Mori Yoshiteru, Kitamura Takayuki, Kawamura Gaku, Sato Kanako, Sato Rui, Araki Yuko, Yamada Yoshitsugu
Department of Anesthesiology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Anesthesiology, Toho University Sakura Medical Center, Sakura, Chiba, Japan.
J Physiol Sci. 2015 Nov;65(6):523-30. doi: 10.1007/s12576-015-0390-7. Epub 2015 Aug 18.
Preoperative fasting as well as surgical stress significantly modifies metabolisms. Recent studies reported the possible advantageous effects of glucose administration on perioperative metabolisms; however, the underlying mechanisms have not been fully elucidated. Rats were allocated to three groups. During the fasting period, groups A and B were administered water, but group C was administered glucose. During laparotomy and the insulin tolerance test (ITT) under sevoflurane anesthesia, group A was administered saline, but groups B and C were administered glucose. During laparotomy, group C showed higher glucose levels and lower β-hydroxybutyrate (β-OHB) levels than group A, and group B showed more decreases in β-OHB levels than group A without differences in changes in glucose levels. Insulin levels and insulin sensitivity during laparotomy were similar among the three groups. No significant difference in insulin sensitivity was also confirmed in ITT. In conclusion, perioperative glucose administration suppresses lipolysis without affecting insulin secretion and sensitivity.
术前禁食以及手术应激会显著改变代谢。近期研究报道了葡萄糖给药对围手术期代谢可能具有的有益作用；然而，其潜在机制尚未完全阐明。将大鼠分为三组。在禁食期间，A组和B组给予水，但C组给予葡萄糖。在七氟醚麻醉下进行剖腹手术和胰岛素耐量试验（ITT）期间，A组给予生理盐水，但B组和C组给予葡萄糖。在剖腹手术期间，C组的血糖水平高于A组，β-羟基丁酸（β-OHB）水平低于A组，B组的β-OHB水平下降幅度大于A组，而血糖水平变化无差异。三组在剖腹手术期间的胰岛素水平和胰岛素敏感性相似。在ITT中也未证实胰岛素敏感性有显著差异。总之，围手术期给予葡萄糖可抑制脂肪分解，而不影响胰岛素分泌和敏感性。
