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Am J Physiol Endocrinol Metab 273: E1209-E1215, 1997;
0193-1849/97 $5.00
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Vol. 273, Issue 6, E1209-E1215, December 1997

SPECIAL COMMUNICATION
Quantifying gluconeogenesis during fasting

Visvanathan Chandramouli, Karin Ekberg, William C. Schumann, Satish C. Kalhan, John Wahren, and Bernard R. Landau

Departments of Medicine, Biochemistry and Pediatrics, Case Western Reserve University, Cleveland, Ohio 44106-4951; and Division of Clinical Physiology, Karolinska Hospital, S-171 76 Stockholm, Sweden

The use of 2H2O in estimating gluconeogenesis' contribution to glucose production (%GNG) was examined during progressive fasting in three groups of healthy subjects. One group (n = 3) ingested 2H2O to a body water enrichment of approx 0.35% 5 h into the fast. %GNG was determined at 2-h intervals from the ratio of the enrichments of the hydrogens at C-5 and C-2 of blood glucose, assayed in hexamethylenetetramine. %GNG increased from 40 ± 8% at 10 h to 93 ± 6% at 42 h. Another group ingested 2H2O over 2.25 h, beginning at 11 h (n = 7) and 19 h (n = 7) to achieve approx 0.5% water enrichment. Enrichment in plasma water and at C-2 reached steady state approx 1 h after completion of 2H2O ingestion. The C-5-to-C-2 ratio reached steady state by the completion of 2H2O ingestion. %GNG was 54 ± 2% at 14 h and 64 ± 2% at 22 h. A 3-h [6,6-2H2]glucose infusion was also begun to estimate glucose production from enrichments at C-6, again in hexamethylenetetramine. Glucose produced by gluconeogenesis was 0.99 ± 0.06 mg · kg-1 · min-1 at both 14 and 22 h. In a third group (n = 3) %GNG reached steady state approx 2 h after 2H2O ingestion to only approx 0.25% enrichment. In conclusion, %GNG by 2 h after 2H2O ingestion and glucose production using [6,6-2H2]glucose infusion, begun together, can be determined from hydrogen enrichments at blood glucose C-2, C-5, and C-6. %GNG increases gradually from the postabsorptive state to 42 h of fasting, without apparent change in the quantity of glucose produced by gluconeogenesis at 14 and 22 h.

deuterium oxide; glucose; glycogen; hexamethylenetetramine


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