Key result
A 4-hour D-glucose infusion did not significantly increase fractional albumin synthesis compared to saline in postoperative patients (11.9%/d vs 12.1%/d; not significant).
Why the study?
Does a 4-hour D-glucose infusion increase albumin synthesis in postoperative patients?
Does a 4-hour D-glucose infusion increase albumin synthesis in postoperative patients?
A standard D-glucose infusion inducing physiologic hyperinsulinemia does not increase albumin synthesis in postoperative patients.
D-glucose infusion does not enhance albumin synthesis postoperatively; leaves open whether alternative substrates or doses affect fractional synthesis rates.
BACKGROUND: Insulin regulates albumin synthesis in vitro and in various experimental models. The current study was undertaken to determine the effects of a physiologic hyperinsulinemia on albumin synthesis in postoperative patients in whom plasma albumin concentrations are decreased. METHODS: Studies were performed in postabsorptive patients after major abdominal operations. Mass spectrometry techniques were used to directly determine the incorporation rate of 1-[(13)C]-leucine into albumin. Consecutive blood samples were taken during a continuous isotope (D-Glc) infusion (0.16 µmol/kg/min). Isotopic enrichments were determined at baseline (period I) and after a 4-hour D-glucose (D-Glc) infusion at currently recommended rates (170 mg/kg/h, n = 10) or after infusion of saline (control group, n = 8) (period II). RESULTS: After D-Glc infusion, plasma insulin concentrations increased significantly (period I, 6.6 ± 1.8 µU/mL; period II, 21.4 ± 2.1 µU/mL; P < .01). In contrast, plasma insulin concentration remained constant in control patients (period I, 3.8 ± 0.9 µU/mL(-1); period II, 5.9 ± 1.1 µU/mL; not significant vs period I, but P < .005 vs the corresponding value at the end of period II in the control group). Hyperinsulinemia was without effect on fractional albumin synthesis (period I, 12.8% ± 1.9%/d; period II, 11.9% ± 1.9%/d; not significant), and synthesis rates corresponded to those measured in controls (period I, 13.0% ± 1.2%/d; period II, 12.1% ± 0.1%/d; not significant vs period I and vs D-Glc infusion). CONCLUSIONS: A standard D-Glc infusion is insufficient to increase albumin synthesis in postoperative patients.
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Rittler et al. (2011) studied Postoperative patients (after major abdominal operations) (n=18). D-glucose (D-Glc) infusion vs. Saline infusion was evaluated on Fractional albumin synthesis rate (p=not significant). A 4-hour D-glucose infusion did not significantly increase fractional albumin synthesis compared to saline in postoperative patients (11.9%/d vs 12.1%/d; not significant).
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