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Different contribution of substrates oxidation to insulin resistance in malnourished elderly patients with cancer
Author(s) -
Gambardella Antonio,
Paolisso Giuseppe,
D'Amore Anna,
Granato Marina,
Verza Mario,
Varricchio Michele
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19931115)72:10<3106::aid-cncr2820721036>3.0.co;2-g
Subject(s) - lipid oxidation , medicine , insulin resistance , endocrinology , carbohydrate metabolism , insulin , lean body mass , glucose clamp technique , lipid metabolism , pancreatic hormone , biochemistry , chemistry , antioxidant , body weight
Background . The relative contribution of malnutrition and cancer to insulin resistance in elderly patients is still poorly understood. Methods . Twenty malnourished and 15 well‐nourished patients with cancer matched for age (70 ± 0.3 versus 69 ± 0.3 years; P = not significant), mean arterial blood pressure (104 ± 8 versus 107 ± 7 mm Hg; P = not significant), gender ratio (10 males/10 females versus 7 males/8 females), and sedentary life style underwent an euglycemic glucose clamp. Simultaneous infusion of 3‐DH‐glucose and indirect calorimetry allowed the authors to determine glucose turnover parameters and analyze substrates oxidation. Results . Malnourished patients displayed a reduced total body glucose metabolism (36 ± 2 versus 31 ± 3 μmol/kg of lean body mass X min P < 0.04), despite higher glucose oxidation. In the same group of patients, the authors demonstrated a significant increase in lipid oxidation and the lack of the inverse relationship between glucose and lipid oxidation (r = 0.07; P = not significant). Insulin infusion enhanced glucose oxidation and suppressed lipid oxidation, but such changes were at lower extent in malnourished patients. Conclusions . Our study confirms the presence of insulin resistance in malnourished patients and demonstrates the relative contribution of substrates oxidation to the insulin resistance itself.