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(Journal of Nutrition. 2001;131:1973-1977.)
© 2001 The American Society for Nutritional Sciences


Articles

Acetic Acid Feeding Enhances Glycogen Repletion in Liver and Skeletal Muscle of Rats1

Takashi Fushimi2, Kenji Tayama, Masahiro Fukaya, Kaori Kitakoshi*, Naoya Nakai*, Yoshinori Tsukamoto and Yuzo Sato*

Central Research Institute, Mitsukan Group Company Limited, Handa 475-8585, Japan and * Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya 464-8601, Japan

2To whom correspondence should be addressed. E-mail: tfushimi{at}mitsukan.co.jp.


    ABSTRACT
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
To investigate the efficacy of the ingestion of vinegar in aiding recovery from fatigue, we examined the effect of dietary acetic acid, the main component of vinegar, on glycogen repletion in rats. Rats were allowed access to a commercial diet twice daily for 6 d. After 15 h of food deprivation, they were either killed immediately or given 2 g of a diet containing 0 (control), 0.1, 0.2 or 0.4 g acetic acid/100 g diet for 2 h. The 0.2 g acetic acid group had significantly greater liver and gastrocnemius muscle glycogen concentration than the control group (P < 0.05). The concentrations of citrate in this group in both the liver and skeletal muscles were >1.3-fold greater than in the control group (P > 0.1). In liver, the concentration of xylulose-5-phosphate in the control group was significantly higher than in the 0.2 and 0.4 g acetic acid groups (P < 0.01). In gastrocnemius muscle, the concentration of glucose-6-phosphate in the control group was significantly lower and the ratio of fructose-1,6-bisphosphate/fructose-6-phosphate was significantly higher than in the 0.2 g acetic acid group (P < 0.05). This ratio in the soleus muscle of the acetic acid fed groups was <0.8-fold that of the control group (P > 0.1). In liver, acetic acid may activate gluconeogenesis and inactivate glycolysis through inactivation of fructose-2,6-bisphosphate synthesis due to suppression of xylulose-5-phosphate accumulation. In skeletal muscle, acetic acid may inhibit glycolysis by suppression of phosphofructokinase-1 activity. We conclude that a diet containing acetic acid may enhance glycogen repletion in liver and skeletal muscle.


KEY WORDS: • acetic acid • glycogen repletion • liver • skeletal muscle • rats


    INTRODUCTION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Fatigue, which is defined physiologically as loss of ability for power output, is caused by depletion of glycogen in muscle, hypoglycemia and other causes (1)Citation . Liver glycogen is used to maintain concentrations of blood glucose, for example, between meals. Glucose supplied from the liver is metabolized in a number of tissues, in particular, the brain. Glycogen is utilized as a fuel in skeletal muscle; therefore, glycogen depletion in liver and skeletal muscle results in central and peripheral fatigue. Thus, the rapid replenishment of glycogen in these tissues is very important for recovery from fatigue. Fasting as well as exercise results in glycogen depletion. Food deprivation for >6 h leads to reduced glycogen concentrations in liver and skeletal muscle of rats. (2Citation ,3)Citation . The consumption of carbohydrates aids glycogen repletion. To our knowledge, however, there have been no other nutritional studies showing the benefits of food in replenishing glycogen.

Vinegar is a commonly used seasoning. Its main component is acetic acid at a concentration of 3–9% for consumer use (4)Citation . Foods such as sushi and marinated meats and vegetables that are prepared with vinegar contain 0.2–1.5 g acetic acid/100 g (5Citation 6Citation 7Citation 8)Citation . Vinegar is also used traditionally as a folk medicine and is believed to have several beneficial effects such as improving appetite, enhancing mineral absorption and speeding recovery from fatigue. Recently, it was shown that a diet containing vinegar at a dietary concentration of 1.6 mL vinegar/100 g diet, for example, enhances the intestinal absorption of calcium (9)Citation . However, no other reports have proved experimentally other nutritional effects of vinegar at concentrations consumed in a normal diet.

