Insulin decreases hepatic acute phase protein levels in severely burned children

Xiaowu Wu, Steven J. Thomas, David Herndon, Arthur P. Sanford, Steven Wolf

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background. Severe burn induces the hepatic acute phase response. In this study, we wondered whether continuous insulin treatment decreases acute phase protein levels in the severely burned. Methods. Eighteen children aged 2 to 17 years with burns >40% of total body surface area were randomized to receive either insulin (n = 9) or no treatment (n = 9) within 72 hours after injury until the wounds were 95% healed. Insulin was given at a continuous rate of ≥ 1.5 μU/kg/min to maintain euglycemia (serum glucose 100-140 μg/dL). Plasma was examined at days 7, 14, 21, and 28 for acute phase protein levels including C-reactive protein, C3 complement, α1-acid glycoprotein, haptoglobin, α2-macroglobulin, prealbumin, transferrin, and retinal-binding protein. Statistical analysis was by ANOVA and t test. Results. With insulin treatment, α1-acid glycoprotein, C3 complement, α2-macroglobulin, and haptoglobin levels decreased (P < .05) after a severe burn compared with control, especially at days 21 and 28. Additionally, the hepatic constitutive proteins (prealbumin, transferrin, and retinal-binding protein) were lower in the insulin-treatment group than those of the control group at day 21 (P < .05). Conclusions. Continuous insulin treatment decreases acute phase protein levels after a severe burn. The results suggest insulin downregulation of the hepatic acute phase response to injury.

Original languageEnglish (US)
Pages (from-to)196-202
Number of pages7
JournalSurgery
Volume135
Issue number2
DOIs
StatePublished - Feb 2004

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Acute-Phase Proteins
Insulin
Liver
Transferrin-Binding Proteins
Macroglobulins
Acute-Phase Reaction
Prealbumin
Haptoglobins
Glycoproteins
Complement C2
Complement C1
Therapeutics
Acids
Body Surface Area
Wounds and Injuries
Burns
C-Reactive Protein
Analysis of Variance
Down-Regulation
Glucose

ASJC Scopus subject areas

  • Surgery

Cite this

Insulin decreases hepatic acute phase protein levels in severely burned children. / Wu, Xiaowu; Thomas, Steven J.; Herndon, David; Sanford, Arthur P.; Wolf, Steven.

In: Surgery, Vol. 135, No. 2, 02.2004, p. 196-202.

Research output: Contribution to journalArticle

Wu, Xiaowu ; Thomas, Steven J. ; Herndon, David ; Sanford, Arthur P. ; Wolf, Steven. / Insulin decreases hepatic acute phase protein levels in severely burned children. In: Surgery. 2004 ; Vol. 135, No. 2. pp. 196-202.
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