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Research Article Free access | 10.1172/JCI106639

Human forearm metabolism during progressive starvation

O. E. Owen and George A. Reichard Jr.

1Fels Research Institute and General Clinical Research Center, Temple University School of Medicine and Smith, Kline & French Laboratories, Philadelphia, Pennsylvania 19140

Find articles by Owen, O. in: PubMed | Google Scholar

1Fels Research Institute and General Clinical Research Center, Temple University School of Medicine and Smith, Kline & French Laboratories, Philadelphia, Pennsylvania 19140

Find articles by Reichard, G. in: PubMed | Google Scholar

Published July 1, 1971 - More info

Published in Volume 50, Issue 7 on July 1, 1971
J Clin Invest. 1971;50(7):1536–1545. https://doi.org/10.1172/JCI106639.
© 1971 The American Society for Clinical Investigation
Published July 1, 1971 - Version history
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Abstract

Forearm muscle metabolism was studied in eight obese subjects after an overnight, 3 and 24 day fast. Arterio-deep-venous differences of oxygen, carbon dioxide, glucose, lactate, pyruvate, free fatty acids, acetoacetate, and β-hydroxybutyrate with simultaneous forearm blood flow were measured. Rates of metabolite utilization and production were thus estimated. Oxygen consumption and lactate and pyruvate production remained relatively constant at each fasting period. Glucose, initially the major substrate consumed, showed decreased consumption after 3 and 24 days of fasting. Acetoacetate and β-hydroxybutyrate consumption after an overnight fast was low. At 3 days of fasting with increased arterial concentrations of acetoactate and β-hydroxybutyrate, consumption of these substrates rose dramatically. At 24 days of fasting, despite further elevation of arterial levels of acetoacetate and β-hydroxybutyrate, the utilization of acetoacetate did not increase further and if anything decreased, while five out of eight subjects released β-hydroxybutyrate across the forearm. Acetoacetate was preferentially extracted over β-hydroxybutyrate. At 24 days of starvation, free fatty acids were the principal fuels extracted by forearm muscle; at this time there was a decreased glucose and also ketone-body consumption by skeletal muscle.

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