Wade Charles E, Baer Lisa A, Wu Xiaowu, Silliman David T, Walters Thomas J, Wolf Steven E
Crit Care. 2013 Oct 7;17(5):R225. doi: 10.1186/cc13048.
Severe trauma is accompanied by a period of hypermetabolism and disuse. In this study, a rat model was used to determine the effects of burn and disuse independently and in combination on body composition, food intake and adipokines.
Male rats were assigned to four groups 1) sham ambulatory (SA), 2) sham hindlimb unloaded (SH), 3) 40% total body surface area full thickness scald burn ambulatory (BA) and 4) burn and hindlimb unloaded (BH). Animals designated to the SH and BH groups were placed in a tail traction system and their hindlimbs unloaded. Animals were followed for 14 days. Plasma, urine, fecal and tissue samples were analyzed.
SA had a progressive increase in body mass (BM), SH and BA no change and BH a reduction. Compared to SA, BM was reduced by 10% in both SH and BA and by 17% when combined in BH. Compared to SA, all groups had reductions in lean and fat body mass with BH being greater. The decrease in lean mass was associated with the rate of urinary corticosterone excretion. The loss in fat mass was associated with decreases in plasma leptin and adiponectin and an increase in ghrelin. Following the acute response to injury, BH had a greater food intake per 100 g BM. Food intake was associated with the levels of leptin, adiponectin and ghrelin.
The effects of the combination of burn and disuse in this animal model were additive, therefore in assessing metabolic changes with severe trauma both injury and disuse should be considered. Furthermore, the observed changes in adipokines, corticosterone and ghrelin provide insights for interventions to attenuate the hypermetabolic state following injury, possibly reducing catabolism and muscle loss and subsequent adverse effects on recovery and function.
严重创伤伴随着一段高代谢和废用期。在本研究中,使用大鼠模型来确定烧伤和废用单独以及联合作用对身体成分、食物摄入量和脂肪因子的影响。
将雄性大鼠分为四组:1)假手术可活动组(SA),2)假手术 hindlimb 卸载组(SH),3)40% 体表面积全层烫伤可活动组(BA),4)烧伤且 hindlimb 卸载组(BH)。指定给 SH 和 BH 组的动物被置于尾部牵引系统中,其 hindlimb 卸载。对动物进行 14 天的跟踪观察。分析血浆、尿液、粪便和组织样本。
SA 组体重(BM)逐渐增加,SH 和 BA 组无变化,BH 组体重下降。与 SA 组相比,SH 和 BA 组的 BM 均降低了 10%,而 BH 组联合时降低了 17%。与 SA 组相比,所有组的瘦体重和脂肪体重均降低,BH 组降幅更大。瘦体重的降低与尿皮质酮排泄率有关。脂肪量的减少与血浆瘦素和脂联素的降低以及胃饥饿素的增加有关。在对损伤的急性反应之后,BH 组每 100 g BM 的食物摄入量更大。食物摄入量与瘦素、脂联素和胃饥饿素的水平有关。
在该动物模型中,烧伤和废用联合作用的影响是累加的,因此在评估严重创伤后的代谢变化时,应同时考虑损伤和废用因素。此外,观察到的脂肪因子、皮质酮和胃饥饿素的变化为减轻损伤后高代谢状态的干预措施提供了思路,可能减少分解代谢和肌肉损失以及随后对恢复和功能的不利影响。