Feeding, fasting and starvation: factors affecting fuel utilization.

نویسندگان

  • I A MacDonald
  • J Webber
چکیده

Cet article porte sur le mCtabolisme de 1’Cnergie et l’utilisation des substrats dans la sous-alimentation. I1 s’intkresse particulikrement aux Ctudes sur l’homme, bien que des Ctudes sur l’animal soient Cgalement prises en compte, avec des distinctions entre le jeiine aigu (jusqu’h 4 jours), des pCriodes plus longues de sous-alimentation et la dCficience chronique en Cnergie (comme dans la sous-alimentation grave et prolongCe). I1 y a des augmentations significatives de la lipolyse du tissu adipeux et la gluconkogenkse hCpatique dam les tout premiers jours du jeiine. Ceci s’accompagne d’une legitre augmentation du taux mCtabolique du repos (TMR), avec un pic aprk 36-48 heures de jeiine, puis une chute qui atteint des valeurs inferieures h la normale. I1 y a Cgalement une rCduction de la sensibilitk h l’insuline dans le jeiine, essentiellement parce que l’insuline ne peut stimuler l’oxydation du glucose, sans que soit affectC son effet de stimuler la synth2se du glycogbne de tout le corps. Outre l’effet sur la lipolyse et le TRM, le jeiine augmente Cgalement la rCponse thermogknique aux perfusions de catCcholamines. Dans la sous-alimentation plus longue et moins grave, il y a une chute du TRM (apr6s 4-7 jours) et une rksistance h l’insuline similaire h celle observCe dans le jeiine aigu. Cette chute du TRM semble &re diie en partie h une diminution de 1’activitC mCtabolique de la masse maigre (MM), mais l’existence de modifications similaires chez l’animal est un sujet de controverse. I1 semble que toute rCduction du TRM par unit6 de MM se fait, en partie au moins, par I’intermCdiaire de rkductions des concentrations de l’insuline plasmatique et du triiodothyronine libre. Chez les sujets qui ont une dCficience chronique en Cnergie le TRM par unit6 de MM n’est pas abaissC, probablement parce que la composition de leur MM est modifiCe. I1 est nCcessaire de poursuivre cette Ctude pour dCfinir les mCcanismes sous-jacents h ces modifications du TRM, h la rCponse thermogknique et h la sensibilitd h l’insuline dans la sous-alimentation.

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عنوان ژورنال:
  • The Proceedings of the Nutrition Society

دوره 54 1  شماره 

صفحات  -

تاریخ انتشار 1995