|
|
||||||||
Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232
In animals receiving total
parenteral nutrition (TPN), infection impairs net hepatic glucose
uptake (NHGU) by 40% and induces mild hyperinsulinemia. In the normal
animal, the majority of the glucose taken up by the liver is diverted
to lactate, but in the infected state, lactate release is curtailed.
Because of the hyperinsulinemia and reduced NHGU, more glucose is
utilized by peripheral tissues. Our aims were to determine the role of
infection-induced hyperinsulinemia in 1) limiting the fall
in NHGU and hepatic lactate release and 2) increasing the
proportion of glucose disposed of by peripheral tissues. Chronically
catheterized dogs received TPN for 5 days via the inferior vena cava.
On day 3, a fibrin clot with a nonlethal dose of E. coli was placed into the peritoneal cavity; sham dogs received a
sterile clot. On day 5, somatostatin was infused to prevent
endogenous pancreatic hormone secretion, and insulin and glucagon were
replaced at rates matching incoming hormone concentrations observed
previously in sham or infected dogs. The TPN-derived glucose infusion
was adjusted to maintain a constant arterial plasma glucose level of
~120 mg/dl. after a basal blood sampling period, the insulin infusion
rate was either maintained constant (infected time control, Hi-Ins,
n = 6; sham time control, Sham, n = 6)
or decreased (infected + reduced insulin, Lo-Ins;
n = 6) for 180 min to levels seen in noninfected dogs
(from 23 ± 2 to 12 ± 1 µU/ml). Reduction of insulin to
noninfected levels decreased NHGU by 1.4 ± 0.5 mg · kg
1 · min
1 (P < 0.05) and nonhepatic glucose utilization by 4.8 ± 0.8 mg · kg
1 · min
1 (P < 0.01). The fall in NHGU was caused by a decline in HGU (
0.6 ± 0.4 mg · kg
1 · min
1) and a
concomitant increase in hepatic glucose production (HGP,
0.8 ± 0.5 mg · kg
1 · min
1); net
hepatic lactate release was not altered. Hyperinsulinemia that
accompanies infection 1) primarily diverts glucose carbon to
peripheral tissues, 2) limits the fall in NHGU by enhancing HGU and suppressing HGP, and 3) does not enhance hepatic
lactate release, thus favoring hepatic glucose storage. Compensatory
hyperinsulinemia plays a critical role in facilitating hepatic and
peripheral glucose disposal during an infection.
total parenteral nutrition; liver; glucose; lactate; dog
This article has been cited by other articles:
![]() |
D. S. Edgerton, A. D. Cherrington, P. Williams, D. W. Neal, M. Scott, L. Bowen, W. Wilson, C. H. Hobbs, C. Leach, M.-c. Kuo, et al. Inhalation of Human Insulin (Exubera) Augments the Efficiency of Muscle Glucose Uptake In Vivo Diabetes, December 1, 2006; 55(12): 3604 - 3610. [Abstract] [Full Text] [PDF] |
||||
![]() |
S.-S. Chen, C. M. Donmoyer, D. A. Pearson, A. Poole, Y. Zhang, D. B. Lacy, and O. P. McGuinness Impact of infection on glucose-dependent liver glucose uptake during TPN: interaction with insulin Am J Physiol Endocrinol Metab, February 1, 2004; 286(2): E286 - E295. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. M. Donmoyer, S.-S. Chen, D. B. Lacy, D. A. Pearson, A. Poole, Y. Zhang, and O. P. McGuinness Infection impairs insulin-dependent hepatic glucose uptake during total parenteral nutrition Am J Physiol Endocrinol Metab, March 1, 2003; 284(3): E574 - E582. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. M. Donmoyer, D. B. Lacy, Y. Zhang, S.-S. Chen, and O. P. McGuinness Impact of chronic fructose infusion on hepatic metabolism during TPN administration Am J Physiol Endocrinol Metab, December 1, 2002; 283(6): E1151 - E1158. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. M. Donmoyer, J. Ejiofor, D. B. Lacy, S.-S. Chen, and O. P. McGuinness Fructose augments infection-impaired net hepatic glucose uptake during TPN administration Am J Physiol Endocrinol Metab, May 1, 2001; 280(5): E703 - E711. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |