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Sources of hepatic glucose production by 2H2O ingestion and Bayesian analysis of 2H glucuronide enrichment

✍ Scribed by T.C. Delgado; C. Barosa; M.M.C.A. Castro; C.F.G.C. Geraldes; M. Bastos; C. Baptista; A. Fagulha; L. Barros; A. Mota; M. Carvalheiro; J.G. Jones; Matthew Merritt

Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
177 KB
Volume
60
Category
Article
ISSN
0740-3194

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✦ Synopsis

Abstract

The contribution of gluconeogenesis to hepatic glucose production (GP) was quantified after ^2^H~2~O ingestion by Bayesian analysis of the position 2 and 5 ^2^H‐NMR signals (H2 and H5) of monoacetone glucose (MAG) derived from urinary acetaminophen glucuronide. Six controls and 10 kidney transplant (KTx) patients with cyclosporine A (CsA) immunosuppressant therapy were studied. Seven KTx patients were lean and euglycemic (BMI = 24.3 Β± 1.0 kg/m^2^; fasting glucose = 4.7 Β± 0.1 mM) while three were obese and hyperglycemic (BMI = 30.5 Β± 0.7 kg/m^2^; fasting glucose = 7.1 Β± 0.5 mM). For the 16 spectra analyzed, the mean coefficient of variation for the gluconeogenesis contribution was 10% Β± 5%. This uncertainty was associated with a mean signal‐to‐noise ratio (SNR) of 79:1 and 45:1 for the MAG H2 and H5 signals, respectively. For control subjects, gluconeogenesis contributed 54% Β± 7% of GP as determined by the mean and standard deviation (SD) of individual Bayesian analyses. For the lean/normoglycemic KTx subjects, the gluconeogenic contribution to GP was 62% Β± 7% (P = 0.06 vs. controls), while hyperglycemic/obese KTx patients had a gluconeogenic contribution of 68% Β± 3% (P < 0.005 vs. controls). These data suggest that in KTx patients, an increased gluconeogenic contribution to GP is strongly associated with obesity and hyperglycemia. Magn Reson Med 60:517–523, 2008. Β© 2008 Wiley‐Liss, Inc.

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