title: Evaluation of the effects of a preoperative 2-hour fast with maltodextrine and glutamine on insulin resistance, acute-phase response, nitrogen balance, and serum glutathione after laparoscopic cholecystectomy: a controlled randomized trial.
abstract: BACKGROUND
  Prolonged preoperative fasting increases insulin resistance (IR). The authors investigated whether an abbreviated preoperative fast with glutamine (GLN) plus a carbohydrate (CHO)-based beverage would improve the organic response after surgery.
  
  
  METHODS
  Forty-eight female patients (19-62 years) were randomized to either standard fasting (control group) or to fasting with 1 of 3 different beverages before video-cholecystectomy. Beverages were consumed 8 hours (400 mL; placebo group: water; GLN group: water with 50 g maltodextrine plus 40 g GLN; and CHO group: water with 50 g maltodextrine) and 2 hours (200 mL; placebo: water; GLN: water with 25 g maltodextrine plus 10 g GLN; and CHO: water with 25 g maltodextrine) before anesthesia. Blood samples were collected pre- and postoperatively.
  
  
  RESULTS
  The mean (SEM) postoperative homeostasis model assessment-insulin resistance was greater (P < .05) in control patients (4.3 [1.3]) than in the other groups (placebo, 1.6 [0.3]; CHO, 2.3 [0.4]; and GLN, 1.5 [0.1]). Glutathione was significantly higher (P < .01) in the GLN group than in both CHO and control groups. Interleukin-6 increased in all groups except the GLN group. The C-reactive protein/albumin ratio was higher (P < .05) in controls than in CHO and GLN groups. The nitrogen balance was less negative in GLN (-2.5 [0.8] gN) than in both placebo (-9.0 [2] gN; P = .001) and control (-6.6 [0.4] gN; P = .04) groups.
  
  
  CONCLUSIONS
  Preoperative intake of a GLN-enriched CHO beverage appears to improve IR and antioxidant defenses and decreases the inflammatory response after video-cholecystectomy.
authors.affiliation: Department of Food and Nutrition, Federal University of Mato Grosso, Cuiaba, Brazil. dianadock@hotmail.com
authors.forename: Diana Borges
authors.initials: DB
authors.lastname: Dock-Nascimento
authors.forename: Jose Eduardo
authors.initials: JE
authors.lastname: de Aguilar-Nascimento
authors.forename: Marcelo Sepulveda
authors.initials: MS
authors.lastname: Magalhaes Faria
authors.forename: Cervantes
authors.initials: C
authors.lastname: Caporossi
authors.forename: Natasha
authors.initials: N
authors.lastname: Slhessarenko
authors.forename: Dan Linetzky
authors.initials: DL
authors.lastname: Waitzberg
mesh_terms: D000210:Acute-Phase Reaction / Q000378:metabolism*; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005215:Fasting / Q000378:metabolism*; D005260:Female; D005973:Glutamine / Q000008:administration & dosage; D005978:Glutathione / Q000097:blood*; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D009584:Nitrogen / Q000097:blood*; D011134:Polysaccharides / Q000008:administration & dosage; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D015850:Interleukin-6; D011134:Polysaccharides; D005973:Glutamine; C008315:maltodextrin; D002097:C-Reactive Protein; D005978:Glutathione; D009584:Nitrogen