PENCERNAAN, ABSORPSI DAN

METABOLISME KARBOHIDRAT

Drs. Hendri Busman, M.Biomed

FAKULTAS KEDOKTERAN
UNIVERSITAS MALAHAYATI
BANDAR LAMPUNG

FUNGSI KARBOHIDRAT
1. SUMBER ENERGI UTAMA
2. CADANGAN ENERGI ( GLIKOGEN )
3. BAHAN PEMBENTUK ZAT LAIN :
- AS. ASCORBAT ( VITAMIN C )
- AS. GLUCORONAT
- PENTOSA

* NUKLEOTIDA
* AS. NUKLEAT

- AS. AMINO
- LIPID : TAG, GANGLIOSIDA, GLIKOLIPID
4. STRUKTUR BIOLOGIS

PENCERNAAN KARBOHIDRAT
* MULUT :
- MEKANIS
- ENZIMATIK
AMYLASE
AMILUM

* OLIGOSAKARIDA
* MALTOTRIOSA

SALIVA

* MALTOSA

ION ClpH : 7,1

3

* USUS HALUS
AMILUM

AMYLASE

- OLIGOSAKARIDA

GLIKOGEN

PANCREAS

- MALTOTRIOSA

pH : 7,1

- MALTOSA

SUKRASE

SUKROSA

GLUKOSA + FRUKTOSA
pH : 5 7

MALTASE

MALTOSA

GLUKOSA
pH : 5,8 6,2

LACTASE
LAKTOSA

GLUKOSA + GALAKTOSA
pH : 5,4 6

TRIHALASE
TRIHALOSA

GLUKOSA
GLUKOSIDASE

OLIGOSAKARIDA

GLUKOSA

INHIBITOR GLUKOSIDASE : OAD

ABSORPSI KARBOHIDRAT
* ABSORPSI : - HEKSOSA : * GLUKOSA
* GALAKTOSA
* FRUKTOSA
* MANNOSA
- PENTOSA : RIBOSA
* ABSORPSI : - PASIF : * SIMPLE DIFFUSION
* FACILITATED DIFFUSION
(GLUT-5)
- ACTIF :
SGLT-1 (K+)Na+ PUMP)

KETERANGAN

2
Gluc.

1.

ACTIVE TRANSPORT

2.

FACILITATED DIFFUSION

3.

SIMPLE DIFFUSION

Gluc.

* Penghambatan transport aktif

- Ouabain ( inhibitor K+ / Na+ pump )
- Phlorizin

ASPEK KLINIK
1. LACTOSE INTOLERANCE
* DEF. : ENZIM LACTASE
* GEJALA : - COLIC USUS
- DIARE
- FLATULENS
a). DEF. LACTASE HEREDITER
- JARANG TERJADI
- PADA NEONATUS
- PEMBERIAN SUSU
- TH

DIARE

: * LLM (LOW LACT MILK)

* YOGURT (PENGGANTI SUSU)

b). PRIMARY LOW LACTASE ACTIVITY

- SERING TERJADI
- PADA ORANG DEWASA
- PENURUNAN AKTIVITAS LAKTASE SECARA
BERANGSUR-ANGSUR
c). SECONDARY LOW LACTASE ACTIVITY
- SEKUNDER DARI PENYAKIT :
* TROPICAL SPRUE
* CELIAC DISEASE
* KWASHIORKOR
* COLITIS
* GASTRO ENTERITIS

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2. SUCRASE DEFICIENCY
- HEREDITER
- NEONATUS
- BERSAMA-SAMA DENGAN ISOMALTASE
DEFICIENCY
- GEJALA : * DIARE
* COLIC USUS
* FLATULENS
3. DISSACHARIDURIA
- DEF. : DISACHARIDASE
- > 30 mg DISAKARIDA ( URINE )
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4. MONOSACHARID MALABSORPSION
- CONGENITAL
- ABSORPSI GLUK / GAL : LAMBAT
- GANGGUAN : GLUT : SGLT-1
- GEJALA : * DIARE
* COLIC USUS
* FLATULENS

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TRANSPORT GLUKOSA
KE DALAM SEL

13

CARBOHYDRATE METABOLISM
GLUCOSE METABOLISM
NONCARBOHYDRATE SUBSTRATE
LACTATE

PENTOSE-PHOSPHATE

Gluconeogenesis

Hexose Monophosphate Shunt

Anaerobic
condition
PYRUVATE
Aerobic
condition
ACETYL-CoA

Glycolysis EM
(Embden Meyerhof)

GLUCOSE

Glycogenesis

Glycogenolysis
(liver)

GLYCOGEN
TCC
CO2 + H2O + E

GLUCORONATE
Uronic acid Pathway
LACTATE

Glycogenolysis
(Muscle)

TCC = TRI CARBOXYLIC ACID CYCLE

PYRUVATE

GLUCOSE-6-P

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GLYCOLYSIS EMBDEN MEYERHOF

* Oxidation of glucose to form pyruvate or lactate
* Occur in all of the tissues, in cytosol of the cells
* ATP are generated from 1 mol of glucose
- In aerobic condition : 8 ATP
- In anaerobic condition : 2 ATP
* Influenced by several factors
Inducer
: - AMP
- ADP
- C.H. Meal
Supresor
: - ATP
- Yodo acetate
- Citrate
- Fluoride
- Glucose-6P
- Fast condtion
- NADH
15

GLIKOLISIS EMBDEN MEYERHOF

16

Three possible catabolic fates of the pyruvate formed in

the pay off phase of glycolysis
GLUCOSE
Glycolysis (10 successive reactions)
2 PYRUVATE
Anaerobic conditions

