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

Details

Serval ID
serval:BIB_E2F27F376DD3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effects of enteral carbohydrates on de novo lipogenesis in critically ill patients.
Journal
The American journal of clinical nutrition
Author(s)
Schwarz J.M., Chioléro R., Revelly J.P., Cayeux C., Schneiter P., Jéquier E., Chen T., Tappy L.
ISSN
0002-9165
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
72
Number
4
Pages
940-5
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
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.
Keywords
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
Create date
24/01/2008 14:37
Last modification date
20/08/2019 17:06
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