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Departments of Medicine, Biochemistry and Pediatrics, Case Western Reserve University, Cleveland, Ohio 44106-4951; and Division of Clinical Physiology, Karolinska Hospital, S-171 76 Stockholm, Sweden
The use of
2H2O
in estimating gluconeogenesis' contribution to glucose production
(%GNG) was examined during progressive fasting in three groups of
healthy subjects. One group (n = 3)
ingested 2H2O
to a body water enrichment of 
0.35% 5 h into the fast. %GNG was
determined at 2-h intervals from the ratio of the enrichments of the
hydrogens at C-5 and C-2 of blood glucose, assayed in
hexamethylenetetramine. %GNG increased from 40 ± 8% at 10 h to 93 ± 6% at 42 h. Another group ingested
2H2O
over 2.25 h, beginning at 11 h (n = 7)
and 19 h (n = 7) to achieve 0.5%
water enrichment. Enrichment in plasma water and at C-2 reached steady
state 1 h after completion of
2H2O
ingestion. The C-5-to-C-2 ratio reached steady state by the completion
of
2H2O
ingestion. %GNG was 54 ± 2% at 14 h and 64 ± 2% at 22 h. A 3-h
[6,6-2H2]glucose
infusion was also begun to estimate glucose production from enrichments
at C-6, again in hexamethylenetetramine. Glucose produced by
gluconeogenesis was 0.99 ± 0.06 mg · kg
1 · min1
at both 14 and 22 h. In a third group
(n = 3) %GNG reached steady state
2 h after
2H2O
ingestion to only 0.25% enrichment. In conclusion, %GNG by 2 h
after
2H2O
ingestion and glucose production using
[6,6-2H2]glucose
infusion, begun together, can be determined from hydrogen enrichments
at blood glucose C-2, C-5, and C-6. %GNG increases gradually from the
postabsorptive state to 42 h of fasting, without apparent change in the
quantity of glucose produced by gluconeogenesis at 14 and 22 h.
deuterium oxide; glucose; glycogen; hexamethylenetetramine
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