Effects of enteral carbohydrates on de novo lipogenesis in critically ill patients.

Détails

ID Serval
serval:BIB_E2F27F376DD3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Effects of enteral carbohydrates on de novo lipogenesis in critically ill patients.
Périodique
The American journal of clinical nutrition
Auteur⸱e⸱s
Schwarz J.M., Chioléro R., Revelly J.P., Cayeux C., Schneiter P., Jéquier E., Chen T., Tappy L.
ISSN
0002-9165
Statut éditorial
Publié
Date de publication
2000
Peer-reviewed
Oui
Volume
72
Numéro
4
Pages
940-5
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Résumé
BACKGROUND: Conversion of glucose into lipid (de novo lipogenesis; DNL) is a possible fate of carbohydrate administered during nutritional support. It cannot be detected by conventional methods such as indirect calorimetry if it does not exceed lipid oxidation. OBJECTIVE: The objective was to evaluate the effects of carbohydrate administered as part of continuous enteral nutrition in critically ill patients. DESIGN: This was a prospective, open study including 25 patients nonconsecutively admitted to a medicosurgical intensive care unit. Glucose metabolism and hepatic DNL were measured in the fasting state or after 3 d of continuous isoenergetic enteral feeding providing 28%, 53%, or 75% carbohydrate. RESULTS: DNL increased with increasing carbohydrate intake (f1.gif" BORDER="0"> +/- SEM: 7.5 +/- 1.2% with 28% carbohydrate, 9.2 +/- 1.5% with 53% carbohydrate, and 19.4 +/- 3.8% with 75% carbohydrate) and was nearly zero in a group of patients who had fasted for an average of 28 h (1.0 +/- 0.2%). In multiple regression analysis, DNL was correlated with carbohydrate intake, but not with body weight or plasma insulin concentrations. Endogenous glucose production, assessed with a dual-isotope technique, was not significantly different between the 3 groups of patients (13.7-15.3 micromol * kg(-1) * min(-1)), indicating impaired suppression by carbohydrate feeding. Gluconeogenesis was measured with [(13)C]bicarbonate, and increased as the carbohydrate intake increased (from 2.1 +/- 0.5 micromol * kg(-1) * min(-1) with 28% carbohydrate intake to 3.7 +/- 0.3 micromol * kg(-1) * min(-1) with 75% carbohydrate intake, P: < 0. 05). CONCLUSION: Carbohydrate feeding fails to suppress endogenous glucose production and gluconeogenesis, but stimulates DNL in critically ill patients.
Mots-clé
Adult, Aged, Blood Glucose, Calorimetry, Indirect, Carbohydrate Metabolism, Carbohydrates, Chromatography, High Pressure Liquid, Enteral Nutrition, Fatty Acids, Female, Gas Chromatography-Mass Spectrometry, Glucagon, Gluconeogenesis, Glucose, Humans, Hydrocortisone, Insulin, Intensive Care, Kinetics, Lipids, Liver, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Radioimmunoassay, Random Allocation, Regression Analysis, Triglycerides
Pubmed
Web of science
Création de la notice
24/01/2008 13:37
Dernière modification de la notice
20/08/2019 16:06
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