Acetic acid administered orally is immediately absorbed; uptake then occurs in liver and peripheral tissues (10Citation ,11)Citation . It is metabolized via acetyl-CoA in the tricarboxylic acid cycle in liver and skeletal muscle (12Citation 13Citation 14)Citation . In vitro, citrate inhibits the activities of phosphofructokinase type 1 (PFK-1)3 and type 2 (PFK-2) in those tissues (15Citation 16Citation 17)Citation . Hence, we hypothesized that acetic acid might stimulate glycogenesis by increasing the influx of glucose 6-phosphate (G-6-P) into the glycogen synthesis pathway through the inhibition of glycolysis due to an increase in citrate concentration.

Here, to evaluate whether supplementing a meal with vinegar might aid in recovery from fatigue, we examined whether a diet containing acetic acid at concentrations corresponding to that in sushi would enhance glycogen repletion in the liver and skeletal muscle using food-deprived rats. In addition, we studied the dose-response effect of dietary acetic acid. We used diets containing glucose as a sugar source to prevent the effect of acetic acid on the stimulation of amylase secretion (18)Citation and polyethylenglycol (PEG) to examine the effect of acetic acid on gastric emptying (19)Citation .


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Animals, feeding protocol and diets.

Male 5-wk-old rats (Sprague-Dawley, Japan SLC, Hamamatsu, Japan) weighing 135 ± 1 g were individually housed in a temperature-controlled room (24 ± 1°C) with a 12-h light:dark cycle. The light period began at 0700 h. The rats had free access to water and were allowed access to a powdered commercial nonpurified diet (MF, Oriental Yeast, Tokyo, Japan) twice a day (from 0900 to 1100 h and from 1700 to 1800 h) for 6 d, after which they were divided into five groups of five rats, each with the same mean body weight (161 ± 2 g). The rats were cared for in accordance with the Guidelines for Animal Experimentation outlined at the 34th Annual Meeting of the Japanese Association for Laboratory Animal Science (May 22, 1987).

The experimental diets, based on the AIN-76 diet (20)Citation , contained glucose instead of sucrose, PEG as an indigestible marker and various concentrations of acetic acid. Each 100 g of diet contained 62.2 g glucose, 0.5 g PEG and 2.5 g/100 g solution containing concentrations of 0, 4, 8 or 16 g acetic acid/100 g diet [designated as control (C), A(0.1), A(0.2) and A(0.4), respectively]. There was no difference in the energy intake per gram body (195 ± 2 J/g) among the fed groups.

After 15 h of food deprivation, the experiments commenced at 0900 h. One group of rats (designated Pre) was killed, and the remaining four groups [C, A(0.1), A(0.2) and A(0.4) according to the diet provided] were each given 2 g of the appropriate experimental diet. All rats consumed the diet within 90 min. The fed rats were decapitated at 1100 h, and immediately serum, liver, gastrocnemius muscles (comprising fast-twitch and slow-twitch fibers) and soleus muscles (comprising mainly slow-twitch fibers), stomach and small intestine were collected. Liver and muscles were freeze-clamped in liquid nitrogen within 2 and 7 min after decapitation, respectively, and stored at -80°C until assay.

Measurements of gastrointestinal PEG and glucose.

Contents of the stomach and small intestine were collected by washing with 3 and 5 mL of saline, respectively. PEG content was measured by turbidimetry (21)Citation . The glucose content of the small intestine was determined by colorimetry (Glucose CII test Wako; Wako Pure Chemicals, Osaka, Japan).

Determinations of liver and skeletal muscle metabolites.

Glycogen concentrations were measured by the method of Lo et al. (22)Citation . G-6-P, fructose 6-phosphate (F-6-P) and fructose 1,6-bisphosphate (F-1,6-P2) were measured by the method of Lowry and Passonneau (23)Citation . Xylulose 5-phosphate (X-5-P), citrate and fructose 2,6-bisphosphate (F-2,6-P2) were determined as previously described (24Citation 25Citation 26Citation , respectively). cAMP was measured by an enzyme immunoassay kit (Direct Cyclic AMP, Assay Designs, Ann Arbor, MI).

Measurements of serum metabolites and hormones.

