Fuel utilization and glucose hyperalimentation after liver resection

K. Ouchi, K. Sakai, S. Matsubara, J. Mikuni, Y. Katayose, S. Matsuno

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Clinical studies and experiments in rats were carried out to elucidate changes in fuel utilization after hepatectomy. In addition, the effect of glucose hyperalimentation on energy metabolism in the liver remnant was studied. Respiratory quotient (RQ) and substrate oxidation rate for fat and glucose were evaluated by indirect calorimetry in eight patients who had undergone liver resection. Patients had a reduced nonprotein RQ of ~0.85 and a reduced ratio of glucose to fat oxidation of ~2.0 on the 1st and 2nd postoperative days. After 80% hepatectomy, rats received either 30 kcal · kg-1 · day-1 (group 1) or 200 kcal · kg-1 · day-1 (group 2) of glucose for 48 h. In both rat groups, hepatic mitochondrial ATP synthesis 12 and 24 h after hepatectomy was accelerated when palmitic acid was used as the substrate and suppressed when pyruvate was used compared with sham-operated groups. This suggests that the energy substrate of the remnant liver was principally fatty acids rather than glucose, which seems to occur also in humans. Hepatic energy charge was within normal limits in group 1 (0.862 ± 0.008) but decreased significantly in group 2 (0.818 ± 0.006, p < 0.01) 12 h after hepatectomy. An abundance of glucose in the early postoperative period therefore caused a hepatic energy derangement by suppressing endogenous fat oxidation. This suppression was corroborated by the findings of lower immunoreactive glucagon and nonesterified fatty acid concentration in group 2. Therefore, glucose hyperalimentation in the early postoperative period after liver resection is not recommended.

Original languageEnglish
Pages (from-to)411-414
Number of pages4
JournalNutrition
Volume10
Issue number5
Publication statusPublished - 1994
Externally publishedYes

Keywords

  • energy substrate
  • glucose hyperalimentation
  • hepatic energy charge
  • hepatic mitochondrial ATP synthesis
  • indirect calorimetry

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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