Glucose production and gluconeogenesis in adults with uncomplicated
falciparum malaria.
Dekker, Evelien, Johannes A. Romijn, Karin Ekberg, John Wahren, Huynh
Van Thien, Mari[diaeresis]ette T. Ackermans, Le Thi Diem Thuy,
Visvanathan Chandramouli, Piet A. Kager, Bernard R. Landau, Hans P.
Sauerwein.
Metabolism Unit, Department of Internal Medicine, Academic Medical
Center, University of Amsterdam, Amsterdam, The Netherlands;
Department of Clinical Physiology, Karolinska Hospital, Stockholm,
Sweden; Bao Loc General Hospital, Lam Dong Province, Vietnam;
Tropical Diseases Research Center, Cho Ray Hospital, Ho Chi Minh
City, Vietnam, Department of Medicine, Case Western Reserve
University, Cleveland, Ohio, USA, Department of Infectious Diseases,
Tropical Medicine and AIDS, Academic Medical Center, University of
Amsterdam, Amsterdam, The Netherlands
APStracts 4:0040E, 1997.
Although glucose production is increased in severe malaria, the
influence of uncomplicated malaria on glucose production is unknown.
Therefore we measured in 8 adult Vietnamese patients with
uncomplicated falciparum malaria and 8 healthy Vietnamese controls
glucose production (by infusion of [6,6-2H2]glucose) and the
fractional contribution of gluconeogenesis (by oral ingestion of
2H2O); glycogenolysis was calculated as the difference between the
two. After 20 h of fasting plasma glucose was 4.7 +/- 0.2 mmol/l in
the patients and 4.3 +/- 0.2 mmol/l in the controls (n.s.). Glucose
production was nearly equal to 25% higher in the patients (16.9 +/-
1.3 vs 13.4 +/- 0.3 _mol.kg-1 .min-1, p=0.01). Fractional and
absolute gluconeogenesis were increased in the patients ( nearly
equal to 87% vs nearly equal to 59% (p<0.001) and 14.6 +/- 1.3
vs 7.9 +/- 0.2 _mol.kg-1.min-1 (p<0.001), respectively). The
contribution of glycogenolysis to total glucose production was
decreased in the patients: 2.3 +/- 0.5 vs 5.5 +/- 0.4 _mol.kg-1.min-1
(p<0.002). In conclusion: in adult patients with uncomplicated
falciparum malaria glucose production is increased by nearly equal to
25% due to an increased rate of gluconeogenesis, whereas
glycogenolysis is decreased. The mechanism by which these changes
occur is uncertain. However, counterregulatory hormone and cytokine
concentrations were increased in the patients.
Received 30 August 1996; accepted in final form 29 January 1997.
APS Manuscript Number E430-6.
Article publication pending Am. J. Physiol. (Endocrinol. Metab.).
ISSN 1080-4757 Copyright 1997 The American Physiological Society.
Published in APStracts on 20 February 1997