Role of insulin and glucose oxidation in mediating the protein catabolism of burns and sepsis

F. Jahoor, R. E. Shangraw, H. Miyoshi, H. Wallfish, David Herndon, R. R. Wolfe

Research output: Contribution to journalArticle

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Abstract

We have investigated the responsiveness of protein kinetics to insulin and the role of glucose oxidation rate as a mediator of the protein catabolic response to burn injury and sepsis by assessing the response of leucine and urea kinetics to a 5-h hyperinsulinemic euglycemic clamp with and without the simultaneous administration of dichloroacetate (DCA) (to further increase glucose oxidation via stimulation of pyruvate dehydrogenase activity) in eight severely burned and eight septic patients. Leucine and urea kinetics were measured by the primed constant infusions of [1-13C]leucine and [15N2]urea. Compared with controls, basal leucine kinetics (flux and oxidation) were significantly elevated (P < 0.01) in both groups of patients. Hyperinsulinemia elicited significant (P < 0.05) decreases in leucine kinetics in both groups of patients. Consistent with this observation, hyperinsulinemia caused urea production to decrease significantly (P < 0.05) in both patient groups. The administration of DCA to patients during hyperinsulinemia elicited a significant increase in glucose oxidation rate compared with the clamp rate (P < 0.05), and the percent of glucose uptake oxidized increased from 45.5 ± 5.5 to 53.5 ± 4.8%; yet the response of leucine and urea kinetics to the clamp plus DCA was not different from the response to the clamp alone. These results suggest that the maximal effectiveness of insulin to suppress protein breakdown is not impaired and that a deficit in glucose oxidation or energy supply is probably not playing a major role in mediating the protein catabolic response to severe burn injury and sepsis.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume257
Issue number3
StatePublished - 1989

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Burns
Leucine
Sepsis
Clamping devices
Urea
Insulin
Glucose
Oxidation
Kinetics
Hyperinsulinism
Proteins
Glucose Clamp Technique
Wounds and Injuries
Pyruvic Acid
Oxidoreductases
Fluxes

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Physiology

Cite this

Jahoor, F., Shangraw, R. E., Miyoshi, H., Wallfish, H., Herndon, D., & Wolfe, R. R. (1989). Role of insulin and glucose oxidation in mediating the protein catabolism of burns and sepsis. American Journal of Physiology - Endocrinology and Metabolism, 257(3).

Role of insulin and glucose oxidation in mediating the protein catabolism of burns and sepsis. / Jahoor, F.; Shangraw, R. E.; Miyoshi, H.; Wallfish, H.; Herndon, David; Wolfe, R. R.

In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 257, No. 3, 1989.

Research output: Contribution to journalArticle

Jahoor, F. ; Shangraw, R. E. ; Miyoshi, H. ; Wallfish, H. ; Herndon, David ; Wolfe, R. R. / Role of insulin and glucose oxidation in mediating the protein catabolism of burns and sepsis. In: American Journal of Physiology - Endocrinology and Metabolism. 1989 ; Vol. 257, No. 3.
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