79143
document
The effect of surgical trauma and insulin on whole-body protein turnover in parenterally-fed undernourished patients . Ten undernourished patients receiving total parenteral nutrition and undergoing major intestinal surgery were restarted on intravenous feeds identical to their pre-operative regimens within 24 h of their operation . Five , chosen at random , received post-operatively 1-2 units insulin/kg body weight/24 h with their feed , while the other five received the feed only . Pre-operatively , and 2 h after commencing their post-operative feeds , rates of whole-body protein synthesis and breakdown were measured over a 9-h period following intravenous injection of a single tracer dose of 15N-glycine by the ammonia and urea end-product methods . During these 9-h study periods measurements were also made of blood glucose , plasma insulin and glucagon , urinary ammonia , nitrogen , creatinine and 3-methylhistidine . Blood glucose and plasma insulin and glucagon concentrations rose post-operatively whether or not insulin was given , but the increment in insulin concentration was significantly greater when insulin was given . Apparent nitrogen balance was positive pre-operatively and became less so post-operatively whether insulin was given or not . Similarly , post-operative increments in urinary excretion of ammonia , creatinine and 3-methylhistidine were not altered by addition of insulin . Protein turnover , as estimated by the ammonia end-product method , tended to rise post-operatively , but there was no significant difference between the increases observed with or without insulin . The urea end-product method suggested that there was no change in whole-body protein turnover after surgery , whether or not insulin was given . This study does not support the clinical use of insulin as a means of modifying protein metabolic losses after major surgery .
79144
Intervention_Pharmacological
insulin
79145
Intervention_Pharmacological
1-2 units insulin/kg body weight/24 h with their feed
79146
Intervention_Control
received the feed only
79147
Intervention_Pharmacological
15N-glycine
79148
Intervention_Pharmacological
insulin
79149
Intervention_Pharmacological
insulin
79150
Intervention_Pharmacological
insulin
79151
Intervention_Pharmacological
insulin
79152
Intervention_Pharmacological
insulin
79153
Intervention_Pharmacological
insulin
79154
Intervention_Pharmacological
insulin
79155
Intervention_Pharmacological
insulin
79156
Intervention_Pharmacological
insulin
79157
Intervention_Pharmacological
insulin
79158
Outcome_Physical
whole-body protein turnover
79159
Outcome_Physical
rates of whole-body protein synthesis and breakdown
79160
Outcome_Physical
blood glucose
79161
Outcome_Physical
plasma insulin and glucagon
79162
Outcome_Physical
urinary ammonia
79163
Outcome_Physical
nitrogen
79164
Outcome_Physical
creatinine
79165
Outcome_Physical
3-methylhistidine
79166
Outcome_Physical
Blood glucose
79167
Outcome_Physical
plasma insulin and glucagon concentrations
79168
Outcome_Physical
insulin concentration
79169
Outcome_Physical
Apparent nitrogen balance
79170
Outcome_Physical
urinary excretion of ammonia
79171
Outcome_Physical
creatinine and 3-methylhistidine
79172
Outcome_Physical
Protein turnover
79173
Outcome_Physical
ammonia end-product
79174
Outcome_Physical
whole-body protein turnover
79175
Outcome_Physical
insulin
79176
Participant_Condition
parenterally-fed undernourished patients .
79177
Participant_Sample-size
Ten
79178
Participant_Condition
undernourished