Svanfeldt Monika, Thorell Anders, Hausel Jonatan, Soop Mattias, Nygren Jonas, Ljungqvist Olle
Division of Surgery, CLINTEC, Karolinska Institutet, Karolinska University Hospital Huddinge and Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm, Sweden.
Clin Nutr. 2005 Oct;24(5):815-21. doi: 10.1016/j.clnu.2005.05.002.
Preoperative intake of a clear carbohydrate-rich drink reduces insulin resistance after surgery. In this study, we evaluated whether this could be related to increased insulin sensitivity at the onset of surgery. Furthermore, we aimed to establish the optimal dose-regimen.
Six healthy volunteers underwent hyperinsulinaemic (0.8 mU/kg/min), normoglycaemic (4.5 mmol/l) clamps and indirect calorimetry on four occasions in a crossover-randomised order; after overnight fasting (CC), after a single evening dose (800 ml) of the drink (LC), after a single morning dose (400 ml, CL) and after intake of the drink in the evening and in the morning before the clamp (LL). Data are presented as mean+/-SD. Statistical analysis was performed using the Student's t-test and ANOVA.
Insulin sensitivity was higher in CL and LL (9.2+/-1.5 and 9.3+/-1.9 mg/kg/min, respectively) compared to CC and LC (6.1+/-1.6 and 6.6+/-1.9 mg/kg/min, P<0.01 vs. CL and LL).
A carbohydrate-rich drink enhances insulin action 3 h later by approximately 50%. Enhanced insulin action to normal postprandial day-time level at the time of onset of anaesthesia or surgery is likely to, at least partly, explain the effects on postoperative insulin resistance.
术前摄入富含碳水化合物的清饮料可降低术后胰岛素抵抗。在本研究中，我们评估了这是否与手术开始时胰岛素敏感性增加有关。此外，我们旨在确定最佳剂量方案。
六名健康志愿者按交叉随机顺序在四个时间点接受高胰岛素血症（0.8 mU/kg/min）、正常血糖（4.5 mmol/l）钳夹试验和间接测热法；在过夜禁食后（CC）、在晚上单次服用（800 ml）饮料后（LC）、在早上单次服用（400 ml，CL）以及在钳夹试验前晚上和早上摄入饮料后（LL）。数据以平均值±标准差表示。使用学生t检验和方差分析进行统计分析。
与CC和LC相比，CL和LL时的胰岛素敏感性更高（分别为9.2±1.5和9.3±1.9 mg/kg/min），而CC和LC时分别为6.1±1.6和6.6±1.9 mg/kg/min（与CL和LL相比，P<0.01）。
富含碳水化合物的饮料在3小时后可使胰岛素作用增强约50%。在麻醉或手术开始时将胰岛素作用增强至正常餐后日间水平可能至少部分解释了对术后胰岛素抵抗的影响。
