OBJECTIVE: To measure whole-body lipolysis and fatty acid re-esterification in critically ill patients. DESIGN: The rates of appearance of glycerol and palmitic acid in blood plasma were measured by infusing stable isotope tracers [2H5]glycerol and [1-13C]palmitic acid, respectively. Energy expenditure was measured by indirect calorimetry. SETTING: Medical ICU of The University of Texas Medical Branch Hospital, a university-based referral center. PATIENTS: Five uninjured critically ill patients. Four patients were hospitalized because of respiratory insufficiency and one because of myocardial infarction. Three patients died during their hospitalization. INTERVENTIONS: Metabolic studies were performed in each patient after an overnight (12-hr) fast. MEASUREMENTS AND MAIN RESULTS: Mean +/- SE glycerol and fatty acid rates of appearance were 4.5 +/- 1.0 and 11.5 +/- 0.8 mumol/kg.min, respectively. The ratio of fatty acid to glycerol rate of appearance was 2.9 +/- 0.5. Resting energy expenditure was 132 +/- 6% of predicted. CONCLUSIONS: An accelerated rate of lipolysis is part of the metabolic response to severe stress, regardless of its etiology. Because the rate of fatty acid release far exceeded energy requirements, fatty acids that were not oxidized as fuel were re-esterified to triglyceride, presumably in the liver.
OBJECTIVE: To measure whole-body lipolysis and fatty acid re-esterification in critically illpatients. DESIGN: The rates of appearance of glycerol and palmitic acid in blood plasma were measured by infusing stable isotope tracers [2H5]glycerol and [1-13C]palmitic acid, respectively. Energy expenditure was measured by indirect calorimetry. SETTING: Medical ICU of The University of Texas Medical Branch Hospital, a university-based referral center. PATIENTS: Five uninjured critically illpatients. Four patients were hospitalized because of respiratory insufficiency and one because of myocardial infarction. Three patients died during their hospitalization. INTERVENTIONS: Metabolic studies were performed in each patient after an overnight (12-hr) fast. MEASUREMENTS AND MAIN RESULTS: Mean +/- SEglycerol and fatty acid rates of appearance were 4.5 +/- 1.0 and 11.5 +/- 0.8 mumol/kg.min, respectively. The ratio of fatty acid to glycerol rate of appearance was 2.9 +/- 0.5. Resting energy expenditure was 132 +/- 6% of predicted. CONCLUSIONS: An accelerated rate of lipolysis is part of the metabolic response to severe stress, regardless of its etiology. Because the rate of fatty acid release far exceeded energy requirements, fatty acids that were not oxidized as fuel were re-esterified to triglyceride, presumably in the liver.
Authors: Ruqaiya M Al Balushi; Jennifer D Paratz; Jeremy Cohen; Merrilyn Banks; Joel Dulhunty; Jason A Roberts; Jeffrey Lipman Journal: BMJ Open Date: 2011-11-14 Impact factor: 2.692
Authors: Goncalo D S Correia; Keng Wooi Ng; Anisha Wijeyesekera; Sandra Gala-Peralta; Rachel Williams; S MacCarthy-Morrogh; Beatriz Jiménez; David Inwald; Duncan Macrae; Gary Frost; Elaine Holmes; Nazima Pathan Journal: Crit Care Med Date: 2015-07 Impact factor: 7.598