1. Inflammation-mediated muscle metabolic dysregulation local and remote to the site of major abdominal surgery
- Author
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Dileep N. Lobo, Despina Constantin, Dumitru Constantin-Teodosiu, Paul L. Greenhaff, and Kristina K. Varadhan
- Subjects
Blood Glucose ,Male ,0301 basic medicine ,Critical Care and Intensive Care Medicine ,Systemic inflammation ,MAFbx, muscle atrophy F-box ,TNF-α, tumour necrosis factor α ,Postoperative Complications ,MuRF1, muscle-RING finger 1 ,0302 clinical medicine ,IR, insulin resistance ,FOXO, forkhead box O ,Abdomen ,Insulin ,Nutrition and Dietetics ,Muscle inflammatory responses ,Middle Aged ,3. Good health ,PDC, pyruvate dehydrogenase complex ,Cytokines ,LPS, lipopolysaccharide ,Female ,IRS1, insulin receptor substrate 1 ,medicine.symptom ,Adult ,CSTL1, cathepsin ,medicine.medical_specialty ,Abdominal surgery ,Inflammation ,Protein degradation ,PI3K/Akt1, phosphotidyl inositol 3-kinase/protein kinase B ,Article ,PPAR, perioxisome proliferator-activated receptor ,Proinflammatory cytokine ,03 medical and health sciences ,Pancreatectomy ,Atrophy ,PCA, perchloric acid ,Digestive System Physiological Phenomena ,Diabetes mellitus ,Internal medicine ,FFA, free fatty acid ,medicine ,Humans ,Muscle, Skeletal ,Herniorrhaphy ,business.industry ,RA, rectus abdominus ,Metabolic response ,medicine.disease ,IL, interleukin ,030104 developmental biology ,Endocrinology ,Postoperative hyperglycaemia ,VL, vastus lateralis ,Hyperglycemia ,Blood sugar regulation ,Gene expression ,business ,PDK, pyruvate dehydrogenase kinase ,030217 neurology & neurosurgery - Abstract
Summary Background & aims Postoperative hyperglycaemia is common in patients having major surgery and is associated with adverse outcomes. This study aimed to determine whether bacteraemia contributed to postoperative systemic inflammation, and whether increases in the expression of muscle mRNAs and proteins reflecting increased muscle inflammation, atrophy and impaired carbohydrate oxidation were evident at the time of surgery, and both local and distant to the site of trauma, and could be associated with impaired glucoregulation. Methods Fifteen adult patients without diabetes undergoing major abdominal surgery participated in this observational study set in a university teaching hospital. Arterialised-venous blood samples and muscle biopsies were obtained before and after major elective abdominal surgery, from sites local (rectus abdominis – RA) and remote to the site of surgery (vastus lateralis – VL). The main outcome measures included blood glucose concentrations, gut permeability and changes in expression of muscle mRNAs and proteins linked to inflammation and glucose regulation. Results Immediately postoperatively, RA demonstrated markedly increased mRNA expression levels of cathepsin-L (7.5-fold, P
- Published
- 2018
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