Splanchnic tissues play a crucial role in uremic glucose intolerance.

Abstract

OBJECTIVE:

Determine the mechanism of glucose intolerance in chronically uremic subjects.

DESIGN:

Comparison of doubly labeled oral glucose tolerance tests.

SUBJECTS:

Seven nondialyzed chronically uremic subjects (creatinine, 420 +/- 104 micromol/L) and 7 healthy subjects, matched for age and body mass index.

INTERVENTION:

Plasma glucose was labeled by an infusion of dideuterated glucose started 120 minutes before ingestion of 1 g/kg of naturally 13C-enriched corn starch glucose. Glucose levels and oxidation were monitored for 330 minutes after glucose ingestion.

RESULTS:

Uremic subjects had normal fasting plasma glucose levels and impaired glucose tolerance with high plasma insulin (P <.001 versus controls). Glucose tolerance was impaired because of an increased total rate of appearance of glucose (cumulated on 330 minutes: uremic, 1,231 +/- 42 mg/kg/330 min, controls, 1,031 +/- 64; P <.05). Peripheral glucose uptake was increased (P <.05) because of an increased nonoxidative disposal (P =.051).

CONCLUSIONS:

Although peripheral glucose uptake resisted the stimulatory effect of the high insulin levels, glucose tolerance was impaired through splanchnic metabolic disturbances: reduced splanchnic glucose uptake and increased endogenous glucose production. The respective contribution of these abnormalities remains to be determined.

• Authors: Vincent Rigalleau, Laurence Baillet, Catherine Lasseur, Karine Moreau, Philippe Chauveau, Michel Aparicio, Sylvie Normand, Michel Desage, Martine Laville, Gérard Deleris, Christian Combe, Henri Gin
• Journal: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation (J Ren Nutr) Vol. 13 Issue 3 Pg. 212-8 (Jul 2003) ISSN: 1532-8503 [Electronic] United States
• PMID: 12874746 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Insulin
• Deuterium
• Glucose

Topics

• Blood Glucose (analysis)
• Case-Control Studies
• Deuterium
• Female
• Glucose (administration & dosage, metabolism)
• Glucose Intolerance (etiology)
• Glucose Tolerance Test
• Humans
• Insulin (blood)
• Male
• Middle Aged
• Oxidation-Reduction
• Uremia (blood, complications, metabolism)
• Viscera (metabolism)