Hyperinsulinemic-normoglycemic clamp administered together with amino acids induces anabolism after cardiac surgery
| العنوان: | Hyperinsulinemic-normoglycemic clamp administered together with amino acids induces anabolism after cardiac surgery |
|---|---|
| المؤلفون: | Arnold S. Kristof, Evan Nitschmann, Roupen Hatzakorzian, Linda Wykes, Thomas Schricker, Dominique Shum-Tim, Takumi Codère-Maruyama, Celine Guichon |
| المصدر: | American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 311:R1085-R1092 |
| بيانات النشر: | American Physiological Society, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Blood Glucose, Male, 0301 basic medicine, medicine.medical_specialty, Anabolism, Physiology, medicine.medical_treatment, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Protein biosynthesis, Humans, Insulin, Amino Acids, Coronary Artery Bypass, Interleukin 6, Aged, Inflammation, Postoperative Care, chemistry.chemical_classification, biology, Amino acid, Cardiac surgery, Protein catabolism, Metabolism, Treatment Outcome, 030104 developmental biology, Endocrinology, Clamp, chemistry, Protein Biosynthesis, biology.protein, Drug Therapy, Combination, Female |
| الوصف: | Cardiac surgery triggers an inflammatory stress response, leading to protein catabolism, a process that even high-dose insulin therapy alone cannot reverse. To determine whether hyperinsulinemic-normoglycemic clamp and perioperative amino acid (AA) supplementation improves whole body protein balance, 20 patients scheduled for elective coronary artery bypass grafting surgery were randomly assigned to have intra- and postoperative hyperinsulinemic-normoglycemic clamp, with or without intravenous AA supplementation. Primed continuous infusions of [6,6-2H2]glucose and l-[1-13C]leucine were used to quantify whole body protein and glucose metabolism before and after surgery. Adipose tissue and serum cytokines were also analyzed to measure their responsiveness to the anabolic effect of AA administration. During hyperinsulinemic-normoglycemic clamp, AA supplementation successfully stimulated whole body protein synthesis, resulting in a positive whole body protein balance after surgery (insulin: −13.6 ± 4.5 vs. insulin + AA: 2.1 ± 5.4 μmol·kg−1·h−1, P < 0.001). Endogenous glucose production was equally suppressed in both groups (insulin: 0.0 ± 3.8 vs. insulin + AA 1.6 ± 1.6 μmol·kg−1·min−1, P = 0.230). AA supplementation led to significant changes in serum and tissue IL-6 (insulin: 246.6 ± 111.2 vs. insulin + AA: 124.5 ± 79.3 pg/ml, P = 0.011). In conclusion, hyperinsulinemic-normoglycemic clamp technique, together with AA supplementation, can induce an anabolic state after open-heart surgery, as quantified by a positive whole body protein balance. |
| تدمد: | 1522-1490 0363-6119 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ca86f23f03a1175444084dc432a85b23Test https://doi.org/10.1152/ajpregu.00334.2016Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....ca86f23f03a1175444084dc432a85b23 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15221490 03636119 |
|---|