Fuel Metabolism in Starvation
Tóm tắt
▪ Abstract This article, which is partly biographical and partly scientific, summarizes a life in academic medicine. It relates my progress from benchside to bedside and then to academic and research administration, and concludes with the teaching of human biology to college undergraduates. My experience as an intern (anno 1953) treating a youngster in diabetic ketoacidosis underscored our ignorance of the controls in human fuel metabolism. Circulating free fatty acids were then unknown, insulin could not be measured in biologic fluids, and β-hydroxybutyric acid, which was difficult to measure, was considered by many a metabolic poison. The central role of insulin and the metabolism of free fatty acids, glycerol, glucose, lactate, and pyruvate, combined with indirect calorimetry, needed characterization in a near-steady state, namely prolonged starvation. This is the main topic of this chapter. Due to its use by brain, D-β-hydroxybutyric acid not only has permitted man to survive prolonged starvation, but also may have therapeutic potential owing to its greater efficiency in providing cellular energy in ischemic states such as stroke, myocardial insufficiency, neonatal stress, genetic mitochondrial problems, and physical fatigue.
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Tài liệu tham khảo
Cahill GF, 2005, Pharos, 68, 8
Cahill GF, 1972, Handbook of Physiology, Section 7: Endocrinology, 563
Cahill GF, 2003, Trans. Am. Clin. Climatol. Assoc., 114, 149
Hannaford MC, 1982, Am. J. Physiol., 243, E251
Lardy HA, 1945, Arch. Biochem., 6, 53
McKinlay WL. 1976.The Last Voyage of the Karluk. A Survivor's Memoir of Arctic Disaster. New York: Martin's Press. 168pp.
Pozefsky T, 1968, Assoc. Am. Physicians, 81, 258
Renold AE, Cahill GF Jr, eds. 1965.Handbook of Physiology, Section 5: Adipose Tissue.Washington, DC: Am. Physiol. Soc. 824pp.
Ruderman NB, 1976, Gluconeogenesis: Its Regulation in Mammalian Species, 515
Schneider ED, Sagan D. 2005.Into the Cool: Energy Flow, Thermodynamics and Life.Chicago: Univ. Chicago Press. 362pp.
Stadtlander Lu JJ, Morgan-Boyd RL, Nelson RA, Peper RL. 2000. Serum chemistries in black bears in active and denning sites.FASEB J.14(4), Abstract 451.5
Suzuki M, 2001, J. Pharmacol., 87, 143
Tilney NL. 2003.Transplant, from Myth to Reality.New York: Donnelley. 320pp.