Serum glucose and free fatty acids (FFA) were measured by colorimetry with individual assay kits (Glucose C II test Wako and NEFA C-test Wako, respectively; Wako Pure Chemicals). Serum insulin and glucagon were assayed by RIA kits (Shionolia Insulin, Shionogi, Osaka, Japan, and Glucagon kit Daiichi, Daiichi Radioisotope Laboratory, Tokyo, Japan, respectively). Serum acetate was determined by capillary gas chromatography (27)Citation .

Enzymatic analysis.

Glycogen synthetase (GS) activity was measured as the ratio of form I GS, which is independent of G-6-P activation, to total enzyme activity. Tissue powdered in liquid nitrogen was homogenized in ~10 volumes of the extraction buffer (50 mmol/L Tris-HCl, pH 7.8, 10 mmol/L EDTA, 100 mmol/L sodium fluoride, 1 mmol/L dithiothreitol, 1 mmol/L phenylmethylsulfonyl fluoride) and then centrifuged at 10,000 x g for 15 min. The supernatant was assayed for GS activity as previously described (28)Citation .

Glucokinase (GK) in liver and hexokinase type II (HK II) in gastrocnemius muscle were assayed by the technique of Newgard et al. (29)Citation and the method of Burcelin et al. (30)Citation , respectively.

Pyruvate dehydrogenase complex (PDC) activity was determined as the ratio of the active enzyme to the total enzyme activity. Liver and gastrocnemius muscle mitochondria were prepared by the technique of Denyer et al. (31)Citation and the activity was measured fluorometrically by coupling to arylamine acetyltransferase (32)Citation .

Statistical analysis.

Data are expressed as means ± SEM. Homogeneity of variance was analyzed by Levene’s test. Statistical evaluation of the results with homogeneous variances was performed by one-way ANOVA. Fisher’s least significant difference test (33)Citation was used to determine whether mean values were significantly different at P < 0.05. The result of the PDC activity in liver had heterogeneous variance and was analyzed by the Kruskal-Wallis nonparametric test.


    RESULTS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Gastrointestinal PEG concentration and the ratio of glucose/PEG in small intestine.

Among the fed groups, there was no difference in either gastrointestinal PEG concentration [mean values were 4.0, 4.0, 3.6 and 4.4 mg (pooled SEM, 0.3) in gut and 4.8, 4.9, 5.1 and 4.5 mg (pooled SEM, 0.3) in small intestine for the C, A(0.1), A(0.2) and A(0.4) groups, respectively.] or the ratio of glucose/PEG in the small intestine [mean values are 5.8, 5.2, 6.2 and 5.1 (pooled SEM, 0.9) for the C, A(0.1), A(0.2) and A(0.4) groups, respectively]; 88% of PEG was recovered.

Glycogen concentrations in liver and gastrocnemius and soleus muscles.

Feeding increased glycogen concentrations in the liver (Fig. 1ACitation ) and skeletal muscles (Fig. 1BCitation , CCitation ). Further, in the liver, the glycogen concentration in group A(0.2) was significantly higher than in group C. In gastrocnemius muscle, glycogen concentrations were significantly greater in the acetic acid–fed groups compared with the Pre group. Moreover, the glycogen concentration in group A(0.2) was significantly higher than in group C. In soleus muscle, the glycogen concentrations in the acetic acid–fed groups were 60% greater than the Pre group but not different from the C group.



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Figure 1. Glycogen concentration in liver (A), gastrocnemius muscle (B), soleus muscle (C) in rats fed diets containing various levels of acetic acid. Values are means ± SEM, n = 5. Significantly different (P < 0.05): +, vs. Pre; #, vs. C. Abbreviations: A(0.1), A(0.2) and A(0.4), rats killed 2 h after consuming a diet containing 0.1, 0.2, 0.4 g acetic acid/100 g diet, respectively; C, rats killed 2 h after consuming a diet without acetic acid; Pre, rats killed before feeding.

 
Concentrations of serum metabolites and hormones.

Feeding significantly increased serum glucose and decreased serum FFA (Table 1Citation ), but there were no differences among the fed groups. Serum insulin concentrations in the fed groups, except in group A(0.2), were significantly higher than in the Pre group, but there were no differences among the fed groups nor were there differences in glucagon or acetate concentrations (data not shown).


