +/- 0.45 to 4.61 +/- 0.48 mumol . kg-1 . min-1, P less than .05). Simulated first-phase insulin release had no effect on the ability of glucagon to increase FEA (0.32 +/- 0.03 to 0.66 +/- 0.03, P less than .05) or NHAU (3.69 +/- 0.80 to 5.10 +/- 0.69 mumol . kg-1 . min-1, P less than .05) but did limit the increase in overall gluconeogenic conversion (114 +/- 37%). Second-phase insulin release had no effect on either the glucagon-induced increase in FEA (0.35 +/- 0.08 to 0.73 +/- 0.04) or NHAU (3.35 +/- 0.92 to 5.13 +/- 0.85 mumol . kg-1 . min-1) but completely inhibited the increase in overall gluconeogenic conversion.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine↗

Leupeptin's effect on organ weight, RNA, DNA, and protein content after long bone fracture in the rat.

Long bone fracture in the rat is accompanied by enhanced urinary nitrogen loss reflecting changes in protein synthesis and breakdown. The effects of leupeptin, an inhibitor of lysosomal proteases, were assessed on organ weights, RNA, DNA, and protein content after injury in the rat. Two groups of 8-week-old rats were studied: The first group received left femoral fracture. Half of these received leupeptin (25 mumole ip/day), and the remainder received saline. The second group served as uninjured pair-fed controls, with half receiving leupeptin and half receiving saline. On Days 0, 1, 2, 4, and 7 after injury, animals were sacrificed and organs were removed for determination of weight, RNA, DNA, and protein content. All injured rats lost weight, with maximum loss occurring on Day 4. Food intake was also reduced. Pair-fed rats lost the same amount of weight as injured ones, and leupeptin could not prevent whole body weight loss. Expressed as percentage of total body weight, livers from leupeptin-treated injured rats weighed 10% greater than saline-treated ones on Days 2, 4, and 7 after injury (P less than 0.05). No differences occurred in RNA, DNA, or protein contents. Diaphragms similarly weighed 10, 20, and 30% greater on Days 2, 4, and 7 after injury, respectively, in leupeptin-treated rats (P less than 0.05). In addition, the RNA and DNA contents of diaphragms were 96 and 88% greater, respectively, in treated rats than in controls (P less than 0.05) on Day 4. It is concluded that leupeptin causes a relative increase in the weights of livers and diaphragms after injury, and causes a marked increase in the RNA and DNA contents of diaphragms.

Animals↗

Beta-endorphin inhibits glucose production in the conscious dog.

The effect of human beta-endorphin (h beta E) infusion (0.2 mg/h) on glucose homeostasis was studied in 10 conscious overnight fasted dogs in which endocrine pancreatic function was fixed at basal levels with somatostatin plus intraportal replacement of basal insulin and glucagon. h beta E caused a fall in plasma glucose from 107 +/- 5 to 76 +/- 6 mg/dl by 3 h (P less than 0.01). This was due to a 25% fall in tracer-determined glucose production (Ra; P less than 0.01). A significantly larger fall in Ra was observed in four dogs in which hypoglycemia was prevented by use of an exogenous glucose infusion (45 vs. 25%, P less than 0.05). These changes occurred in the absence of changes in circulating levels of insulin, glucagon, epinephrine, norepinephrine, and cortisol. We conclude that the naturally occurring opioid peptide, beta-endorphin, inhibits glucose production by the liver in vivo. This appears to be a direct effect of the opioid on the liver, since the inhibition took place in the absence of changes in the other hormones measured. These results suggest that endorphins act on glucose homeostasis in a complex way, both by affecting other glucoregulatory hormones as demonstrated elsewhere, and by directly modulating hepatic glucose production as shown here.

Animals↗

Effects of morphine on glucose homeostasis in the conscious dog.

