Relationship between glucose oxidation and FFA concentration in septic cancer-bearing patients |
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Authors: | H P Sauerwein G R Pesola J S Groeger M Jeevanandam M F Brennan |
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Affiliation: | Surgical Metabolism Laboratory, Memorial Sloan-Kettering Cancer Center, New York. |
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Abstract: | Glucose oxidation is inhibited in severely ill patients. The present investigation was designed to study the relationship between glucose tissue uptake, glucose oxidation, and FFA concentration in septic cancer-bearing patients. The influence of glucose infusion alone (3.9 mg x kg-1 x min-1), followed by a euglycemic clamp with the same glucose load, on oxidation of glucose, plasma FFA concentration, and lipid oxidation were measured in eight septic cancer-bearing patients. During infusion of 3.9 mg glucose x kg-1 x min-1 glucose tissue uptake was 4.6 +/- 0.3 mg x kg-1 x min-1, glucose oxidation 0.5 +/- 0.2 mg x kg-1 x min-1, FFA concentration 377 +/- 52 mumol x L-1, and lipid oxidation 2.0 +/- 0.2 mumol x kg-1 x min-1. During the euglycemic clamp glucose tissue uptake was 4.4 +/- 0.3 mg x kg-1 x min-1, glucose oxidation rose to 1.8 mg x kg-1 x min-1 (.001 less than P less than .01), FFA concentration dropped to 202 +/- 23 mumol x L-1 (P less than .001), and lipid oxidation to 1.2 +/- 0.2 mumol x kg-1 x min-1 (.001 less than P less than .01). Nonprotein respiratory quotient rose from 0.73 +/- 0.02 to 0.85 +/- 0.02 (.001 less than P less than .01); 11% +/- 5% of the total amount of glucose taken up by the tissues was oxidized during infusion of glucose alone and increased to 42% +/- 6% during the euglycemic glucose clamp. It is concluded that in septic cancer-bearing patients glucose oxidation is inhibited during infusion of 3.9 mg glucose x kg-1 x min-1, even when expressed as percentage of glucose tissue uptake. With insulin, glucose tissue uptake was not influenced, but glucose oxidation expressed as percentage of glucose tissue uptake was normalized. |
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