Preoperative oral carbohydrate treatment attenuates immediate postoperative insulin resistance

被引:205
作者
Soop, M
Nygren, J
Myrenfors, P
Thorell, A
Ljungqvist, O
机构
[1] Ersta Hosp, Karolinska Inst, Ctr Gastrointestinal Dis, S-11691 Stockholm, Sweden
[2] Karolinska Hosp, Dept Surg, S-17176 Stockholm, Sweden
[3] Karolinska Hosp, Dept Anesthesia, S-17176 Stockholm, Sweden
[4] Huddinge Univ Hosp, Karolinska Inst, Dept Surg, S-14186 Stockholm, Sweden
来源
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM | 2001年 / 280卷 / 04期
关键词
surgery; glucose metabolism; glucose clamp technique; stable isotopes;
D O I
10.1152/ajpendo.2001.280.4.E576
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Postoperative insulin resistance is a well-characterized metabolic state that has been shown to correlate with the length of postoperative stay in hospital. Preoperative intravenous or oral carbohydrate treatment has been shown to attenuate the development of postoperative insulin resistance measured 1 day after surgery. To study the effects of preoperative oral carbohydrate treatment on postoperative changes in insulin resistance and substrate utilization, in the absence of postoperative confounding factors, 15 patients were double-blindly treated with either a carbohydrate-rich beverage (12.5%) (n = 8) or placebo (n = 7) before undergoing total hip replacement surgery. Insulin sensitivity, endogenous glucose release, and substrate oxidation rates were measured before and immediately after surgery. Whole body insulin sensitivity decreased by 18% in the treatment group vs. 43% in the placebo group (P < 0.05, Student's t-test for unpaired data). In both groups, the major mechanism of insulin resistance was an inhibition of insulin-induced nonoxidative glucose disposal after surgery. The better preservation of insulin sensitivity in the treatment group was attributable to a less reduced glucose disposal in peripheral tissues and increased glucose oxidation rates.
引用
收藏
页码:E576 / E583
页数:8
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