This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Zhang, X.-J. Articles by Wolfe, R. R. Search for Related Content PubMed PubMed Citation Articles by Zhang, X.-J. Articles by Wolfe, R. R. Social Bookmarking                         What's this?

Role of Basal Insulin in the Regulation of Protein Kinetics and Energy Metabolism in Septic Patients

Metabolism Unit, Shriner's Burns Institute, and the Departments of Surgery and Anesthesiology, The University of Texas Medical Branch, Galveston, Texas

Kelly R. Kunkel, M.D.

Metabolism Unit, Shriner's Burns Institute, and the Departments of Surgery and Anesthesiology, The University of Texas Medical Branch, Galveston, Texas

Farook Jahoor, PH.D.

Metabolism Unit, Shriner's Burns Institute, and the Departments of Surgery and Anesthesiology, The University of Texas Medical Branch, Galveston, Texas

Robert R. Wolfe, PH.D.

Metabolism Unit, Shriner's Burns Institute, and the Departments of Surgery and Anesthesiology, The University of Texas Medical Branch, Galveston, Texas

We have investigated the role of basal insulin concentration on leucine kinetics (determined by means of 1-[¹³C]leucine) and energy metabolism (determined by indirect calorimetry) in eight septic patients by reducing insulin (and glucagon) secretion by somatostatin infusion. Basal glucagon concentration was elevated (744 ± 381 pg/mL), and insulin concentration was normal (10 ± 4 µU/mL). Basal resting energy expenditure (REE) was 151 ± 8% that of predicted basal energy expenditure, and leucine appearance (Ra), oxidation, and nonoxidative disposal rates were all elevated above the normal ranges. Somatostatin infusion reduced insulin concentration by 52% and glucagon concentration by 64%. This resulted in a significant increase in the rate of leucine oxidation from 0.96 ± 0.08 to 1.18 ± 0.14 µmol/kg/min (p < 0.01), and nonoxidative leucine disposal decreased from 2.95 ± 0.18 to 2.67 ± 0.17 µmol/kg/min (p < 0.01). Somatostatin infusion also caused significant increases in REE and fat oxidation from 1310 ± 100 to 1505 ± 128 kcal/m²/day (p < 0.05) and from 1.72 ± 0.24 to 2.41 ± 0.41 mg/kg/min, respectively, and a slight decrease of carbohydrate oxidation from 1.51 ± 0.49 to 1.31 ± 0.49 mg/kg/min. These metabolic responses can be attributed to the reduction in insulin concentration, because they are in the opposite direction of changes that would occur as a consequence of a reduction in glucagon concentration. We conclude that the basal insulin plays an important role in attenuating net protein loss and energy expenditure. (Journal of Parenteral and Enteral Nutrition 15:394-399, 1991)

Journal of Parenteral and Enteral Nutrition, Vol. 15, No. 4, 394-399 (1991)
DOI: 10.1177/0148607191015004394


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				X.-J. Zhang, D. L. Chinkes, S. E. Wolf, and R. R. Wolfe Insulin but not growth hormone stimulates protein anabolism in skin wound and muscle Am J Physiol Endocrinol Metab, April 1, 1999; 276(4): E712 - E720. [Abstract] [Full Text] [PDF]

				D. S. Hardin, A. LeBlanc, S. Lukenbaugh, L. Para, and D. K. Seilheimer Proteolysis Associated With Insulin Resistance in Cystic Fibrosis Pediatrics, March 1, 1998; 101(3): 433 - 437. [Abstract] [Full Text] [PDF]