This study was designed to assess the effects of morphine sulfate on glucose kinetics and on glucoregulatory hormones in conscious overnight fasted dogs. One group of experiments established a dose-response range. We studied the mechanisms of morphine-induced hyperglycemia in a second group. We also examined the effect of low dose morphine on glucose kinetics independent of changes in the endocrine pancreas by the use of somatostatin plus intraportal replacement of basal insulin and glucagon. In the dose-response group, morphine at 2 mg/h did not change plasma glucose, while morphine at 8 and 16 mg/h caused a hyperglycemic response. In the second group of experiments, morphine (16 mg/h) caused an increase in plasma glucose from a basal 99 +/- 3 to 154 +/- 13 mg/dl (P less than 0.05). Glucose production peaked at 3.9 +/- 0.7 vs. 2.5 +/- 0.2 mg/kg per min basally, while glucose clearance declined to 1.7 +/- 0.2 from 2.5 +/- 0.1 ml/kg per min (both P less than 0.05). Morphine increased epinephrine (1400 +/- 300 vs. 62 +/- 8 pg/ml), norepinephrine (335 +/- 66 vs. 113 +/- 10 pg/ml), glucagon (242 +/- 53 vs. 74 +/- 14 pg/ml), insulin (30 +/- 9 vs. 10 +/- 2 microU/ml), cortisol (11.1 +/- 3.3 vs. 0.9 +/- 0.2 micrograms/dl), and plasma beta-endorphin (88 +/- 27 vs. 23 +/- 6 pg/ml); all values P less than 0.05 compared with basal. These results show that morphine-induced hyperglycemia results from both stimulation of glucose production as well as inhibition of glucose clearance. These changes can be explained by rises in epinephrine, glucagon, and cortisol. These in turn are part of a widespread catabolic response initiated by high dose morphine that involves activation of the sympathetic nervous system, the endocrine pancreas, and the pituitary-adrenal axis. Also, we report the effect of a 2 mg/h infusion of morphine on glucose kinetics when the endocrine pancreas is clamped at basal levels. Under these conditions, morphine exerts a hypoglycemic effect (25% fall in plasma glucose, P less than 0.05) that is due to inhibition of glucose production (by 25-43%, P less than 0.05). The hypoglycemia was independent of detectable changes in insulin, glucagon, epinephrine and cortisol, and was not reversed by concurrent infusion of a slight molar excess of naloxone. Therefore, we postulate that the hypoglycemic effect of morphine results from the interaction of the opiate with non-mu receptors either in the liver or the central nervous system.

Animals↗

Interorgan relationships of alanine and glutamine during fasting in the conscious dog.

This study was designed to assess the interorgan relationships of glutamine and alanine in the conscious, overnight fasted dog, and to determine changes which occur with progressive fasting. Dogs were fasted for 18 hr (n = 6), 48 hr (n = 6), and 96 hr (n = 6) prior to the study. Catheters had been previously implanted in the femoral artery, renal vein, portal vein, and hepatic vein, and were used for blood sampling at 30-min intervals during the 3-hr experimental period. Hepatic and renal blood flows were determined by indocyanine green and para-aminohippuric acid (PAH) extraction methods, respectively. Balance data (micromoles/kilogram/minute) were estimated by multiplying the appropriate arteriovenous concentration differences by blood flows. Hepatic uptake of glutamine decreased 50% after a 48-hr fast, and by 96 hr, the liver became a net producer of glutamine. Gut utilization remained constant throughout fasting. The kidney's utilization gradually increased with fasting. The hepatic extraction of alanine fell with fasting, declining to 40% of its original uptake at 96 hr. The gut's production of alanine fell during the first 48 hr of fasting, but remained stable thereafter. The kidney's production of alanine increased throughout the period of starvation. The arterial concentration of glutamine rose with fasting, while that of alanine fell even with a 48 hr fast. The liver, by becoming a net producer of glutamine, and the kidney, by increasing its production of alanine, decrease demands for peripheral release of these two amino acids, and thus may have protein-sparing actions during fasting.

Alanine↗

The effect of acute and chronic glucocorticoid excess on leucine kinetics and protein turnover in vivo.

