科研之友
微信
新浪微博
Facebook
分享链接
摘要
Background: Insulin regulates albumin synthesis in vitro and in various experimental models. The current study was undertaken to determine the effects of a physiologic hyperinsulinemia on albumin synthesis in postoperative patients in whom plasma albumin concentrations are decreased. Methods: Studies were performed in postabsorptive patients after major abdominal operations. Mass spectrometry techniques were used to directly determine the incorporation rate of 1-[(13)C]-leucine into albumin. Consecutive blood samples were taken during a continuous isotope (D-Glc) infusion (0.16 mu mol/kg/min). Isotopic enrichments were determined at baseline (period I) and after a 4-hour D-glucose (D-Glc) infusion at currently recommended rates (170 mg/kg/h, n = 10) or after infusion of saline (control group, n = 8) (period II). Results: After D-Glc infusion, plasma insulin concentrations increased significantly (period I, 6.6 +/- 1.8 mu U/mL; period II, 21.4 +/- 2.1 mu U/mL; P <.01). In contrast, plasma insulin concentration remained constant in control patients (period I, 3.8 +/- 0.9 mu U/mL(-1); period II, 5.9 +/- 1.1 mu U/mL; not significant vs period I, but P <.005 vs the corresponding value at the end of period II in the control group). Hyperinsulinemia was without effect on fractional albumin synthesis (period I, 12.8% mu 1.9%/d; period II, 11.9% +/- 1.9%/d; not significant), and synthesis rates corresponded to those measured in controls (period I, 13.0% +/- 1.2%/d; period II, 12.1% +/- 0.1%/d; not significant vs period I and vs D-Glc infusion). Conclusions: A standard D-Glc infusion is insufficient to increase albumin synthesis in postoperative patients. (JPEN J Parenter Enteral Nutr. 2011; 35: 405-411)
- 出版日期2011-5
