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J Clin Invest. Mar 1969; 48(3): 574–583.
PMCID: PMC535723
Liver and kidney metabolism during prolonged starvation
Oliver E. Owen, Philip Felig, Alfred P. Morgan, John Wahren, and George F. Cahill, Jr.
Elliott P. Joslin Research Laboratory, Boston, Massachusetts 02215
Cardiovascular Unit, the Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115
Cardiovascular Unit, Department of Surgery, Harvard Medical School, Boston, Massachusetts 02115
Peter Bent Brigham Hospital, Boston, Massachusetts 02115
Joslin Diabetes Foundation, Inc., Boston, Massachusetts 02215
Abstract
This study quantifies the concentrations of circulating insulin, growth hormone, glucose, free fatty acids, glycerol, β-hydroxybutyrate, acetoacetate, and alpha amino nitrogen in 11 obese subjects during prolonged starvation. The sites and estimated rates of gluconeogenesis and ketogenesis after 5-6 wk of fasting were investigated in five of the subjects.
Blood glucose and insulin concentrations fell acutely during the 1st 3 days of fasting, and alpha amino nitrogen after 17 days. The concentration of free fatty acids, β-hydroxybutyrate, and acetoacetate did not reach a plateau until after 17 days.
Estimated glucose production at 5-6 wk of starvation is reduced to approximately 86 g/24 hr. Of this amount the liver contributes about one-half and the kidney the remainder. Approximately all of the lactate, pyruvate, glycerol, and amino acid carbons which are removed by liver and kidney are converted into glucose, as evidenced by substrate balances across these organs.
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