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Randomized clinical trial of the effect of preoperative oral carbohydrate treatment on postoperative whole-body protein and glucose kinetics
Division of Surgery, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm.
Division of Surgery, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm; Centre for Gastrointestinal Disease, Ersta Hospital, Stockholm.
Division of Surgery, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm; Centre for Gastrointestinal Disease, Ersta Hospital, Stockholm.
Division of Surgery, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm; Centre for Gastrointestinal Disease, Ersta Hospital, Stockholm.
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2007 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 94, no 11, p. 1342-50Article, review/survey (Refereed) Published
Abstract [en]

Background: Preoperative oral carbohydrate (CHO) reduces postoperative insulin resistance. In this randomized trial, the effect of CHO on postoperative whole-body protein turnover was studied.

Methods: Glucose and protein kinetics ([6,6(2)H(2)]D-glucose, [(2)H(5)]phenylalanine, [(2)H(2)]tyrosine and [(2)H(4)]tyrosine) and substrate oxidation (indirect calorimetry) were studied at baseline and during hyperinsulinaemic normoglycaemic clamping before and on the first day after colorectal resection. Fifteen patients were randomized to receive a preoperative beverage with high (125 mg/ml) or low (25 mg/ml) CHO content.

Results: Three patients were excluded after the intervention, leaving six patients in each group. After surgery whole-body protein balance did not change in the high oral CHO group, whereas it was more negative in the low oral CHO group after surgery at baseline (P = 0.003) and during insulin stimulation (P = 0.005). Insulin-stimulated endogenous glucose release was similar before and after surgery in the high oral CHO group, but was higher after surgery in the low oral CHO group (P = 0.013) and compared with the high oral CHO group (P = 0.044).

Conclusion: Whole-body protein balance and the suppressive effect of insulin on endogenous glucose release are better maintained when patients receive a CHO-rich beverage before surgery.

Place, publisher, year, edition, pages
West Sussex, United Kingdom: John Wiley & Sons, 2007. Vol. 94, no 11, p. 1342-50
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-40515DOI: 10.1002/bjs.5919ISI: 000251209800005PubMedID: 17902094Scopus ID: 2-s2.0-36349006361OAI: oai:DiVA.org:oru-40515DiVA, id: diva2:777422
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2017-12-05Bibliographically approved

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