Hepatic insulin resistance during canine sepsis. 1991

M P McLane, and T W Tomasik, and W R Law, and R M Raymond
Department of Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois 60153.

Glucose dyshomeostasis and insulin resistance are well-documented characteristics of sepsis. The insulin resistance could be manifested in a decreased peripheral glucose uptake and/or an increased hepatic glucose output. To investigate the hepatic and peripheral responses to insulin in a three-day model of sepsis, 14 mongrel dogs were studied. Animals were randomly assigned to a SEPTIC (n = 5), SHAM (n = 4), or CONTROL (n = 5) group. Sepsis was induced in anesthetized dogs via a midline laparotomy with subsequent placement of a fecal-soaked gauze sponge around intestines. SHAM and CONTROL dogs were pair-fed with the SEPTIC dogs. On the third day, animals were anesthetized, intubated, and ventilated. Via a left-side laparotomy, electromagnetic flow probes were placed to measure hepatic arterial and portal venous blood flows. Cannulas were placed in femoral, portal, and hepatic veins and femoral artery to measure hepatic outputs of glucose, lactate, and oxygen during hyperinsulinemic-euglycemic clamps ranging from 0.4 to 4,000 mU insulin/min. Portal venous insulin concentrations in SEPTIC animals were significantly increased compared to CONTROL animals during 0.4 and 4 mU insulin/min infusions. An insulin infusion rate of 40 mU/min significantly decreased net hepatic glucose output (NHGO) in CONTROL animals but did not affect NHGO in SHAM or SEPTIC animals. An insulin infusion rate of 4,000 mU/min significantly decreased NHGO in all groups. An attempt to analyze the ED50 of the three dose-response curves was inconclusive. Glucose infusion rates (GIR) increased during insulin infusion but the GIR were not different between groups at any insulin infusion rate.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007328 Insulin A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1). Iletin,Insulin A Chain,Insulin B Chain,Insulin, Regular,Novolin,Sodium Insulin,Soluble Insulin,Chain, Insulin B,Insulin, Sodium,Insulin, Soluble,Regular Insulin
D007333 Insulin Resistance Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS. Insulin Sensitivity,Resistance, Insulin,Sensitivity, Insulin
D007773 Lactates Salts or esters of LACTIC ACID containing the general formula CH3CHOHCOOR.
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008297 Male Males
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D011169 Portal Vein A short thick vein formed by union of the superior mesenteric vein and the splenic vein. Portal Veins,Vein, Portal,Veins, Portal
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D005260 Female Females
D005947 Glucose A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. Dextrose,Anhydrous Dextrose,D-Glucose,Glucose Monohydrate,Glucose, (DL)-Isomer,Glucose, (alpha-D)-Isomer,Glucose, (beta-D)-Isomer,D Glucose,Dextrose, Anhydrous,Monohydrate, Glucose

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