Cellular mechanisms underlying the protective effects of preoperative feeding: a randomized study investigating muscle and liver glycogen content, mitochondrial function, gene and protein expression

Annals of Surgery
Sherif AwadDileep N Lobo

Abstract

To investigate the effects of preoperative feeding with a carbohydrate-based drink that also contained glutamine and antioxidants (oral nutritional supplement [ONS], Fresenuis Kabi, Germany) on glycogen reserves, mitochondrial function, and the expression of key metabolic genes and proteins. Preoperative carbohydrate loading attenuates the decline in postoperative insulin sensitivity but the cellular mechanisms underlying this remain unclear. Two groups of 20 patients undergoing laparoscopic cholecystectomy participated in this randomized placebo-controlled double-blind study. Patients received either 600 mL of ONS or placebo the evening before surgery, and again 300 mL 3 to 4 hours before anesthesia. A 300-mL aliquot of ONS contained 50 g of carbohydrate, 15 g of glutamine and antioxidants. Blood was sampled before ingestion of the evening drink, after induction of anesthesia, and on postoperative day 1 for measurement of concentrations of glucose, glutamine, and antioxidants. Rectus abdominis muscle and liver biopsies were performed intraoperatively to determine glycogen and glutamine concentrations, mitochondrial function, pyruvate dehydrogenase kinase (PDK4), forkhead transcription factor 1 (FOXO1), and metallothionein 1A (...Continue Reading

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Citations

Aug 7, 2013·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Tomoaki YatabeMasataka Yokoyama
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Dec 14, 2011·Current Opinion in Clinical Nutrition and Metabolic Care·Sherif Awad, Dileep N Lobo
Aug 24, 2018·Plastic and Reconstructive Surgery·Sean B Orenstein, Robert G Martindale
Apr 1, 2011·Current Opinion in Anaesthesiology·Sherif Awad, Dileep N Lobo

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