The present studies were undertaken to assess the effects of excess cortisol on amino acid exchange in the conscious dog. Three groups of 18-hr fasted dogs with catheters chronically implanted in the femoral artery were studied: Group I (n = 6) received saline; Groups II and III (n = 5, each) received ACTH intravenously (1 U/min) for 7 hr; in addition, Group III received ACTH, 500 U/day intramuscularly for 4 days. Leucine rates of appearance (Ra) and clearance were measured using a constant infusion of L-4,5-[3H]leucine. ACTH treatment resulted in a 9-fold increase in plasma cortisol in Groups II and III (from 2 +/- 1 to 18 +/- 1 and 17 +/- 2 micrograms/dl, in II and III, respectively P less than 0.001), with no effect on either plasma insulin or glucagon. Plasma leucine (mmole/liter) increased from 118 +/- 6 (I) to 153 +/- 6 (II, P less than 0.005) to 275 +/- 35 (III, P less than 0.001). Leucine Ra (micromoles/kilogram/minute) did not change in II, but rose by 39% (P less than 0.005) in III. Clearance (milliliters/kilogram/minute) dropped from 25 +/- 2 (I) to 18 +/- 2 (II, P less than 0.005), to 15 +/- 2 (III, P less than 0.001). It is concluded that acute elevations of cortisol increased plasma leucine only by inhibiting its rate of disposal, whereas chronic elevations had a dual effect; they inhibited leucine disposal and increased its entry into the plasma compartment, suggesting an inhibition of protein synthesis and stimulation of protein breakdown.

Adrenocortical Hyperfunction↗

Failure of somatostatin to modify effect of glucagon on carbohydrate metabolism in the dog.

Somatostatin is widely used to inhibit insulin and glucagon release by the pancreas in studies of metabolic regulation in vivo. To determine whether the peptide can directly modify the metabolic effects of an increment in glucagon in overnight-fasted conscious dogs, glucagon was increased in the presence (+S) or absence (-S) of somatostatin. Either somatostatin (+S; 0.8 microgram . kg-1 . min-1) or a two-stage pancreatectomy (-S) was used to inhibit the endocrine pancreas, and at the same time replacement infusions of insulin (285-300 microU . kg-1 .min-1) and glucagon (0.65 ng . kg-1 . min-1) were given. After a 40-min control period the plasma glucagon level was raised fourfold in the presence of fixed basal insulin. Plasma insulin in both groups were similar [11 +/- 2 (+S) and 9 +/- 1 (-S) microU/ml]. Glucagon rose from 64 +/- 11 to 225 +/- 19 and 92 +/- 11 to 219 +/- 20 pg/ml in the +S and -S groups, respectively. Tracer-determined ([3-3H]glucose) glucose production rose by 5.28 +/- 1.02 (+S) and 4.25 +/- 1.12 (-S) mg . kg-1 . min-1 at 15 min and fell similarly over 3 h in both groups. Plasma glucose rose similarly in both groups peaking at 195 +/- 15 (+S) and 174 +/- 8 (-S) mg/dl. Plasma alanine fell similarly over 3 h [133 +/- 35 (+S) and 138 +/- 42 (-S) mumol/liter]. Conversion of [14C]alanine and [14C]-lactate to [14C]glucose rose progressively over 3 h in both groups, eventually being elevated by 210 +/- 58 (+S) and 148 +/- 48% (-S). We conclude that in the dog somatostatin at the dose used does not alter the effect of an increment in glucagon on carbohydrate metabolism.

Alanine↗

Leupeptin inhibits adrenocorticotropic hormone-induced protein breakdown in the conscious dog.

To elucidate the role of proteinase inhibitors in the regulation of protein breakdown in vivo, we measured the effect of leupeptin on the rate of appearance of leucine in the plasma compartment in overnight-fasted conscious dogs. Two groups of dogs were studied. The control group (I) received saline infusion, and the experimental group (II) was rendered hypercatabolic with daily administration of adrenocorticotropic hormone (ACTH) (500 U/d) for 4 d.ACTH treatment increased plasma cortisol from 2+/-0.4 to 17+/-2 mug/dl (P < 0.005). It raised plasma leucine levels (mumol/liter) from 123+/-6 in I to 206+/-5 in II (P < 0.01) and its rate of appearance into the plasma compartment (micromoles per kilogram per minute) from 3.1+/-0.1 in I to 4.6+/-0.3 in II (P < 0.01). Whole blood alanine concentration (micromoles per liter) increased by 50% (from 387+/-31 to 577+/-53, P < 0.01) and whole blood glutamine concentration (micromoles per liter) increased from 653+/-51 to 917+/-93 (P < 0.01). Leupeptin infusion in the ACTH-treated group significantly decreased both the concentration of plasma leucine and its rate of appearance. Blood glutamine declined by 30% (P < 0.05) after leupeptin, but no effect on blood alanine was observed. Leupeptin had no effect on the saline control group. These data indicate that leupeptin decreases the accelerated rate of protein breakdown induced by cortisol excess. The fact that it did not affect protein degradation in controls may indicate that control of protein breakdown in the postabsorptive state may differ from that during accelerated turnover. Thus, the antibiotic proteinase enzyme inhibitors may be potentially useful in treating conditions of inappropriate protein breakdown.

