Local forearm and whole-body respiratory quotient in humans after an oral glucose load: methodological problems

The effects of an oral glucose load of 75 g on the local forearm and whole-body energy thermogenesis were measured in normal subjects during the 4 h after the glucose intake. Simultaneous assessment of substrate metabolism in the forearm was performed. Energy expenditure (EE) increased after the glucose load and had not returned to baseline level at the end of the experiment. Whole-body respiratory quotient (RQ) was, on average, 0.80 (SD 0.05) in the baseline condition and increased to a maximum of 0.91 (0.03) and then decreased to baseline level at the end of the experiment. The local forearm oxygen uptake increased 30 min after the glucose intake and remained elevated during the rest of the experiment. The carbon dioxide output from the forearm did not increase before 90 min after the glucose load. Consequently the local forearm RQ decreased significantly from a baseline value of 0.86 (0.17) to 0.63 (0.17) 30 min after the glucose load (P < 0.05). Ninety min after the glucose load RQ increased to a maximum level at 0.95 (0.22) and decreased then gradually to baseline level. The experiments emphasize several methodological problems in the measurement of local forearm RQ. The whole-body RQ and local forearm RQ are not significantly different in the fasting state. The finding of a decrease in local forearm RQ below 0.70 30 min after the glucose load probably indicates a non-steady state in the carbon dioxide exchange. Thus, indirect calorimetry cannot be applied locally during short time periods.