Effect of intensive vs conventional insulin therapy on perioperative nutritional substrates metabolism in patients undergoing gastrectomy

doi:10.3748/wjg.v18.i21.2695

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 21

This Article

Citation of this article

Corresponding Author of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (3465)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-2) series, Tables (1-3) series.

Item

Count

PDF

365

HTML

2885

Figures (1-2)

107

Tables (1-3)

108

Sum=3465

Jun 7, 2012 (publication date) through Apr 24, 2024

Times Cited of This Article

Times Cited (3)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Brief Article

World J Gastroenterol. Jun 7, 2012; 18(21): 2695-2703
Published online Jun 7, 2012. doi: 10.3748/wjg.v18.i21.2695

Table 1 Baseline characteristics of patients

Variable	IIT	CIT	Statistics	Sig
Age (yr)	59.13 ± 10.06	58.94 ± 10.99	t-tests	0.943
Male-no/total (no %)	24/32 (75%)	24/32 (75%)	χ² tests	1
Weight (kg)	61.18 ± 6.82	60.47 ± 5.49	t-tests	0.411
BMI (kg/m²)	23.83 ± 1.37	24.15 ± 1.12	t-tests	0.309
Waistline (cm)	84.38 ± 7.76	87.94 ± 8.71	t-tests	0.089
CEA (ng/mL)	4.52 ± 5.61	3.37 ± 4.88	t-tests	0.384
CA-199φ (U/mL)	23.94 ± 23.20	10.69 ± 13.64	t-tests	0.07
Surgery time (min)	145.81 ± 19.57	141.25 ± 26.24	t-tests	0.387
Ln-HOMA-IR	0.586 ± 0.104	0.633 ± 0.116	t-tests	0.769
Hypertension	10/32	10/32	χ² tests	1
SOFA (organs dysfunction)
Blood/lung/renal/hepatic	2/0/4/0	2/2/2/0	χ² tests	0.446
Child-Pugh (A/B/C)	28/4/0 (32)	30/2/0 (32)	χ² tests	0.518
ASA grading (I/II/III/> III)	2/22/8/0 (32)	2/22/8/0 (32)	χ² tests	1
NYHA (I/II/III/IV)	8/18/6/0 (32)	10/16/6/0 (32)	χ² tests	0.496
NRS 1-2/3-4/5-6 scores	10/20/2 (32)	18/14/0 (32)	χ² tests	0.1
MNA 26-24/24-17/17-14	6/24/2 (32)	8/24/0 (32)	χ² tests	0.09

IIT: Intensive insulin therapy; CIT: Conventional insulin therapy; BMI: Body mass index; CEA: Carcinoembryonic antigen; SOFA: Sequential organ failure assessment; HOMA-IR: Homeostasis model assessment of insulin resistance; ASA: American Society of Anesthesiologists; NRS: Nutrition risk screen; MNA: Mini-nutrition assessment; NYHA: New York Heart Association; φplus: Levenes’test for equality of variances F not assumed (P < 0.05), need Satterthwaite t test; Sig: Significant. All values with t test are mean ± SD and with χ² tests are ratio (n/N).

