The effect of sepsis on the oxidation of carbohydrate and fat

Abstract

Oxidative metabolism has been studied by indirect calorimetry in 27 patients with sepsis and in 7 non-septic patients while they were all receiving total parenteral nutrition. Glucose oxidation was reduced in the septic patients and fat oxidation continued despite the infusion of an excess of glucose. The extent of these changes depended on the severity of the septic state as measured by the scoring system described in the preceding paper. The mechanism of these changes is not known. They were not related to an elevation of the plasma nonesterified fatty acid concentration. Alterations must have occurred in the way fat was taken up and metabolized by the cells. Here insulin resistance and the highly significant positive relationship found between the plasma cortisol concentration and the sepsis score might be important.

Surviving sepsis campaign: research priorities for sepsis and septic shock

“…Decreased activity in electron transport chain complexes I, III, IV and ATP synthase has also been demonstrated [183,184]. Sepsis is also known to alter substrate preference, with a decrease in the utilization of glucose (glucose intolerance) relative to fat and protein [204,205]. As a result, septic patients tend to be hyperglycemic.…”

Whole-body β-oxidation of 18:2ω6 and 18:3ω3 in the pig varies markedly with weaning strategy and dietary 18:3ω3

“…For instance, during severe inflammation, energy expenditure is increased and the respiratory quotient is decreased, indicating an increase in whole-body fat oxidation (10)(11)(12)(13)(14). The extent to which PUFA such as 18:2 6 contributes to this inflammation-…”

Mitchiner Memorial Lecture, 1986: The Surgeon’s Oldest Enemy

“…: able to demonstrate th at fat is th e ma in fu e l used by the grossly septic patic nt 22 • We showed that glucose ox idatiun was nega ti ve ly. a nd fat oxidatio n posit ively, related to the severi ty of sepsis eve n in pati ents receiving glucose in significant quantit ies 21 . Further assessment of this phe no men on has bee n unde rtaken using th e hyperglycaemi c glucose clamp tech ni que.…”