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1 Nemours Children's Clinic, Jacksonville, Florida 32207; 2 Centre d'Investigation Clinique, Hôpital Robert-Debré, Paris, France; 3 US Department of Agriculture Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas 77030; and 4 Unité 539, Institut National de La Santé et de la Recherche Médicale, Centre de Recherche en Nutrition Humaine, Hôpital Hotel-Dieu, 44093 Nantes, France
To determine the effect
of glucose availability on glutamine metabolism, glutamine kinetics
were assessed under conditions of hyperglycemia resulting from
1) intravenous infusion of 7.5% dextrose in healthy adults
and 2) insulin deficiency in young adults with
insulin-dependent diabetes mellitus (IDDM). Eight healthy adults and
five young adults with IDDM were studied in the postabsorptive state by
use of a primed continuous infusion of
D-[U-14C]glucose,
L-[5,5,5-2H3]leucine, and
L-[3,4-13C]glutamine. Whether resulting from
insulin deficiency or dextrose infusion, the rise in plasma glucose was
associated with increased glucose turnover (23.5 ± 0.7 vs.
12.9 ± 0.3 µmol · kg
1 · min
1,
P < 0.01 and 20.9 ± 2.5 vs. 12.8 ± 0.4 µmol · kg
1 · min
1,
P = 0.03, in health and IDDM, respectively). In both
cases, high blood glucose failed to alter glutamine appearance rate
(Ra) into plasma [298 ± 9 vs. 312 ± 14 µmol · kg
1 · h
1,
not significant (NS) and 309 ± 23 vs 296 ± 26 µmol · kg
1 · h
1, NS, in
health and IDDM, respectively] and the estimated fraction of glutamine
Ra arising from de novo synthesis (210 ± 7 vs.
217 ± 10 µmol · kg
1 · h
1, NS and
210 ± 16 vs. 207 ± 21 µmol · kg
1 · h
1, NS, in
health and IDDM, respectively). When compared with the euglycemic day,
the apparent contribution of glucose to glutamine carbon skeleton
increased when high plasma glucose resulted from intravenous dextrose
infusion in healthy volunteers (10 ± 0.8 vs. 4.8 ± 0.3%,
P < 0.01) but failed to do so when hyperglycemia resulted from insulin deficiency in IDDM. We conclude that
1) the contribution of glucose to the estimated rate of
glutamine de novo synthesis does not increase when elevation of plasma
glucose results from insulin deficiency, and 2) the transfer
of carbon from glucose to glutamine may depend on insulin availability.
leucine; isotope labeling; energy metabolism; substrate cycling; nutrition
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