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Table 1. Serum metabolites and hormones in rats fed diets containing various levels of acetic acid12

 
Concentrations of metabolites and enzyme activities in liver.

The concentrations of F-2,6-P2 in groups C and A(0.1) were significantly higher than in the Pre group (Table 2Citation ), with a generally lower level in group A(0.2) than in group C (P < 0.08). Feeding increased the concentration of X-5-P, but this value was lower in the acetic acid–fed groups than in group C [C vs. A(0.1), P < 0.06; C vs. A(0.2) and A(0.4), P < 0.01]. Concentrations of G-6-P, F-6-P, F-1,6-P2, citrate and cAMP were not different among the groups, although the citrate and F-6-P concentrations in the acetic acid–fed groups were >1.3-fold (P > 0.1) and <0.9-fold (P > 0.1), respectively, of those values in group C. There were no significant differences in GK, GS or PDC activities among any of the groups (data not shown).


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Table 2. Metabolites in liver of rats fed diets containing various levels of acetic acid12

 
Concentrations of metabolites, the ratio of F-1,6-P2/F-6-P and enzyme activity in gastrocnemius muscle.

The concentration of G-6-P in group A(0.2) was significantly higher than in the Pre, C and A(0.1) groups (Table 3Citation ). There were no significant differences among any of the groups in the concentrations of citrate, F-2,6-P 2, F-6-P or F-1,6-P2, but the citrate concentrations in groups A(0.2) and A(0.4) were 1.4-fold that in group C (P > 0.1). The F-1,6-P2/F-6-P ratio in group C generally was higher than in the other groups [Table 3Citation ; C vs. Pre and A(0.2), P < 0.02; C vs. A(0.1) and A(0.4), P < 0.09]. Feeding significantly increased GS activity (Pre vs. all fed groups: P < 0.05), but there were no differences among the fed groups. There were no differences among any of the groups in HK II or PDC activities (data not shown).


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Table 3. Metabolites in gastrocnemius muscle of rats fed diets containing various levels of acetic acid12

 
Concentrations of metabolites and the ratio of F-1,6-P2 /F-6-P in soleus muscle.

There were no significant differences among any of the groups in the concentrations of G-6-P, F-6-P, F-1,6-P2 or citrate and the F-1,6-P2/F-6-P ratio (data not shown). The means of F-1,6-P2/F-6-P ratio in acetic-acid-fed groups were <0.8-fold that in group C (P > 0.1).


    DISCUSSION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Here we have confirmed that a diet containing acetic acid at concentrations similar to those consumed in a normal meal enhances glycogen repletion in the liver and skeletal muscles of rats (Fig. 1ACitation , BCitation , CCitation ). The effect in liver and gastrocnemius muscle appeared to be linear up to 0.2 g acetic acid/100 g diet.

Neither the gastrointestinal PEG content nor the glucose/PEG ratio differed among the fed groups, indicating that dietary acetic acid did not influence gastric emptying, the rate of food intake or glucose absorption. The serum acetate concentrations in the acetic acid–fed groups were > 1.4-fold that in group C. Acetate administered orally to humans has been shown to be absorbed and metabolized within 1.5 h (11)Citation . Thus, it seems likely that the absorbed acetate had been metabolized in the acetic acid–fed groups, which might explain why the citrate concentrations in liver and skeletal muscles tended to be greater than that in group C.

