Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.
State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.
Nutrients. 2022 Sep 4;14(17):3653. doi: 10.3390/nu14173653.
(1) Background: Nutritional support is one of the most important cornerstones in the management of patients with severe burns, but the carbohydrate-to-fat ratios in burn nutrition therapy remain highly controversial. In this study, we aimed to discuss the effects of different ratios of carbohydrate-fat through enteral nutrition on the metabolic changes and organ damage in burned rats. (2) Methods: Twenty-four burned rats were randomly divided into 5%, 10%, 20% and 30% fat nutritional groups. REE and body weight were measured individually for each rat daily. Then, 75% of REE was given in the first week after burns, and the full dose was given in the second week. Glucose tolerance of the rats was measured on days 1, 3, 7, 10 and 14. Blood biochemistry analysis and organ damage analysis were performed after 7 and 14 days of nutritional therapy, and nuclear magnetic resonance (NMR) and insulin content analysis were performed after 14 days. (3) Results: NMR spectra showed significant differences of glucose, lipid and amino acid metabolic pathways. The energy expenditure increased, and body weight decreased significantly after burn injury, with larger change in the 20%, 5% and 30% fat groups, and minimal change in the 10% fat group. The obvious changes in the level of plasma protein, glucose, lipids and insulin, as well as the organ damage, were in the 30%, 20% and 5% fat groups. In relative terms, the 10% fat group showed the least variation and was closest to normal group. (4) Conclusion: Lower fat intake is beneficial to maintaining metabolic stability and lessening organ damage after burns, but percentage of fat supply should not be less than 10% in burned rats.
(1)背景:营养支持是严重烧伤患者治疗的最重要基石之一,但烧伤营养治疗中的碳水化合物与脂肪的比例仍存在很大争议。在本研究中,我们旨在讨论通过肠内营养给予不同碳水化合物-脂肪比例对烧伤大鼠代谢变化和器官损伤的影响。(2)方法:24 只烧伤大鼠随机分为 5%、10%、20%和 30%脂肪营养组。对每只大鼠进行单独的个体测量,测量其静息能量消耗(REE)和体重。烧伤后第一周给予 75%REE,第二周给予全剂量。在烧伤后第 1、3、7、10 和 14 天测量大鼠的葡萄糖耐量。在营养治疗后第 7 和 14 天进行血液生化分析和器官损伤分析,并在第 14 天进行磁共振(NMR)和胰岛素含量分析。(3)结果:NMR 谱显示葡萄糖、脂质和氨基酸代谢途径存在显著差异。烧伤后能量消耗增加,体重明显下降,20%、5%和 30%脂肪组变化较大,10%脂肪组变化较小。血浆蛋白、葡萄糖、脂质和胰岛素水平以及器官损伤均发生明显变化,30%、20%和 5%脂肪组变化最大。相对而言,10%脂肪组变化最小,与正常组最接近。(4)结论:低脂肪摄入有利于维持烧伤后代谢稳定和减轻器官损伤,但烧伤大鼠的脂肪供给百分比不应低于 10%。