【10肥】断食默示录 完结篇 长期饥饿期间电解质的变化

黑色字体是原文献

红色字体是机翻

蓝色字体是人肉翻，校对，讲解，注释等等

Weight loss due to fasting

Rate of weight loss with starvationWith total acaloric fasting, a certain healthy 41 yr old member of a cloistered religious community lost 0.9kg per day for the first few days of the fast, a rate which decreased to a stable 0.3kg/day towards the third week of fasting.

禁食减肥

禁食减肥率在完全非传统禁食的情况下，一位41岁的健康的与世隔绝的宗教团体成员在禁食的头几天每天减重0.9公斤，在禁食的第三周，这一比率降至稳定的0.3公斤/天。

基本数据跟我差不多 ，一般前3天掉1-3kg，后面每天0.7 0.5 0.6之类浮动 约到后面越少

This rate seems consistent among various experimentally fasted subjects. Most seem to lose about 20% of their body weight during a 30 day fast.

这一比率在各种实验禁食的受试者中似乎是一致的。大多数人似乎在30天的禁食中减掉了大约20%的体重。

没试过30days+，不发言了。。

The total amount of weight lost in the course of a fasting experiment is not representative of the critical care population. Our patients are infrequently monastic ovolactovegetarians with a normal BMI. Additionally, in a critical care setting the metabochanges in the rate of urinary electrolyte loss during starvationlic demands are greatly increased. One can only estimate that the ICU patient loses weight at a much faster rate, especially if burns, trauma or sepsis are involved.

禁食实验过程中体重减轻的总量不能代表重症监护人群。我们的患者很少是体重指数正常的素食主义者。此外，在重症监护环境中，饥饿需求期间尿电解质损失率的代谢变化大大增加。人们只能估计重症监护室患者的体重减轻速度要快得多，尤其是在涉及烧伤、创伤或败血症的情况下。

这个肯定 毕竟患者的身体比起健康人肯定有问题，尤其创伤烧伤类，本身还需要额外蛋白修复以及各种能量供应，这个说得通，傻子都懂。但是患者尿电解质损失率增加这个暂时理解不了，按理说病人体内基础代谢会更低，理论上每日代谢产物也会低。。怎么电解质流逝还多呢

Electrolyte changes during prolonged starvation

The 41 yr old monk lost 0.9kg per day for the first few days of the fast. This initial rapid weight loss is not totally due to the loss of dry nutrient mass. Think about it: the burning of 0.9kg of fat protein and carbohydrate in one day day would yield 3150 kcal in total, which is insane (given that a basal metabolic rate we agreed on is 1800 kcal/day).

The extra weight loss is actually due to diuresis and natriuresis. The urinary loss of the sodium cation is obligatory loss. As ketone anions are lost in the urine, they require a cation to accompany them; initially this is sodium, and later in the fast it is ammonium.

Potassium decreases initially, and remains stable at around 3.0 mmol/L. There is a constant rate of urinary potassium loss, which is thought to be the result of lean tissue dissolving. It seems to parallel the rate of proteolysis, and it seems related to lean body mass.

Magnesium remains surprisingly stable.

Calcium remains stable

Phosphate remains stable

Uric acid levels increase, perhaps as a product of protein catabolism; not only that but urate seems to compete with ketoacids for renal tubular transport sites.

长期饥饿期间电解质的变化

这位41岁的僧人在斋戒的头几天每天减重0.9公斤。这种最初的快速减肥并不完全是由于干燥营养物质的损失。想想看：一天内燃烧0.9公斤的脂肪蛋白和碳水化合物总共会产生3150千卡的热量，这太疯狂了（考虑到我们商定的基础代谢率是1800千卡/天）。

额外的体重减轻实际上是由于利尿和利尿。尿中钠离子的损失是必然的损失。由于酮阴离子在尿液中丢失，它们需要一种阳离子伴随；一开始是钠，后来禁食是铵。

很合理，tongniao必然带走一部分阳离子。而且3150大卡几乎是正常人2天的基础代谢量，算算就会发现不对劲

钾最初减少，并在3.0mmol/L左右保持稳定。尿钾的流失率是恒定的，这被认为是瘦组织溶解的结果。它似乎与蛋白水解的速率相似，而且似乎与瘦体重有关。

受组织什么鬼，，应该是瘦肉肌把。。这个也合理，当瘦肉开始水解后，体内蛋白分解会有一个拐点，之后曲线开始走平。。这个有空回头把另个文献讲解下届时会有图表格的说。。

镁保持惊人的稳定。

钙保持稳定

磷酸盐保持稳定

尿酸水平升高，可能是蛋白质分解代谢的产物；不仅如此，尿酸盐似乎与酮酸竞争肾小管转运位点。

盲猜这是因为肾小管转运位点，这尿酸盐 et 酮酸 ，准确说是尿酸根 and 酮酸根 ，使用的系同一种同向转运体？