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Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232
During chronic total parenteral nutrition
(TPN), net hepatic glucose uptake (NHGU) and net hepatic lactate
release (NHLR) are markedly reduced (
~45 and ~65%,
respectively) with infection. Because small quantities of fructose are
known to augment hepatic glucose uptake and lactate release in normal
fasted animals, the aim of this work was to determine whether acute
fructose infusion with TPN could correct the impairments in NHGU and
NHLR during infection. Chronically catheterized conscious dogs received
TPN for 5 days via the inferior vena cava at a rate designed to match daily basal energy requirements. On the third day of TPN
administration, a sterile (SHAM, n = 12) or
Escherichia coli-containing (INF, n = 11)
fibrin clot was implanted in the peritoneal cavity. Forty-two hours
later, somatostatin was infused with intraportal replacement of insulin
(12 ± 2 vs. 24 ± 2 µU/ml, SHAM vs. INF, respectively) and
glucagon (24 ± 4 vs. 92 ± 5 pg/ml) to match concentrations previously observed in sham and infected animals. After a 120-min basal
period, animals received either saline (Sham+S, n = 6;
Inf+S, n = 6) or intraportal fructose (0.7 mg · kg
1 · min
1; Sham+F,
n = 6; Inf+F, n = 5) infusion for 180 min. Isoglycemia of 120 mg/dl was maintained with a variable glucose
infusion. Combined tracer and arteriovenous difference techniques were
used to assess hepatic glucose metabolism. Acute fructose infusion with
TPN augmented NHGU by 2.9 ± 0.4 and 2.5 ± 0.3 mg · kg
1 · min
1 in Sham+F
and Inf+F, respectively. The majority of liver glucose uptake was
stored as glycogen, and NHLR did not increase substantially. Therefore,
despite an infection-induced impairment in NHGU and different hormonal
environments, small amounts of fructose enhanced NHGU similarly in sham
and infected animals. Glycogen storage, not lactate release, was the
preferential fate of the fructose-induced increase in hepatic glucose
disposal in animals adapted to TPN.
liver; lactate release; dog; glycogen
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