Single-dose carbohydrate treatment in the immediate preoperative phase diminishes development of postoperative peripheral insulin resistance

Gjessing, Petter Fosse; Hagve, Martin; Fuskevåg, Ole-Martin; Revhaug, Arthur; Irtun, Øivind

doi:10.1016/j.clnu.2014.02.010

Cited by 24 publications

(13 citation statements)

References 29 publications

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“…In a recent animal study, postoperative whole body glucose disposal rate was higher after carbohydrate treatment than fasting and this correlated negatively with muscle PDK4 protein expression [16] . The same study group demonstrated, in pigs, that a single dose of carbohydrate preoperatively was sufficient to reduce postoperative IR, as measured by the HEC [17] . However, a recent multiple-treatments meta-analysis on 62 participants studied using HEC showed no significant difference in any of the comparisons (between carbohydrate treatment and fasting, water or placebo) [12] .…”

Section: Discussionmentioning

confidence: 84%

“…One CT image slice for each participant at the third lumbar vertebra level was selected and the images were analysed using SliceOmatic V4.2 software (Tomovision, Montreal, Canada) to quantify fat free mass (FFM), fat mass (FM), skeletal muscle index (SMI) and myosteatosis ( Supplemental Digital Content – Experimental ) [15] , [16] , [17] , [18] , [19] , [20] .…”

Section: Methodsmentioning

confidence: 99%

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Postoperative inflammation and insulin resistance in relation to body composition, adiposity and carbohydrate treatment: A randomised controlled study

et al. 2019

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Section: Discussionmentioning

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Postoperative inflammation and insulin resistance in relation to body composition, adiposity and carbohydrate treatment: A randomised controlled study

et al. 2019

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“…Regulation of PDC has been suggested as a key mechanism contributing to the protective effect of preoperative feeding (4), whereas mitochondrial dysfunction has been hypothesized to be central to the development of postoperative insulin resistance (3). Furthermore, we have demonstrated recently that following major abdominal surgery in pigs, an increase in PDK4 mRNA and protein expression in skeletal muscle leads to decreased insulin-stimulated oxidative glucose disposal and peripheral insulin resistance (19,21). This indicates that impaired PDC activity after surgical trauma leads to reduced capacity for mitochondrial pyruvate oxidation and a reduced effect of insulin on oxidative glucose disposal (25,43,55).…”

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confidence: 97%

“…The decline in insulin sensitivity in the postoperative phase has been thoroughly documented and is reflected mainly by impaired glucose disposal in peripheral tissues, primarily skeletal muscle (21,36).…”

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confidence: 99%

Skeletal muscle mitochondria exhibit decreased pyruvate oxidation capacity and increased ROS emission during surgery-induced acute insulin resistance

Hagve

Gjessing

Fuskevåg

et al. 2015

American Journal of Physiology-Endocrinology and Metabolism

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Hagve M, Gjessing PF, Fuskevåg OM, Larsen TS, Irtun Ø. Skeletal muscle mitochondria exhibit decreased pyruvate oxidation capacity and increased ROS emission during surgery-induced acute insulin resistance. Am J Physiol Endocrinol Metab 308: E613-E620, 2015. First published February 10, 2015; doi:10.1152/ajpendo.00459.2014.-Development of acute insulin resistance represents a negative factor after surgery, but the underlying mechanisms are not fully understood. We investigated the postoperative changes in insulin sensitivity, mitochondrial function, enzyme activities, and release of reactive oxygen species (ROS) in skeletal muscle and liver in pigs on the 2nd postoperative day after major abdominal surgery. Peripheral and hepatic insulin sensitivity were assessed by D-[6,6-2 H2]glucose infusion and hyperinsulinemic euglycemic step clamping. Surgical trauma elicited a decline in peripheral insulin sensitivity (ϳ34%, P Ͻ 0.01), whereas hepatic insulin sensitivity remained unchanged. Intramyofibrillar (IFM) and subsarcolemma mitochondria (SSM) isolated from skeletal muscle showed a postoperative decline in ADP-stimulated respiration (VADP) for pyruvate (ϳ61%, P Ͻ 0.05, and ϳ40%, P Ͻ 0.001, respectively), whereas VADP for glutamate and palmitoyl-Lcarnitine (PC) was unchanged. Mitochondrial leak respiration with PC was increased in SSM (1.9-fold, P Ͻ 0.05) and IFM (2.5-fold, P Ͻ 0.05), indicating FFA-induced uncoupling. The activity of the pyruvate dehydrogenase complex (PDC) was reduced (ϳ32%, P Ͻ 0.01) and positively correlated to the decline in peripheral insulin sensitivity (r ϭ 0.748, P Ͻ 0.05). All other mitochondrial enzyme activities were unchanged. No changes in mitochondrial function in liver were observed. Mitochondrial H2O2 and O2 ·Ϫ emission was measured spectrofluorometrically, and H2O2 was increased in SSM, IFM, and liver mitochondria (ϳ2.3-, ϳ2.5-, and ϳ2.3-fold, respectively, all P Ͻ 0.05). We conclude that an impairment in skeletal muscle mitochondrial PDC activity and pyruvate oxidation capacity arises in the postoperative phase along with increased ROS emission, suggesting a link between mitochondrial function and development of acute postoperative insulin resistance.reactive oxygen species; surgery; insulin resistance; mitochondria; skeletal muscle; liver AFTER SURGERY, the development of an acute transitory state of insulin resistance has been identified as a negative factor associated with increased morbidity and hospital stay (45), but the physiological and molecular mechanisms underlying this condition are not fully elucidated. The decline in insulin sensitivity in the postoperative phase has been thoroughly documented and is reflected mainly by impaired glucose disposal in peripheral tissues, primarily skeletal muscle (21, 36).Oxidative glucose disposal in skeletal muscle is regulated by the pyruvate dehydrogenase complex (PDC), which is an enzyme complex that regulates the flux of glucose-borne pyruvate into the mitochondria by converting pyruvate to acetylCoA, which subsequently enters the ...

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“…This effect seems particularly related to the CHO dose administered 2 to 3 hours before the induction of anesthesia. 45 As a consequence, insulin resistance is decreased, protein breakdown reduced, and muscle strength improved. 46,47 This might turn in a faster surgical recovery as indicated by the results of a recent Cochrane meta-analysis showing a 1 day reduction in hospital stay after abdominal surgery.…”

Section: Preoperative Fasting and Preoperative Oral Carbohydrate Drinksmentioning

confidence: 99%

Anesthesia for Colorectal Surgery

Baldini

Fawcett

2015

Anesthesiology Clinics

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Single-dose carbohydrate treatment in the immediate preoperative phase diminishes development of postoperative peripheral insulin resistance

Cited by 24 publications

References 29 publications

Postoperative inflammation and insulin resistance in relation to body composition, adiposity and carbohydrate treatment: A randomised controlled study

Postoperative inflammation and insulin resistance in relation to body composition, adiposity and carbohydrate treatment: A randomised controlled study

Skeletal muscle mitochondria exhibit decreased pyruvate oxidation capacity and increased ROS emission during surgery-induced acute insulin resistance

Anesthesia for Colorectal Surgery

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