Περίληψη:
According to current textbook wisdom the liver is the exclusive site of
glucose production in humans in the postabsorptive state. Although many
animal and in vitro data have documented that the kidney is capable of
gluconeogenesis, production of glucose by the human kidney in the
postabsorptive state has generally been regarded as negligible. This
traditional view is based on net balance measurements which, other than
after a prolonged fast or during metabolic acidosis, showed no
significant net renal glucose release. However, recent studies have
refuted this view by combining isotopic and balance techniques, which
have demonstrated that renal glucose production accounts for 25% of
systemic glucose production. Moreover, these studies indicate that
glucose production by the human kidney is stimulated by epinephrine,
inhibited by insulin and is excessive in diabetes mellitus. Since renal
glucose release is largely, if not exclusively, due to gluconeogenesis,
it is likely that the kidney is as important a gluconeogenic organ as
the liver. The most important renal gluconeogenic precursors appear to
be lactate, glutamine and glycerol. The implications of these recent
findings on the understanding of the physiology and pathophysiology of
human glucose metabolism are discussed.
Συγγραφείς:
Stumvoll, M
Meyer, C
Mitrakou, A
Nadkarni, V
Gerich, JE