Absorption↗

The effect of thyroid hormones on gluconeogenesis and forearm metabolism in man.

The present study was designed to examine the effects of excess T3 on total body glucose production and forearm exchange of glucose, amino acids, and other metabolites. Five healthy male volunteers were studied after an overnight fast, before and 7 days after the administration of 150 micrograms/day T3. Glucose production (milligrams per kg/min) was measured using a primed continuous infusion of [3-3H]glucose and gluconeogenic index (micromoles per kg/min) was measured by following the conversion of infused [14C]alanine to [14C]glucose. Blood flow across the forearm was measured using capacitance plethysmography and forearm release of substrates was determined by the Fick principle. After T3 administration, there was a 3.7-fold rise in T3 from 150 +/- 15 to 530 +/- 12 ng/dl (P less than 0.001), with no change in insulin (12 +/- 1 microU/ml pre-T3 vs. 13 +/- 2 microU/ml post-T3) and glucagon (79 +/- 5 pre-T3 vs. 84 +/- 7 pg/ml post-T3). T3 administration resulted in an increase in plasma glucose (from 83 +/- 5 to 98 +/- 5 mg/dl; P less than 0.05), net glucose uptake by the forearm (from 250 +/- 90 to 712 +/- 60 nmol/100 ml forearm tissue X min; P less than 0.005) and glucose production (1.7 +/- 0.09 to 2.2 +/- 0.08 mg/kg X min; P less than 0.005), without a change in glucose clearance (2.1 +/- 0.02 vs. 2.0 +/- 0.02 ml/kg X min); the rate of conversion of [14C]alanine to [14C]glucose increased by 30% (0.56 +/- 0.03 to 0.74 +/- 0.03 mumol/ kg X min P less than 0.005). These values were associated with a 25% increase in blood lactate to 712 +/- 69 mumol/liter (P less than 0.05) and a 131% increase in lactate release across the forearm to 434 +/- 90 (P less than 0.005). Forearm release of alanine (96 +/- 29 nmol/100 ml forearm tissue X min) and glutamine (151 +/- 41 nmol/100 ml forearm tissue X min) increased by 90% (P less than 0.005 and P = 0.04, respectively), with no change in their concentrations. Forearm release of branched chain amino acids did not change, while those of their ketoacids, alpha-ketoisocaproate (KIC) and alpha-ketoisovalerate (KIV), doubled (to 64 +/- 9 mumol/liter for KIC and 39 +/- 6 mumol/liter for KIV; P less than 0.05). These were associated with a 45% increase in the branched chain amino acid levels and a 46% rise in both KIC and KIV levels to 41 +/- 9 and 28 +/- 7 mumol/liter, respectively (P less than 0.05). There was a concurrent significant (P less than 0.05) change in the arterial levels of phenylalanine (-32%), tyrosine (-29%), threonine (-20%), glycine (-20%), and serine (-15%), without any change in their efflux across the forearm. The data indicate that a pharmacologically induced rise in T3, to levels comparable to those seen in hyperthyroidism, results in enhanced glucose production, with an increase in glucose uptake by the forearm. The former can be partially accounted for by an increase in hepatic gluconeogenesis, glycogenolysis, or possibly increased renal glucose production...

Adult↗

Insulin as a mediator of hepatic glucose uptake in the conscious dog.

