The objective of this study was to investigate the relationship between plasma and brain glucose levels during euglycemia and hypoglycemia in healthy subjects and patients with type 1 diabetes mellitus (T1DM). Hyperinsulinemic euglycemic (5 mmol/L) and hypoglycemic (3 mmol/L) [1-(13)C]glucose clamps were performed in eight healthy subjects and nine patients with uncomplicated T1DM (HbA(1c) 7.7 ± 1.4%). Brain glucose levels were measured by (13)C magnetic resonance spectroscopy. Linear regression analysis was used to fit the relationship between plasma and brain glucose levels and calculate reversible Michaelis-Menten (MM) kinetic parameters. Brain glucose values during euglycemia (1.1 ± 0.4 μmol/g vs. 1.1 ± 0.3 μmol/g; P = 0.95) and hypoglycemia (0.5 ± 0.2 μmol/g vs. 0.6 ± 0.3 μmol/g; P = 0.52) were comparable between healthy subjects and T1DM patients. MM kinetic parameters of combined data were calculated to be maximum transport rate/cerebral metabolic rate of glucose (T(max)/CMR(glc)) = 2.25 ± 0.32 and substrate concentration at half maximal transport (K(t)) = 1.53 ± 0.88 mmol/L, which is in line with previously published data obtained under hyperglycemic conditions. In conclusion, the linear MM relationship between plasma and brain glucose can be extended to low plasma glucose levels. We found no evidence that the plasma to brain glucose relationship or the kinetics describing glucose transport over the blood-brain barrier differ between healthy subjects and patients with uncomplicated, reasonably well-controlled T1DM.

译文

:这项研究的目的是研究健康受试者和1型糖尿病(T1DM)患者在正常血糖和低血糖期间血浆与脑葡萄糖水平之间的关系。高血糖正常血糖(5 mmol / L)和低血糖(3 mmol / L)[1-(13)C]葡萄糖钳夹法在8例健康受试者和9例单纯T1DM(HbA(1c)7.7±1.4%)患者中进行。脑葡萄糖水平通过(13)C磁共振波谱法测量。使用线性回归分析来拟合血浆和脑葡萄糖水平之间的关系,并计算可逆的迈克尔斯-门腾(MM)动力学参数。在正常血糖(1.1±0.4μmol/ g vs. 1.1±0.3μmol/ g; P = 0.95)和低血糖(0.5±0.2μmol/ g vs. 0.6±0.3μmol/ g; P = 0.52)期间的脑葡萄糖值之间具有可比性健康受试者和T1DM患者。组合数据的MM动力学参数计算为最大葡萄糖转运速率/脑代谢速率(T(max)/ CMR(glc))= 2.25±0.32和最大转运量一半时的底物浓度(K(t))= 1.53± 0.88 mmol / L,与先前在高血糖条件下获得的数据相符。总之,血浆和脑葡萄糖之间的线性MM关系可以扩展到低血糖水平。我们没有发现证据表明血浆与脑部葡萄糖之间的关系或描述通过血脑屏障进行葡萄糖转运的动力学在健康受试者和未受复杂控制且合理控制的T1DM患者之间存在差异。

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