Short-term hypercaloric carbohydrate loading increases surgical stress resilience by inducing FGF21.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_4235435871D0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Short-term hypercaloric carbohydrate loading increases surgical stress resilience by inducing FGF21.
Journal
Nature communications
Author(s)
Agius T., Emsley R., Lyon A., MacArthur M.R., Kiesworo K., Faivre A., Stavart L., Lambelet M., Legouis D., de Seigneux S., Golshayan D., Lazeyras F., Yeh H., Markmann J.F., Uygun K., Ocampo A., Mitchell S.J., Allagnat F., Déglise S., Longchamp A.
ISSN
2041-1723 (Electronic)
ISSN-L
2041-1723
Publication state
Published
Issued date
05/02/2024
Peer-reviewed
Oui
Volume
15
Number
1
Pages
1073
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Identifiant FNS: SNSF-PZ00P3-185927 / SNSF-310030-176158
Abstract
Dietary restriction promotes resistance to surgical stress in multiple organisms. Counterintuitively, current medical protocols recommend short-term carbohydrate-rich drinks (carbohydrate loading) prior to surgery, part of a multimodal perioperative care pathway designed to enhance surgical recovery. Despite widespread clinical use, preclinical and mechanistic studies on carbohydrate loading in surgical contexts are lacking. Here we demonstrate in ad libitum-fed mice that liquid carbohydrate loading for one week drives reductions in solid food intake, while nearly doubling total caloric intake. Similarly, in humans, simple carbohydrate intake is inversely correlated with dietary protein intake. Carbohydrate loading-induced protein dilution increases expression of hepatic fibroblast growth factor 21 (FGF21) independent of caloric intake, resulting in protection in two models of surgical stress: renal and hepatic ischemia-reperfusion injury. The protection is consistent across male, female, and aged mice. In vivo, amino acid add-back or genetic FGF21 deletion blocks carbohydrate loading-mediated protection from ischemia-reperfusion injury. Finally, carbohydrate loading induction of FGF21 is associated with the induction of the canonical integrated stress response (ATF3/4, NF-kB), and oxidative metabolism (PPARγ). Together, these data support carbohydrate loading drinks prior to surgery and reveal an essential role of protein dilution via FGF21.
Keywords
Animals, Female, Humans, Male, Mice, Diet, Carbohydrate Loading, Dietary Carbohydrates/metabolism, Dietary Proteins/metabolism, Fibroblast Growth Factors/metabolism, Liver/surgery, Liver/metabolism, Mice, Inbred C57BL, Reperfusion Injury/metabolism, Surgical Procedures, Operative
Pubmed
Web of science
Open Access
Yes
Funding(s)
Swiss National Science Foundation
Swiss National Science Foundation
Fondation Novartis
Fondation Leenaards
Swiss National Science Foundation
Create date
06/02/2024 18:47
Last modification date
27/07/2024 6:00
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