Relative influence of glucose and insulin on peripheral amino acid metabolism in severely burned patients

Dennis Gore, Steven Wolf, David Herndon, Robert R. Wolfe

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Protein catabolism and glucose intolerance are prominent in critically injured patients. The objective of this study was to assess if glucose or insulin availability influences the extent of protein catabolism in hypermetabolic patients. Methods: Amino acid net balance from the leg was quantitated in 6 severe burn victims. Furthermore, whole body and leg protein kinetics were assessed with 2H5 phenylalanine and 15N alanine. Measurements were obtained after a 9-hour fast, during an IV glucose infusion (30 μmol/kg per minute), and during a hyperinsulinemic (500 mIU/kg per minute) euglycemic clamp. Results: Compared with fasting values, the administration of glucose resulted in a significantly increased efflux of amino acids from the leg. In contrast, insulin administration significantly decreased the cumulative net efflux of amino acids. During hyperinsulinemia, isotopic measurements demonstrated a significant decrease in alanine appearance and an increase in phenylalanine disappearance into the leg. Conclusions: These findings demonstrate that in critically injured patients, acute hyperglycemia increases muscle catabolism despite an endogenous insulin response. In contrast, exogenous insulin given in sufficient amount impedes muscle protein loss. The mechanism for this anabolic effect of insulin may vary between different amino acids.

Original languageEnglish (US)
Pages (from-to)271-277
Number of pages7
JournalJournal of Parenteral and Enteral Nutrition
Volume26
Issue number5
StatePublished - Sep 2002

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amino acid metabolism
insulin
Insulin
Leg
legs
Amino Acids
Glucose
glucose
amino acids
protein metabolism
Phenylalanine
phenylalanine
Alanine
alanine
Anabolic Agents
Proteins
Glucose Clamp Technique
Glucose Intolerance
protein depletion
hyperinsulinemia

ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)

Cite this

Relative influence of glucose and insulin on peripheral amino acid metabolism in severely burned patients. / Gore, Dennis; Wolf, Steven; Herndon, David; Wolfe, Robert R.

In: Journal of Parenteral and Enteral Nutrition, Vol. 26, No. 5, 09.2002, p. 271-277.

Research output: Contribution to journalArticle

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