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Hepatic anaplerosis provides carbons for gluconeogenesis (GNG) and triglyceride (TG) synthesis. We aimed to optimize a protocol that measures hepatic anaplerotic contribution for GNG, TG synthesis, and hepatic pentose phosphate pathway (PPP) activity using a single dose of oral [U<jats:sup>\u221213<\/jats:sup>C<jats:sub>3<\/jats:sub>]glycerol paired with an oral sugar tolerance test (OSTT) in a population with significant insulin resistance. The OSTT (75 g glucose + 25 g fructose) was administered to eight obese adolescents with polycystic ovarian syndrome (PCOS) followed by ingestion of [U-<jats:sup>13<\/jats:sup>C<jats:sub>3<\/jats:sub>]glycerol at t = 180 or t = 210 min. <jats:sup>13<\/jats:sup>C-labeling patterns of serum glucose and TG-glycerol were determined by nuclear magnetic resonance. <jats:sup>13<\/jats:sup>C enrichment in plasma TG-glycerol was detectable and stable from 240 to 390 min with the [U-<jats:sup>13<\/jats:sup>C<jats:sub>3<\/jats:sub>]glycerol drink at t = 180 min(3.65\u2009\u00b1\u20092.3 to 4.47\u2009\u00b1\u20091.4%; P &gt; 0.4), but the enrichment was undetectable at 240 min with the glycerol drink at t = 210 min. The relative contribution from anaplerosis was determined at the end of the OSTT [18.5\u2009\u00b13.4% ( t = 180 min) vs. 16.0\u2009\u00b1\u20093.5% ( t = 210 min); P = 0.27]. [U-<jats:sup>13<\/jats:sup>C<jats:sub>3<\/jats:sub>]glycerol was incorporated into GNG 390 min after the OSTT with an enrichment of 7.5\u201312.5%. Glucose derived from TCA cycle activity was 0.3\u20131%, and the PPP activity was 2.8\u20134.7%. In conclusion, it is possible to obtain relative measurements of hepatic anaplerotic contribution to both GNG and TG esterification following an OSTT in a highly insulin-resistant population using a minimally invasive technique. Tracer administration should be timed to allow enough de novo TG esterification and endogenous glucose release after the sugar drink. <\/jats:p>","DOI":"10.1152\/ajpregu.00047.2019","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T17:47:15Z","timestamp":1556732835000},"page":"R134-R142","source":"Crossref","is-referenced-by-count":13,"title":["A simple method to monitor hepatic gluconeogenesis and triglyceride synthesis following oral sugar tolerance test in obese adolescents"],"prefix":"10.1152","volume":"317","author":[{"given":"Anne-Marie","family":"Carreau","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunsook S.","family":"Jin","sequence":"additional","affiliation":[{"name":"Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 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