HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 286/4/E529    most recent 00258.2003v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (13) Citing Articles via Google Scholar Google Scholar Articles by Gore, D. C. Articles by Wolfe, R. R. Search for Related Content PubMed PubMed Citation Articles by Gore, D. C. Articles by Wolfe, R. R.

Extremity hyperinsulinemia stimulates muscle protein synthesis in severely injured patients

Department of Surgery, The University of Texas Medical Branch, Galveston, Texas 77555

Submitted 10 June 2003 ; accepted in final form 19 November 2003

Insulin has a well-recognized anabolic effect on muscle protein, yet critically ill, severely injured patients are often considered "resistant" to the action of insulin. The purpose of this study was to assess the in vivo effects of hyperinsulinemia on human skeletal muscle in severely injured patients. To accomplish this goal, 14 patients with burns encompassing >40% of their body surface area underwent metabolic evaluation utilizing isotopic dilution of phenylalanine, femoral artery and vein blood sampling, and sequential muscle biopsies of the leg. After baseline metabolic measurements were taken, insulin was infused into the femoral artery at 0.45 mIU·min^-1·100 ml leg volume^-1 to create a local hyperinsulinemia but with minimal systemic perturbations. Insulin administration increased femoral venous concentration of insulin (P < 0.01) but with only a 4% (insignificant) decrease in the arterial glucose concentration and a 7% (insignificant) decrease in the arterial concentration of phenylalanine. Extremity hyperinsulinemia significantly increased leg blood flow (P < 0.05) and the rate of muscle protein synthesis (P < 0.05). Neither the rate of muscle protein breakdown nor the rate of transmembrane transport of phenylalanine was significantly altered with extremity hyperinsulinemia. In conclusion, this study demonstrates that insulin directly stimulates muscle protein synthesis in severely injured patients.

insulin resistance; phenylalanine; burns; muscle catabolism; critical illness; hypermetabolic response

This article has been cited by other articles:

				D. C. Gore, R. R. Wolfe, and D. L. Chinkes Quantification of amino acid transport through interstitial fluid: assessment of four-compartment modeling for muscle protein kinetics Am J Physiol Endocrinol Metab, January 1, 2007; 292(1): E319 - E323. [Abstract] [Full Text] [PDF]

				L. Langouche, I. Vanhorebeek, and G. Van den Berghe Glycaemic control in trauma patients, is there a role? Trauma, January 1, 2006; 8(1): 13 - 19. [Abstract] [PDF]

				R. Koopman, A. J. M. Wagenmakers, R. J. F. Manders, A. H. G. Zorenc, J. M. G. Senden, M. Gorselink, H. A. Keizer, and L. J. C. van Loon Combined ingestion of protein and free leucine with carbohydrate increases postexercise muscle protein synthesis in vivo in male subjects Am J Physiol Endocrinol Metab, April 1, 2005; 288(4): E645 - E653. [Abstract] [Full Text] [PDF]

				H. Sugita, M. Kaneki, M. Sugita, T. Yasukawa, S. Yasuhara, and J. A. J. Martyn Burn injury impairs insulin-stimulated Akt/PKB activation in skeletal muscle Am J Physiol Endocrinol Metab, March 1, 2005; 288(3): E585 - E591. [Abstract] [Full Text] [PDF]