title: [Pathophysiology of impaired insulin sensitivity in the perioperative period].
abstract: Hyperglycemia and insulin resistance are frequently observed during critical illness. The underlying pathophysiology is not yet fully understood, although hyperglycemia predicts post-surgical morbidity and mortality. Apparently perioperative insulin resistance has a complex pathophysiology and tissue-specific differences have to be considered. Multiple causative factors and intracellular signalling pathways have been identified driving the development of systemic perioperative insulin resistance. This review will focus on mechanisms involving the classical insulin signalling cascade.
authors.affiliation: Klinik für Endokrinologie und Stoff wechsel, Charité-Universitätsmedizin Berlin, Campus Mitte, Germany. anke.assmann@charite.de
authors.forename: Anke
authors.initials: A
authors.lastname: Assmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Spranger
mesh_terms: D000758:Anesthesia; D003422:Critical Care; D016207:Cytokines / Q000378:metabolism; D050171:Dyslipidemias / Q000097:blood / Q000150:complications; D051275:Glucose Transporter Type 4 / Q000378:metabolism; D006728:Hormones / Q000097:blood / Q000502:physiology; D006943:Hyperglycemia / Q000209:etiology / Q000378:metabolism; D007249:Inflammation / Q000473:pathology; D007328:Insulin / Q000502:physiology*; D007333:Insulin Resistance / Q000235:genetics / Q000502:physiology*; D019990:Perioperative Care; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology; D017027:Protein Tyrosine Phosphatases / Q000378:metabolism; D012307:Risk Factors; D015398:Signal Transduction / Q000502:physiology
chemical_list: D016207:Cytokines; D051275:Glucose Transporter Type 4; D006728:Hormones; D007328:Insulin; C495692:SLC2A4 protein, human; D017027:Protein Tyrosine Phosphatases