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Surgery-induced insulin resistance in human patients relations to glucoseutilization and transport
Departments of Surgery, Huddinge University Hospital, Stockholm, Sweden; Department of Surgery, Huddinge University Hospital, Huddinge, Sweden.
Departments of Surgery, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
Joslin Diabetes Center, Harvard Medical School, Boston MA, United States.
Div. of Endocrinology and Metabolism, Mayo Clinic, Rochester MN, United States.
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1999 (English)In: American Journal of Physiology, ISSN 0002-9513, E-ISSN 2163-5773, Vol. 276, no 4, p. E754-E761Article in journal (Refereed) Published
Abstract [en]

To investigate the underlying molecular mechanisms for surgery-induced insulin resistance in skeletal muscle, six otherwise healthy patients undergoing total hip replacement were studied before, during, and after surgery. Patients were studied under basal conditions and during physiological hyperinsulinemia (60 microU/ml). Biopsies of vastus lateralis muscle were used to measure GLUT-4 translocation, glucose transport, and glycogen synthase activities. Surgery reduced insulin-stimulated glucose disposal (P < 0.05) without altering the insulin-stimulated increase in glucose oxidation or suppression of endogenous glucose production. Preoperatively, insulin infusion increased plasma membrane GLUT-4 in all six subjects (P < 0.05), whereas insulin-stimulated GLUT-4 translocation only occurred in three patientspostoperatively (not significant). Moreover, nonoxidative glucose disposal rates and basal levels of glycogen synthase activities in muscle were reduced postoperatively (P < 0.05). These findings demonstrate that peripheral insulin resistance develops immediately postoperatively and that this condition might be associated with perturbations in insulin-stimulated GLUT-4 translocation as well as nonoxidative glucose disposal, presumably at the level of glycogen synthesis.

Place, publisher, year, edition, pages
American Physiological Society , 1999. Vol. 276, no 4, p. E754-E761
National Category
Physiology Surgery
Identifiers
URN: urn:nbn:se:oru:diva-63893ISI: 000079650100020PubMedID: 10198313Scopus ID: 2-s2.0-0032924450OAI: oai:DiVA.org:oru-63893DiVA, id: diva2:1171091
Note

Funding agencies:

NIDDK NIH HHS DK-41973 

NIAMS NIH HHS R01 AR-42238 

NCRR NIH HHS RR-00585 

Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-02-05Bibliographically approved

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Ljungqvist, Olle

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