OBJECTIVE: To study the effect of a D-beta-hydroxybutyrate infusion on protein metabolism, lipolysis, and endogenous glucose production in septic patients. DESIGN: Prospective, randomized trial. SETTING:Intensive care unit (ICU) and metabolic unit at a university hospital. PATIENTS: Twelve ICU patients with sepsis and six healthy normal subjects. INTERVENTIONS:Septic patients were administered 4-hr infusions of either D-beta-hydroxybutyrate or a control solution, 12 hrs after parenteral nutrition was replaced with an isotonic saline infusion. MEASUREMENTS AND MAIN RESULTS: The appearance and oxidation rates of leucine (L[1-13C]leucine) and endogenous glucose production (D[6,6-2H2]glucose), plasma fatty acids, and glycerol values were measured before and at the end of infusion of D-beta-hydroxybutyrate or control solution. Unlike the control test, the D-beta-hydroxybutyrate infusion decreased glucose production, fatty acids, and glycerol concentrations, but failed to decrease the leucine oxidation rate. CONCLUSION:Exogenous ketone-bodies infusion decreased lipolysis and glucose production in septic patients but had no beneficial effect on protein metabolism, as evaluated with L[1-13C]leucine.
RCT Entities:
OBJECTIVE: To study the effect of a D-beta-hydroxybutyrate infusion on protein metabolism, lipolysis, and endogenous glucose production in septic patients. DESIGN: Prospective, randomized trial. SETTING: Intensive care unit (ICU) and metabolic unit at a university hospital. PATIENTS: Twelve ICU patients with sepsis and six healthy normal subjects. INTERVENTIONS: Septic patients were administered 4-hr infusions of either D-beta-hydroxybutyrate or a control solution, 12 hrs after parenteral nutrition was replaced with an isotonic saline infusion. MEASUREMENTS AND MAIN RESULTS: The appearance and oxidation rates of leucine (L[1-13C]leucine) and endogenous glucose production (D[6,6-2H2]glucose), plasma fatty acids, and glycerol values were measured before and at the end of infusion of D-beta-hydroxybutyrate or control solution. Unlike the control test, the D-beta-hydroxybutyrate infusion decreased glucose production, fatty acids, and glycerol concentrations, but failed to decrease the leucine oxidation rate. CONCLUSION: Exogenous ketone-bodies infusion decreased lipolysis and glucose production in septic patients but had no beneficial effect on protein metabolism, as evaluated with L[1-13C]leucine.
Authors: Alex Buga; Madison L Kackley; Christopher D Crabtree; Teryn N Sapper; Lauren Mccabe; Brandon Fell; Rich A LaFountain; Parker N Hyde; Emily R Martini; Jessica Bowman; Yue Pan; Debbie Scandling; Milene L Brownlow; Annalouise O'Connor; Orlando P Simonetti; William J Kraemer; Jeff S Volek Journal: Front Nutr Date: 2021-03-24