The aim of this study was to determine whether a physiological increment in plasma insulin could promote substantial hepatic glucose uptake in response to hyperglycemia brought about by intravenous glucose infusion in the conscious dog. To accomplish this, the plasma glucose level was doubled by glucose infusion into 36-h fasted dogs maintained on somatostatin, basal glucagon, and basal or elevated intraportal insulin infusions. In the group with basal glucagon levels and modest hyperinsulinemia (33 +/- 2 micro U/ml), the acute induction of hyperglycemia (mean increment of 120 mg/dl) caused marked net hepatic glucose uptake (3.7 +/- 0.5 mg . kg-1 . min-1). In contrast, similar hyperglycemia brought about in the presence of basal glucagon and basal insulin levels described net hepatic glucose output in 56%, but did not cause net hepatic glucose uptake. The length of fast was not crucial to the response because similar signals (insulin, 38 +/- 6 micro U/ml; glucose increment, 127 mg/dl) promoted identical net hepatic glucose uptake (3.8 +/- 0.6 mg . kg-1 . min-1) in dogs fasted for only 16 h. In conclusion, in the conscious dog, a) physiologic increments in plasma insulin have a marked effect on the ability of hyperglycemia to stimulate net hepatic glucose uptake, and b) it is not necessary to administer glucose orally to promote substantial net hepatic glucose uptake.

Animals↗

Absorption and disposition of a glucose load in the conscious dog.

The quantitative disposition of an intragastrically administered glucose load was studied in eight conscious 18-h fasted dogs using isotopic and arteriovenous (A-V) techniques. During the control period, the gut utilized 25% of the basal net hepatic glucose output (2.8 +/- 0.2 mg.kg-1.min-1). After glucose ingestion, 80% of the load was absorbed as glucose, 11% was converted across the gut to lactate and alanine, and 4% was oxidized to CO2. Two percent of the load remained in the gut 4 h after glucose administration and 3% was unaccounted for. During the absorptive period, net hepatic glucose balance (NHGB) varied considerably (mean range = output of 1.8 to uptake of 9.1 mg.kg-1.min-1), while endogenous hepatic glucose production (Ra hp) showed a consistent 80% suppression. The total net hepatic glucose uptake during the absorptive period (150 +/- 10 min) accounted for the disposal of 24 +/- 10% of the ingested load, and the amount of glucose escaping the splanchnic bed was 40 +/- 3%. Overall NHGB correlated positively with basal arterial glucose and insulin levels and negatively with basal arterial glycerol and FFA and with peak absorptive arterial glucose and insulin levels. These data suggest that the hepatic response to an ingested glucose load depends in part on the degree of metabolic fast of the animal at the time of glucose ingestion; the latter may be a major determinant of the roles played by the tissues in glucose disposal.

Absorption↗

Disposal of alpha-ketoisocaproate: roles of liver, gut, and kidneys.

The alpha-keto analogues of the branched-chain amino acids, and particularly that of leucine, alpha-ketoisocaproate (KIC), have been found to reduce urea synthesis and as a result have been proposed for the treatment of uremia and portal systemic encephalopathy. Because little is known about the fate of these keto acids in the intact animal, we examined the disposal of a KIC load in five conscious overnight-fasted dogs with catheters previously implanted in an artery, and in the portal, hepatic, and renal veins. During the absorptive period (54 +/- 9 min; range, 20-75 min), 62 +/- 5% of the administered load (6,358 +/- 662 mumol) of the keto acid was absorbed as KIC and 23 +/- 3% was transaminated across the gut and entered as leucine. The hepatic uptake of KIC was equivalent to 35 +/- 5% (2.316 +/- 419 mumol) of the administered load, and of that, one-third was transaminated to leucine and two-thirds were converted to ketone bodies. The splanchnic output of KIC amounted to 1,732 +/- 256 mumol of 27 +/- 2% of the administered load, half of which was transaminated across the kidneys to leucine. As a result, the amount of KIC reaching the extrahepatic extrarenal tissues as KIC carbon amounted to 15% of the load administered. We conclude that the majority of an intragastrically administered KIC load reaches the (extrarenal) peripheral tissues in the form of leucine or ketone bodies. The study also underscores the importance of the "gut," the kidneys, and the liver in metabolism of the absorbed KIC load.

Amino Acids, Branched-Chain↗