Surgery-induced insulin resistance in human patients: Relation to glucose transport and utilization

A. Thorell, J. Nygren, M. F. Hirshman, T. Hayashi, K Sreekumaran Nair, E. S. Horton, L. J. Goodyear, O. Ljungqvist

Research output: Contribution to journalArticle

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Abstract

To investigate the underlying molecular mechanisms for surgeryinduced insulin resistance in skeletal muscle, six otherwise healthy patients undergoing total hip replacement were studied before, during, and after surgery. Patients were studied under basal conditions and during physiological hyperinsulinemia (60 μU/ml>. Biopsies of vastus lateralis muscle were used to measure GLUT-4 translocation, glucose transport, and glycogen synthase activities. Surgery reduced insulin-stimulated glucose disposal (P < 0.05 without altering the insulin-stimulated increase in glucose oxidation or suppression of endogenous glucose production. Preoperatively, insulin infusion increased plasma membrane GLUT-4 in all six subjects (P < 0.05), whereas insulin-stimulated GLUT-4 translocation only occurred in three patients postoperatively (not significant). Moreover, nonoxidative glucose disposal rates and basal levels of glycogen synthase activities in muscle were reduced postoperatively (P < 0.05). These findings demonstrate that peripheral insulin resistance develops immediately postoperatively and that this condition might be associated with perturbations in insulin-stimulated GLUT-4 translocation as well as nonoxidative glucose disposal, presumably at the level of glycogen synthesis.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume276
Issue number4 39-4
StatePublished - 1999

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Surgery
Insulin Resistance
Insulin
Glucose
Glycogen Synthase
Muscle
Muscles
Hip Replacement Arthroplasties
Quadriceps Muscle
Hyperinsulinism
Glycogen
Biopsy
Vascular Resistance
Cell membranes
Skeletal Muscle
Cell Membrane
Oxidation

Keywords

  • Glucose transport
  • Glycogen synthesis
  • Nonoxidative glucose disposal

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Biochemistry
  • Physiology (medical)

Cite this

Surgery-induced insulin resistance in human patients : Relation to glucose transport and utilization. / Thorell, A.; Nygren, J.; Hirshman, M. F.; Hayashi, T.; Nair, K Sreekumaran; Horton, E. S.; Goodyear, L. J.; Ljungqvist, O.

In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 276, No. 4 39-4, 1999.

Research output: Contribution to journalArticle

Thorell, A, Nygren, J, Hirshman, MF, Hayashi, T, Nair, KS, Horton, ES, Goodyear, LJ & Ljungqvist, O 1999, 'Surgery-induced insulin resistance in human patients: Relation to glucose transport and utilization', American Journal of Physiology - Endocrinology and Metabolism, vol. 276, no. 4 39-4.
Thorell, A. ; Nygren, J. ; Hirshman, M. F. ; Hayashi, T. ; Nair, K Sreekumaran ; Horton, E. S. ; Goodyear, L. J. ; Ljungqvist, O. / Surgery-induced insulin resistance in human patients : Relation to glucose transport and utilization. In: American Journal of Physiology - Endocrinology and Metabolism. 1999 ; Vol. 276, No. 4 39-4.
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