Abstract
The dietary regulation of jejunal glycolytic and disaccharidase enzyme activities is well documented, however failure of adaptation has been described (Gastroenterology 58:990 1970). The mechanism of these adaptive changes is not known. This report describes 2 females aged 9 and 11 years with exogenous obesity. Both had 5 hour oral glucose tolerance tests (OGTT) with serial measurement of blood glucose, insulin and serum inorganic phosphorous (SIP). There was an inappropriate insulin-glucose ratio (I/G), mean 1.4, range 0.6 to 1.8 (normal controls, mean 0.4 range 0.2 to 0.7) and a lack of fall in SIP during the OGTT, suggesting that the insulin was biologically abnormal (Clin. Res. 19:201 1971). Jejunal biopsies were performed after 48 hours of fasting and again after 96 hours of a high carbohydrate (CHO) diet. The activities of jejunal pyruvate kinase (PK) lactase and sucrase(S) were assayed. The PK activities (U/g wet wt. and the sucrase-lactase ratio (S/L) with fasting were 34.6 and 1.81 in one and 39.6 and 2.54 in the other subject, while with feeding were 36.2, 1.63, 40.4 and 2.38 respectively. Both patients were re-studied 2 months after the institution of a low simple CHO diet. At this time I/G and SIP fall during the OGTT were normal . The PK activities with fasting and feeding were 27.2 and 51.8 in one and 42.2 and 53.1 in the other, while the S/L with fasting and feeding were 1.73, 2.79, and 1.88, 2.41 respectively. These data suggest that the dietary regulation of PK and S is mediated through insulin and the lack of adaptation in obesity may be due to the presence of biologically abnormal insulin.
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Dubois, R., Gotlin, R., Rodgerson, D. et al. Studies on the dietary regulation of jejunal pyruvate kinase and sucrase activities. Pediatr Res 5, 388 (1971). https://doi.org/10.1203/00006450-197108000-00071
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DOI: https://doi.org/10.1203/00006450-197108000-00071