Does hyperketonemia affect protein or glucose kinetics in postabsorptive or traumatized man?
Leucine and glucose turnover were measured using simultaneous infusions of [13C]leucine and [2H]glucose before and during an infusion of Na DL-hydroxybutyrate (Na DL-HB) in overnight-fasted patients the day before and 3 days after total hip replacement. The ketone body infusion before surgery resulted in a significant increase in plasma leucine concentration and leucine turnover, while glucose concentration and turnover decreased. Surgery increased leucine turnover. Ketone body infusion after surgery caused a further increased leucine turnover while turnover fell as before surgery. We suggest that exogenous ketone bodies decrease hepatic glucose production and probably stimulate a rise in protein synthesis above breakdown leading to a decreased nitrogen excretion as observed by other investigators. Despite the metabolic adaptation to trauma, this response was not affected by surgery.
Crowe
P J
PJ
Nuffield Department of Surgery, John Radcliffe Hospital, Oxford, United Kingdom.
Royle
G T
GT
Wagner
D
D
Burke
J F
JF
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D002247:Carbon Isotopes; D003903:Deuterium; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D006622:Hip Prosthesis; D006801:Humans; D006885:Hydroxybutyrates / Q000008:administration & dosage / Q000494:pharmacology*; D007262:Infusions, Intravenous; D007328:Insulin / Q000097:blood; D007657:Ketone Bodies / Q000097:blood*; D007700:Kinetics; D007930:Leucine / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011506:Proteins / Q000378:metabolism; D014947:Wounds and Injuries / Q000378:metabolism*
D001786:Blood Glucose; D002096:C-Peptide; D002247:Carbon Isotopes; D006885:Hydroxybutyrates; D007328:Insulin; D007657:Ketone Bodies; D011506:Proteins; D003903:Deuterium; D007930:Leucine; D005947:Glucose