The sepsis-glucose intolerance riddle: a hormonal explanation.
Glucose intolerance has been commonly observed in sepsis and has been attributed to a multitude of endocrine and metabolic disorders. From 1977 to 1978, 19 patients were studied using intravenous glucose tolerance tests to evaluate this phenomenon; 15 patients presented with ongoing sepsis and four patients served as stress controls. Glucose intolerance was found to be a significant finding in less than 40% of the septic group. This state of intolerance was noted to be associated with a high mortality rate (60%), whereas glucose tolerance in sepsis was associated with a much improved mortality rate (10%). Hormone levels were correlated with glucose tolerance curves using the parameters of insulin, glucagon, growth hormone, cortisol, and epinephrine levels. Glucose intolerance and a high mortality rate were linked to sustained hyperglucagonemia, which was unresponsive to glucose challenge, and to marked suppression of growth hormone. This apparently represents a decompensated peripheral metabolic energy deficit, which results in the increased mortality rate.
D001424:Bacterial Infections / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D004837:Epinephrine / Q000097:blood; D005934:Glucagon / Q000097:blood; D005951:Glucose Tolerance Test; D013006:Growth Hormone / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D008875:Middle Aged
D001786:Blood Glucose; D006728:Hormones; D007328:Insulin; D013006:Growth Hormone; D005934:Glucagon; D006854:Hydrocortisone; D004837:Epinephrine