In liver, the concentration of F-2,6-P2 was lower in group A(0.2) than in group C (Table 2)Citation . F-2,6-P2 is a potent regulator of gluconeogenesis and glycolysis through the inhibition of fructose-1,6-bisphosphatase (F16BPase) and the activation of PFK-1, respectively [reviewed in (34Citation 35Citation 36)Citation ]. F-2,6-P2 activates glycolysis at concentrations above 5 nmol/g (37)Citation . The concentrations of F-2,6-P2 in the acetic acid–fed groups were lower than the activating concentration of 5 nmol/g. Also, the citrate concentrations in the acetic acid–fed groups tended to be greater than in group C. Together with the lack of difference in PDC activity, it is possible that acetic acid feeding might lead not only to enhanced gluconeogenesis by the activation of F16BPase but also to the suppression of glycolysis by the inhibition of PFK-1 activity. F-2,6-P2 synthesis is controlled by the bifunctional enzyme, phosphofructokinase-2/fructose-2,6-bisphosphatase (PFK-2/F26BPase), which is regulated by both phosphorylation, an active form of F-2,6-P2 degradation, and dephosphorylation, an active form of F-2,6-P2 synthesis. Phosphorylation and dephosphorylation of PFK-2/F26BPase are catalyzed by cAMP-dependent protein kinase and X-5-P-activated protein phosphatase 2A (PP2A), respectively (38Citation ,39)Citation . Among the fed groups, there were no differences in cAMP. However, X-5-P levels in groups A(0.2) and A(0.4) were significantly lower than in the C group, which is consistent with results from studies that perfused acetic acid into liver (40)Citation . In this way, the lower concentrations of X-5-P in the acetic acid–fed groups increased the phosphorylation state of the bifunctional enzyme, leading to lower PP2A activity and finally resulting in the lower concentrations of F-2,6-P2 in those rats. X-5-P is generated from G-6-P and from F-6-P and glyceraldehyde 3-phosphate (Gly-3-P) catalyzed by transketolase in the pentose pathway. A low [NADP+]/[NADPH] ratio inhibits the activity of glucose 6-phosphate dehydrogenase. Acetate administration has been reported to decrease this ratio in liver (41)Citation . Because the activity of transketolase is in equilibrium under both starved and fed conditions (42)Citation , a decrease of either F-6-P or Gly-3-P results in a low X-5-P concentration. The F-6-P concentrations in the acetic acid–fed groups generally were below that in group C, suggesting that the low concentrations of X-5-P in the acetic acid–fed groups might be due to reduction of influx of hexose 6-phosphates toward the pentose phosphate pathway.

The pathway of glycogen synthesis in liver is mainly via gluconeogenesis (indirect pathway) or a glucose phosphorylation step (direct pathway) (43)Citation . The direct pathway has two stages, i.e., glucose phosphorylation, which was not affected by acetic acid feeding because there were no differences in GK activity among any of the groups, and the conversion of G-6-P into glycogen. Because G-6-P is used as a precursor for not only glycogen synthesis but also glycolysis and the pentose phosphate cycle, inhibition of these steps supports the preferential utilization of G-6-P for glycogenesis. This suggests that the enhancement of glycogen repletion by acetic acid may result from the activation of both the indirect pathway by inhibition of F-2,6-P2 synthesis caused by a decrease of X-5-P accumulation and the direct pathway by activating the preferential utilization of G-6-P for glycogenesis due to the suppression of glycolysis and the pentose phosphate pathway.

In gastrocnemius muscle, we found a higher concentration of G-6-P in group A(0.2) compared with group C (Table 3)Citation . G-6-P plays an important role in the regulation of glycogen synthesis in skeletal muscle (44)Citation . When 30–50% of the GS present in muscle is in the G-6-P-independent form, physiologic concentrations of G-6-P can accelerate glycogen synthesis in the presence of inhibitors of GS such as AMP, ADP and ATP (45)Citation . Thus, an enhancement in glycogenesis in gastrocnemius muscle by acetic acid feeding might result from the higher concentration of G-6-P, although we found no differences in the ratio of the G-6-P–independent form of GS to total enzyme among the fed groups. Accumulation of G-6-P is caused by activation of glucose transport/phosphorylation steps or by inhibition of glycolysis. HK II activity has been reported to correlate with the concentration of the insulin-sensitive glucose transporter GLUT4 (46)Citation and we found no differences among the fed groups in HK II activity or in serum insulin concentration (Table 1)Citation ; these findings indicate that acetic acid feeding did not affect the glucose transport/phosphorylation steps. That the F-1,6-P2/F-6-P ratio, which reflects PFK-1 activity (47)Citation , was lower in the acetic acid–fed groups than in group C (Table 3)Citation and that there were no differences in PDC activity among the fed groups suggest that acetic acid may suppress glycolysis through inhibition of PFK-1 activity. However, there were no differences among the fed groups in the concentration of F-2,6-P2, which is the activator of muscle PFK-1. In gastrocnemius muscle, the effect of acetic acid on PFK-1 was not the same as in liver because skeletal muscle PFK-2/F26BPase lacks a phosphorylation site (48)Citation . Torheim (49)Citation reported that in vitro citrate at a physiologic concentration, 250 µmol/L, inhibits the activation of PFK-1 by F-1,6-P2 (at 0–90 µmol/L) and F-2,6-P2 (at 0–5 µmol/L). Here we found that the concentrations of citrate, F-1,6-P2 and F-2,6-P2 were 110–170, 30–60 and 1.5–2.3 nmol/g, respectively. These concentrations are in agreement with Torheim’s report (49)Citation . Further, the citrate concentrations in groups A(0.2) and A(0.4) were >1.3-fold that of group C, but there were no differences in F-1,6-P2 and F-2,6-P2 concentrations among any of the groups. Hence, in gastrocnemius muscle, the enhancement of glycogen repletion by acetic acid feeding might result from the accumulation of G-6-P secondary to inhibition of PFK-1 activity.

