Abstract: |
Glucose oxidation is inhibited in severely ill patients. The present investigation was designed to study the relationship between glucose tissue uptake, glucose oxidation, and FFA concentration in septic cancer-bearing patients. The influence of glucose infusion alone (3.9 mg × kg-1 × min-1), followed by a euglycemic clamp with the same glucose load, on oxidation of glucose, plasma FFA concentration, and lipid oxidation were measured in eight septic cancer-bearing patients. During infusion of 3.9 mg glucose × kg-1 × min-1 glucose tissue uptake was 4.6 ± 0.3 mg × kg-1 × min-1, glucose oxidation 0.5 ± 0.2 mg × kg-1 × min-1, FFA concentration 377 ± 52 μmol × L-1, and lipid oxidation 2.0 ± 0.2 μmol × kg-1 × min-1. During the euglycemic clamp glucose tissue uptake was 4.4 ± 0.3 mg × kg-1 × min-1, glucose oxidation rose to 1.8 mg × kg-1 × min-1 (.001 < P < .01), FFA concentration dropped to 202 ± 23 μmol × L-1 (P < .001), and lipid oxidation to 1.2 ± 0.2 μmol × kg-1 × min-1 (.001 < P < .01). Nonprotein respiratory quotient rose from 0.73 ± 0.02 to 0.85 ± 0.02 (.001 < P < .01); 11% ± 5% of the total amount of glucose taken up by the tissues was oxidized during infusion of glucose alone and increased to 42% ± 6% during the euglycemic glucose clamp. It is concluded that in septic cancer-bearing patients glucose oxidation is inhibited during infusion of 3.9 mg glucose × kg-1 × min-1, even when expressed as percentage of glucose tissue uptake. With insulin, glucose tissue uptake was not influenced, but glucose oxidation expressed as percentage of glucose tissue uptake was normalized. © 1988. |