O2

2 ETHANOL + 2 CO2
Alcohol fermentaion in yeast

aerobic
conditions
2C02

anaerobic conditions
LACTATE

Fermentation to lactate in vigorously

Contracting
muscle, in erythrocytes,
and
is some microorganisme

2 ACETYL-CoA
Citric
Acid
cycle

4 CO2 + 4H2O
Animal, plant, and many microbial
Cells under aerobic conditions

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TOTAL ENERGY ARE GENERATED FROM

OXIDATION OF ONE MOL OF GLUCOSE TO
FORM CO2 + H2O
GLUCOSE
8 ATP
Pyruvate

Pyruvate

3 ATP

3 ATP

Acetyl- CoA

Acetyl Co-A

TCC
12 ATP

TCC
12 ATP

38 ATP

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EFICIENCY OF GLUCOSE OXIDATION

One mol of glucose oxidation to form.
CO2 + H2O, are generated 38 ATP
38 ATP = 38 x 51,6 KJ (Kilo Joule)
= 1961 KJ

One mol of glucose is combusted in a calorimeter (in vitro),

approximatelly 2870 KJ are liberated as heat.
1961
2870
32% are liberated as heat.

19

GLYCOGENESIS & GLYCOGENOLYSIS

* Almost occur in all of the tissues
Especially in the liver and muscles
* Biomedical importance :
- Liver glycogen is source of blood glucose, because
there is glucose-6-phosphatase activity in the liver
- Muscle glycogen is not source of blood glucose, because
there is not glucose-6-phosphatase activity in muscle.
So muscle glycogen is only source of glucose for glycolysis
within the muscle itself (anaerobic glycolysis)
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* Glycogen storage diseases

- Inherited
- Deficient mobilization of glycogen
- Or deposition of abnormal forms of glycogen
muscular weakness or even death

* Influenced by several factors

- Hormonal : insulin, glucagon etc.
- Nutrition : - Carbohydrate meal
- During fasting

Gluccogenesis
glycogenolysis
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REGULATION OF GLYCOGENESIS &

GLYCOGENOLYSIS
* Epinephrin
* Glucagon :
(only on the liver)

* Insulin
+

Equilibrium

Phosphodiesterase

Adenyl Cyclase

cAMP

cAMP

Glycogenesis

Glycogenesis

Glycogenolysis

Glycogenolysis

22

GLUCONEOGENESIS
* Biomedical importance :
- To maintain blood glucose concentration
- To clear the products of the metabolism of other tissues
from the blood
eg, Lactate & Glycerol
* Occur especially in the liver and kidney
* Influenced by several factors :
- hormonal
- Nutrition
* Sources of noncarbohydrate substrates :
- Lactate
- Propionat (Plants)
- Glycerol (fat)
- Glucogenic Amino Acids

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Perubahan berbagai macam gula menjadi glukosa

Lactose

Trehalose

CH2OH

Lactase

trehalase

CH2OH

H
D-Glucose

OH

OH

Glucose-1Phosphate

ATP

Phosphoglucose
-mutase

Hexokinase

HOCH2 O CH2OH
H

HO

ATP

Glucose-6Phosphate

Hexokinase

Fructose-6Phosphate

CH2OH
H
OH

ATP

fruktokinase

OH
HO

OH

Fructose-1,6Biphosphate

Hexokinase

Mannose-6-phosphate
Phosphomannose
isomerase

+ Dihydroacetone phospate

Triose kinase

ATP

OH

H
H
D-Mannose

ATP

Fructose-1-phospate
Liceralhehide

UDP-glucose

OH

OH H
D-Fructose

UDP-galactose

OH

OH

H
OH
D-Galaktose

Phosphorylase

OH
Sucrase

H
OH

OH

Sucrose

Glycogen
Pi

OH

H
OH

Triose phosphate
isomerase

Glyceraldehid-3-phospate

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BLOOD GLUCOSE
Sources :
1. Carbohydrate (Diet)
2. Liver glycogens (Glycogenolysis)
3. Noncarbohydrate substrates (Gluconeogenesis)
* Concentration :
During fasting : 3,3 - 3,9 mmol/l = 60 - 70 mg%
After the ingestion of a carbohydrate meal :
6,5 7,2 mmol/l = 120 130 mg%
Post absorptive state : 4,5 5,5 mmol/l = 80 100 mg%
Normal fasting blood glucose : 3,9 6 mmol/l
= 70 110 mg%
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* Renal threshold : 9,5 10 mmol/l = 170 180 mg%

More than 9,5 mmol/l = 170 mg%
Glucosuria
* Influenced by several factors :
- Hormonal : insulin & secretin
Epinephrin / nor epinephrin
Glucagon
Growth Hormon
ACTH
Glucocorticoids
Tyroxin
- Nutrition & Drug :
Tolbutamid (OAD)
Amino acids
FFA

26

REGULATION OF BLOOD GLUCOSE

Insulin

+
Phosphodiesterase enzyme
Glycolytic enzymes
Glucose transporters

Glucagon
Epinephrin
Nor epinephrin

+
Adenyl Cyclase
Gluconeogenetic
Enzzymes

Glycogenesis
Glycolysis
Glucose transport into
the cells

Glucogenolysis
Gluconeogenesis

Blood Glucose

Blood Glucose

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GLUCOSE TOLERANCE
Glucose tolerance
Diabetes mellitus
Liver damage
Several infection disease
Obesity
Hyperpituitarism
Cortex adrenal hyperfunction
Hyperglycemia
Glucosuria
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Glucose tolerance
Hypopitutarissm
Cortex adrenal hypofunction
(Addisons disease)
Hyper insulinism

Hypoglycemia

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