INFLUENCE OF OPERATION ON GLUCOSE-METABOLISM AND LIPOLYSIS IN HUMAN ADIPOSE-TISSUE - A MICRODIALYSIS STUDY

Objective: To investigate the effect of an operation on metabolism in human adipose tissue. Design: Open study. Setting: Department of Surge ry and the Research Centre at Huddinge Hospital. Subjects: 13 non-obes e patients who underwent elective cholecystectomy, and 5 control subje cts. Interventions: Microdialysis of the extracellular compartment of abdominal subcutaneous adipose tissue was done before, during and afte r a 45-minute intravenous infusion of 20 g glucose before, and one day after, the operation. Main outcome measures: Concentrations of glycer ol, glucose, lactate and pyruvate in the tissue dialysate and in venou s plasma. Results: After operation, the baseline plasma insulin concen tration doubled (p < 0.001) and the fasting glucose concentration rose from 4.4 (0.1) to 5.3 (0.2) mmol/l (p < 0.001). In response to the gl ucose infusion, the maximum increase in plasma insulin trebled (p < 0. 01) and the integrated concentrations (area under the curve) of plasma glucose, lactate and pyruvate were significantly more pronounced (p < 0.02-p < 0.001) after than before operation. The suppression of plasm a glycerol and free fatty acid concentrations was similar before and a fter operation (50-60%). The reduction in the concentrations of glycer ol in adipose tissue, and the increases in the concentrations of gluco se, lactate, and pyruvate, after intravenous infusion of glucose were not influenced by the operation. Conclusion: A moderately serious oper ation rapidly induces a deterioration in total body glucose homeostasi s, partly as a result of peripheral insulin resistance. This does not affect the utilization of glucose by adipose tissue or the antilipolyt ic response to glucose infusion.