Effect of ketone bodies on hyperglycemia and lactic acidemia in hemorrhagic stress.
BACKGROUND
To investigate the effect of hyperketonemia on altered glucose metabolism under stress conditions, we infused sodium D-3-hydroxybutyrate (3-OHB) into rats in hemorrhagic hypotension and evaluated the plasma concentration of substrates related to glucose metabolism.


METHODS
Three groups of anesthetized rats (weight, 280 g to 320 g) were bled acutely, and their mean arterial pressures were maintained at 40 mm Hg. From 1 hour before hemorrhage to the end of the experiment, rats in the first group (n = 10) were infused with 3-OHB at a rate of 30 mumol/kg.min (3-OHB group), those in the second group (n = 10) received glucose and sodium bicarbonate (glucose group), and the remaining 10 rats received only sodium bicarbonate and no energy substrates (control group). Sodium bicarbonate was used to control the alkalizing effect of 3-OHB.


RESULTS
Hyperketonemia (1158 +/- 30 mumol/L - 1618 +/- 154 mumol/L) occurred only in the 3-OHB group. Hyperglycemia and lactic acidemia during hemorrhagic shock were suppressed significantly compared with the control group. Plasma concentration of alanine was also lower compared with the control group. In the glucose group, although plasma lactate concentration was lower, plasma glucose concentration was not suppressed, and plasma alanine concentration was higher in comparison with the control group during hemorrhagic shock. There was no significant difference in plasma insulin concentration among the three groups.


CONCLUSIONS
These results suggest that administered 3-OHB may suppress glycolysis during hemorrhagic shock.
Katayama
M
M
Department of Traumatology, Osaka University Medical School, Japan.
Hiraide
A
A
Sugimoto
H
H
Yoshioka
T
T
Sugimoto
T
T
D020155:3-Hydroxybutyric Acid; D000140:Acidosis, Lactic / Q000150:complications / Q000378:metabolism*; D000409:Alanine / Q000097:blood; D000818:Animals; D001786:Blood Glucose; D006019:Glycolysis / Q000187:drug effects; D006885:Hydroxybutyrates / Q000494:pharmacology*; D006943:Hyperglycemia / Q000150:complications / Q000378:metabolism*; D007262:Infusions, Intravenous; D007328:Insulin / Q000097:blood; D007657:Ketone Bodies / Q000097:blood / Q000494:pharmacology*; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D012769:Shock / Q000150:complications / Q000378:metabolism*
D001786:Blood Glucose; D006885:Hydroxybutyrates; D007328:Insulin; D007657:Ketone Bodies; D007773:Lactates; D019344:Lactic Acid; D000409:Alanine; D020155:3-Hydroxybutyric Acid