The quantification of gluconeogenesis in healthy men by (2)H2O and [2-(13)C]glycerol yields different results: rates of gluconeogenesis in healthy men measured with (2)H2O are higher than those measured with [2-(13)C]glycerol

Abstract

The quantification of gluconeogenesis (GNG) by (2)H2O and [2-(13)C]glycerol and the mass isotopomer dilution analysis of glucose does not involve assumptions regarding the enrichment of the oxaloacetate precursor pool. To compare these two methods we measured GNG in six healthy postabsorptive males under identical, strictly standardized, eucaloric conditions, once after oral administration of (2)H2O and once during a primed continuous infusion of [2-(13)C]glycerol. Endogenous glucose production (EGP) was measured by infusion of [6,6-(2)H(2)]glucose. EGP was not different after (2)H2O administration or during [2-(13)C]glycerol infusion (12.2 +/- 0.7 vs. 11.7 +/- 0.3 micromol/kg.min). However, GNG measured after (2)H2O administration was significantly higher than that during [2-(13)C]glycerol infusion (7.4 +/- 0.7 vs. 4.9 +/- 0.6 micromol/kg.min; P = 0.03), representing approximately 60% and 41% of EGP, respectively. The (2)H2O study was repeated during primed continuous infusion of unlabeled glycerol, showing that infusion of glycerol at the rate used in the [2-(13)C]glycerol method does not affect the measurement of GNG with (2)H2O, viz. 7.4 +/- 0.7 without glycerol vs. 7.6 +/- 0.9 micromol/kg.min with glycerol, representing approximately 60% vs. 62% of EGP. In conclusion, GNG measured by (2)H(2)O yields higher results than those measured by [2-(13)C]glycerol. This discrepancy is not merely caused by infusion of glycerol per se. Rather, the discrepancy between both methods probably relates to conceptual problems in underlying assumptions in one or both methods.