Carbohydrate metabolism in man: effect of elective operations and major injury.

Long, Chen; Spencer, J L; Kinney, John M.; Geiger, John W.

doi:10.1152/jappl.1971.31.1.110

Cited by 186 publications

(42 citation statements)

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“…These conflicting results may be partially explained by either species differences or dose of TNF given, that is, 20 and 125 ag/kg of TNF were administered in monkeys and in rats, respectively, which was 2-and 12-fold more than we used. Increased glucose production and utilization are major features of the metabolic response to the infection ( 1,2,50). Previous studies demonstrated that administration of TNF causes hypoglycemia (51 ), and this finding has been partially explained by the fact that TNF increases glucose utilization both in vitro (52,53) and in vivo (51,54,55), although there are conflicting results (56).…”

Section: Discussionmentioning

confidence: 99%

“…In clinical situations such as trauma, sepsis, and cancer, marked changes in glucose ( 1,2) and lipid (3,4) metabolism occur that may affect both morbidity and mortality (5). Alterations in lipid kinetics that ultimately lead to hepatic fat accumulation, thereby possibly contributing to metabolic failure of the liver (6,7), have been of particular concern.…”

Section: Introductionmentioning

confidence: 99%

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Short-term effects of tumor necrosis factor on energy and substrate metabolism in dogs.

Sakurai¹,

Zhang²,

Wolfe³

1993

J. Clin. Invest.

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In vivo short-term effects of recombinant human TNF-a on lipolysis, FFA flux, fat oxidation, triglyceride-fatty acid cycling, and glucose kinetics were evaluated with stable isotopic tracers and indirect calorimetry along with monitoring of hemodynamic parameters in fasted dogs. High-dose TNF infusion ( 10 ,gg/kg) caused a fall in mean arterial pressure (P < 0.01), pulmonary arterial pressure (P < 0.001), and cardiac index (CI) (P < 0.05). The rate of appearance of glycerol (Ra glycerol) and the rate of appearance of FFA (Ra FFA) were decreased by 20% (P < 0.05) and by 42% (P < 0.01), respectively. Total fat oxidation fell by 23% (P < 0.05). In contrast, TNF infusion significantly increased glucose production by 13% (P < 0.05) and metabolic clearance rate of glucose by 25% (P < 0.01). However, TNF infusion did not change energy expenditure. Low-dose TNF infusion (3.5 ;tg/kg) caused changes similar in all respects, except magnitude, to the highdose effects. There was a significant correlation between percent change of CI (ACI) and percent change of rate of appearance of palmitate (Ra palmitate; ARa palmitate) (P < 0.0001, r = 0.69), Ra FFA (ARa FFA) (P < 0.0001, r = 0.60), and Ra glycerol (ARa glycerol) (P < 0.0329, r = 0.36). The correlation between ACI and ARa palmitate was greater than the correlation between ACI and ARa glycerol (P = 0.028). We conclude that the acute response to TNF causes a shift towards carbohydrate as an energy substrate in a dose-dependent manner by both decreasing the availability of FFAs and increasing glucose production. (J. Clin. Invest. 1993.91:2437-2445

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Short-term effects of tumor necrosis factor on energy and substrate metabolism in dogs.

Sakurai¹,

Zhang²,

Wolfe³

1993

J. Clin. Invest.

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“…Severe trauma is followed by a period of food deprivation accompanied by an increased demand by the body for metabolic fuels [14] adding to the impaired hormonal and cellular immunity that follow injury [15]. It is well recognised that malnutrition causes wounds to heal inadequately and incompletely [17] and that wound healing improves 1-2 weeks after adequate food intake, regardless of the patient's nutritional status [6,18].…”

Section: Introductionmentioning

confidence: 99%

Nutritional status and wound healing in open fractures of the lower limb

Dwyer

John

Mam

et al. 2005

International Orthopaedics (SICOT)

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Forty-three patients averaging 28.2 (range 16-74) years with open fractures of the lower limbs were studied prospectively for 40 weeks using anthropometrical, biochemical and haematological parameters to ascertain their relationship to wound healing following injury. Nearly half (21/43) of the patients were malnourished at admission and the number increased to 22 a week after injury. Dietary advice and better food intake improved nutritional status with only 13 patients remaining malnourished at the 40th week. Wound healing was earlier when creatinine-height index was normal throughout the course of treatment and was delayed when serum albumin level was low.Résumé Nous avons suivi prospectivement, pendant quarante semaines, 43 malades avec des fractures combinées du membre inférieur en utilisant des paramètres anthropométrique, biochimique et hématologique pour étudier leur relation avec la cicatrisation des parties molles après l'accident. Prés de la moitié des patients (21/43) étaient considérés comme malnutris à leur admission. Les conseils diététiques et une meilleure prise de la nourriture ont amélioré le statut nutritionnel avec seulement treize malades dans le groupe malnutris à la quarantième semaine. La guérison des blessures était plus précoce quand l'index de créatinine était normal durant le cours du traitement et a été retardée quand le niveau de sérum albumine était bas.

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“…In spite of the glucose intoler ance there is little evidence that glucose turnover or oxidation is decreased after injury except very early in the acute phase (Stoner, 1970). Kinney et al (1970) and Long et al (1971) have shown that glucose oxidation is essentially un changed in minor degrees of trauma. In severe injury, however, glucose oxidation and turnover may be actually increased.…”

mentioning

confidence: 99%

Evaluation of Carbohydrates in Parenteral Nutrition

Wretlind¹

1975

Ann Nutr Metab

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Carbohydrate metabolism in man: effect of elective operations and major injury.

Cited by 186 publications

References 0 publications

Short-term effects of tumor necrosis factor on energy and substrate metabolism in dogs.

Short-term effects of tumor necrosis factor on energy and substrate metabolism in dogs.

Nutritional status and wound healing in open fractures of the lower limb

Evaluation of Carbohydrates in Parenteral Nutrition

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