Table 2 Body composition

Values	Group	n	Day 0	1st	3rd	7th	P value
ICF	IIT	32	22.42 ± 2.55	21.90 ± 2.57	21.48 ± 2.64	21.09 ± 2.19^c,e	0.026
	CIT	32	22.66 ± 2.69	21.97 ± 2.69	21.34 ± 2.54	20.17 ± 2.02^c
ECF	IIT	32	11.31 ± 1.64	11.57 ± 1.75	11.34 ± 1.62	11.06 ± 1.55^c	0.381
	CIT	32	11.35 ± 1.71	11.63 ± 1.63	11.40 ± 1.58	11.11 ± 1.63^c
FM	IIT	32	11.76 ± 3.43	11.18 ± 3.55	10.65 ± 2.87	10.17 ± 2.40^c,e	0.042
	CIT	32	11.83 ± 4.15	10.93 ± 3.88	10.02 ± 2.84	9.18 ± 2.24^c
BM	IIT	32	2.70 ± 0.34	2.68 ± 0.33	2.63 ± 0.35	2.64 ± 0.39	0.418
	CIT	32	2.69 ± 0.36	2.61 ± 0.34	2.60 ± 0.34	2.62 ± 0.36
PM	IIT	32	12.13 ± 1.68	11.41 ± 1.53^a	11.08 ± 1.62	11.01 ± 1.41^e	0.009
	CIT	32	12.19 ± 1.52	11.38 ± 1.53	10.89 ± 1.52	10.45 ± 1.24^c
TBW	IIT	32	33.73 ± 5.09	33.47 ± 4.94	32.83 ± 4.49	32.15 ± 4.51	0.263
	CIT	32	34.01 ± 4.86	33.6 ± 4.84	32.74 ± 4.73	32.28 ± 4.85
MM	IIT	32	45.86 ± 6.05	44.88 ± 5.84	43.91 ± 5.70	43.16 ± 5.32^c	0.146
	CIT	32	46.20 ± 5.85	44.98 ± 5.74	43.63 ± 5.42	42.73 ± 5.24^c
FFM	IIT	32	48.56 ± 7.24	47.56 ± 6.98	46.54 ± 6.85	45.80 ± 7.01	0.179
	CIT	32	48.89 ± 7.11	47.59 ± 7.01	46.23 ± 6.94	45.35 ± 6.86^c
BW	IIT	32	60.32 ± 8.45	58.74 ± 8.55	57.19 ± 7.84	55.97 ± 7.55^c	0.094
	CIT	32	60.72 ± 8.88	58.52 ± 8.32	56.25 ± 7.68	54.53 ± 7.12^c

ICF: Internal cell fluid; ECF: External cell fluid; FM: Fat mass; BM: Bone mass; PM: Protein mass; TBW: Total body water; FFM: Free fat mass; MM: Muscle mass; BW: Body weight; IIT: Intensive insulin therapy; CIT: Conventional insulin therapy. There were significant differences between preoperative day 0 and postoperative day 1 (^aP < 0.05), between day 0 and postoperative day 7 (^cP < 0.05) and between the two groups at the same time (^eP < 0.05), respectively.

Table 3 Changes in plasma proteins and lipids (mean ± SD)

Values	Group	n	Day 0	1st	3rd	7th	P value
ALB (g/L)	IIT	32	35.50 ± 2.36	33.72 ± 2.02^a,g	31.70 ± 2.37^c,g	34.64 ± 2.29^e,g	0.009
	CIT	32	36.09 ± 2.47	32.47 ± 2.47	30.34 ± 3.13	33.45 ± 2.93
TP (g/L)	IIT	32	61.90 ± 3.97	57.97 ± 3.83^a,g	55.85 ± 3.53^c,g	59.81 ± 3.56^e	0.023
	CIT	32	62.18 ± 4.26	56.09 ± 3.57	54.13 ± 2.96	58.89 ± 3.78
TG (mol/L)	IIT	32	1.45 ± 0.40	0.70 ± 0.16^a	0.83 ± 0.18^c	1.44 ± 0.21^e	0.267
	CIT	32	1.64 ± 0.30	0.76 ± 0.23	0.94 ± 0.18	1.52 ± 0.19
TC (μmol/L)	IIT	32	4.36 ± 0.16	3.64 ± 0.12^a	3.55 ± 0.10	3.92 ± 0.13^e	0.207
	CIT	32	4.74 ± 0.16	3.81 ± 0.12	3.60 ± 0.10	4.30 ± 0.13
FFAn (nmol/L)	IIT	32	0.43 ± 0.084	0.92 ± 0.114^a,g	0.86 ± 0.097^c,g	0.71 ± 0.086^e,g	0.016
	CIT	32	0.40 ± 0.092	1.03 ± 0.148	0.93 ± 0.104	0.84 ± 0.106

IIT: Intensive insulin therapy; CIT: Conventional insulin therapy; TP: Total protein; ALB: Albumin; TG: Triglyceride; TC: Total cholesterol; FFA: Free fat acid. There were significant differences in values between preoperative days 0 and postoperative day 1 (^aP < 0.05), between postoperative days 1 and 3 (^cP < 0.05) and between postoperative days 3 and 7 respectively (^eP < 0.05) respectively. There was a significant difference between the two groups at the same time (^gP < 0.05).

Citation: Liu HC, Zhou YB, Chen D, Niu ZJ, Yu Y. Effect of intensive vs conventional insulin therapy on perioperative nutritional substrates metabolism in patients undergoing gastrectomy. World J Gastroenterol 2012; 18(21): 2695-2703
URL: https://www.wjgnet.com/1007-9327/full/v18/i21/2695.htm
DOI: https://dx.doi.org/10.3748/wjg.v18.i21.2695