In soleus muscle, glycogen concentrations in all of the acetic acid–fed groups were 1.1-fold that in group C. Because glycogen repletion of soleus muscle takes priority over that in gastrocnemius muscle and liver (50)Citation , this indicated that the soleus muscle in the acetic acid–fed groups might have approached a state of glycogen repletion 2 h after feeding. The F-1,6-P2/F-6-P ratios in the acetic acid–fed groups were all <0.8-fold that in group C. This suggests that the mechanism of the enhancement of glycogen repletion in this tissue by acetic acid feeding might be the same as that in gastrocnemius muscle.

Our results show that dietary acetic acid can enhance glycogen repletion in both liver and skeletal muscle. The mechanism of this effect is different in liver and skeletal muscle. In liver, acetic acid feeding enhances glycogen repletion by activation of gluconeogenesis and the preferential utilization of G-6-P for glycogenesis. In skeletal muscle, the enhancement of glycogen repletion by acetic acid feeding results from the accumulation of G-6-P due to suppression of glycolysis. We used acetic acid at concentrations comparable to those found in a normal diet. Therefore, we conclude that supplementing meals with vinegar may be beneficial in the recovery of liver and skeletal muscle glycogen, for example, upon fatigue, after skipping meals, postexercise or as part of an athlete’s breakfast on the day of competition.


    ACKNOWLEDGMENTS
 
We thank Y. Kimura and N. Sugino for excellent technical assistance.


    FOOTNOTES
 
1 Presented at the meeting of the Japanese Society of Nutrition and Food Science (JSNFS), May 28–30, 1999, Tokyo, Japan [Fushimi, T., Tayama, K., Tsukamoto, Y., Kitakoshi, K., Nakai, N. & Sato, Y. (1999) Effect of the diet containing acetic acid on glycogen repletion. JSNFS 53rd Meeting Program & Abstracts (in Japanese), p. 57]. Back

3 Abbreviations used: A(0.1), A(0.2) and A(0.4), rats 2 h after being fed a diet containing 0.1, 0.2, 0.4 g acetic acid/100 g diet, respectively; C, rats 2 h after being fed a diet without acetic acid; FFA, free fatty acids; F-6-P, fructose 6-phosphate; F-1,6-P2, fructose 1,6-bisphosphate; F-2,6-P2, fructose 2,6-bisphosphate; F16Bpase, fructose-1,6-bisphosphatase; GK, glucokinase; Gly-3-P, glyceraldehyde 3-phosphate; G-6-P, glucose 6-phosphate; GS, glycogen synthetase; HK II, hexokinase type II; PDC, pyruvate dehydrogenase complex; PEG, polyethylenglycol; PFK, phosphofructokinase; PFK-2/F26Bpase, the bifunctional enzyme, phosphofructokinase-2 and fructose-2,6-bisphosphatase; PP2A, protein phosphatase 2A; Pre, rats killed before feeding; X-5-P, xylulose 5-phosphate. Back

Manuscript received November 2, 2000. Initial review completed December 29, 2000. Revision accepted April 17, 2001.


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 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
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