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HEALTHY MAN
BY MICHAEL SOMOGYI
(From the Laboratory of the Jewish Hospital of St. Louis, St. Louis)
for instance, as the blood sugar has risen to high levels during the 1st hour
after the administration of glucose, the ketone bodies dropped by 45 per
cent below the postabsorptive level. In the 3rd and 4th hours, however,
when the blood sugar receded to the low level of 50 mg. per cent, keto-
nemia increased and exceeded the lowest previous level by 272 per cent,
and t>hc postabsorptive level by 104 per cent. Cases 2, 3, and 4 show
changes of the same character t’o an even more pronounced degree.
The observations on the last two casts given in Table TI mere made on
healthy students after 3 days of fasting. As may be noted, in Case 5
TABLE I
Showing !l’hat Postabsorptive h’etonemic Level of Healthy Individuals Ikdines within
hydrate in the metabolism of the liver, the organ which is the source of the
ketone bodies that appear in the blood. Our findings show the existence
of the same process in the intact, normal organism that Edson (2) observed
in liver slices, namely the liver cells oxidize preferentially carbohydrate,
so that when these are available in abundance, the oxidation of fats is
suppressed and, as a consequence, the production of ketone bodies dim-
inishes.
TABLE 11
Case 3 Case 4
74 0.39 83 0.36
174 0.47 161
78 146 0.23
6Q 37 0.32
66 69 0.65
67 2.32 81 3.26
Case 5 Case 6
-1-
61 38.1 57 44.3
180 15.8 239 23.5
186 2.8 207 5.5
155 2.1 98 2.5
138 1.9 49 10.8
greater is the rise in the ketonemic level. In support of this view we point
to Case 4 in Table II, in which the hypoglycemia was more intensive
than in the other three examples, and it soon was followed by a substantial
increase of the blood sugar. After 4 hours had elapsed since the adminis-
tration of glucose, this increment in the glucose content of the blood can
be accounted for only by hepatic glycogenolysis. From a comparison of
the blood sugar changes in Cases 1, 2, 3, and 4, it is evident that the in-
crease in the rate of hepatic glycogenolysis was distinctly higher in Case 4
than in Cases 1, 2, and 3. Concurrently, the increase in ketonemia also
was greater; it represents an elevation of 803 per cent above the post-
absorptive, and of 1300 per cent above the lowest (2 hour) ketonemic
level.
SUMMARY
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