Trial reportThe Journal of clinical investigation1998
Insulin therapy in burn patients does not contribute to hepatic triglyceride production.
Trial report in The Journal of clinical investigation, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 64 citations in OpenAlex.
- Intensive insulin therapy improves insulin sensitivity and mitochondrial function in severely burned children.Critical care medicine · 2010Trial
- A submaximal dose of insulin promotes net skeletal muscle protein synthesis in patients with severe burns.Annals of surgery · 1999Trial
- Nutrition Considerations for Burn Patients: Optimizing Recovery and Healing.European burn journal · 2023Review
- Smoking results in accumulation of ectopic fat in the liver.Diabetes, metabolic syndrome and obesity : targets and therapy · 2019Article
- Outcome of Critically ill Patients Undergoing Mandatory Insulin Therapy Compared to Usual Care Insulin Therapy: Protocol for a Pilot Randomized Controlled Trial.JMIR research protocols · 2018Article
- Burn injury: review of pathophysiology and therapeutic modalities in major burns.Annals of burns and fire disasters · 2017Article
- Nutrition and metabolism in burn patients.Burns & trauma · 2017Review
- Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models.International journal of molecular sciences · 2016Review
- Proteins and amino acids are fundamental to optimal nutrition support in critically ill patients.Critical care (London, England) · 2014Review
- Association of postburn fatty acids and triglycerides with clinical outcome in severely burned children.The Journal of clinical endocrinology and metabolism · 2013Article
- Nutrition in burns: Galveston contributions.JPEN. Journal of parenteral and enteral nutrition · 2011Review
- What, how, and how much should patients with burns be fed?The Surgical clinics of North America · 2011Review
- The hypermetabolic response to burn injury and interventions to modify this response.Clinics in plastic surgery · 2009Review
- Modulation of the hypermetabolic response to trauma: temperature, nutrition, and drugs.Journal of the American College of Surgeons · 2009Article
- Propranolol decreases splanchnic triacylglycerol storage in burn patients receiving a high-carbohydrate diet.Annals of surgery · 2002Article
- The hepatic response to thermal injury: is the liver important for postburn outcomes?Molecular medicine (Cambridge, Mass.)Review
- Alcohol Modulation of the Postburn Hepatic Response.Journal of burn care & research : official publication of the American Burn AssociationReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
Lipid kinetics were studied in six severely burned patients who were treated with a high dose of exogenous insulin plus glucose to promote protein metabolism. The patients were 20+/-2-yr-old (SD) with 63+/-8% total body surface area burned. They were studied in a randomized order (a) in the fed state on the seventh day of a control period (C) of continuous high-carbohydrate enteral feeding alone, and (b) on the seventh day of enteral feeding plus exogenous insulin (200 pmol/h = 28 U/h) with extra glucose given as needed to avoid hypoglycemia (I+G). Despite a glucose delivery rate approximately 100% in excess of energy requirements, the following lipid parameters were unchanged: (a) total hepatic VLDL triglyceride (TG) secretion rate (0.165+/-0.138 [C] vs. 0.154+/- 0.138 mmol/kg . d-1 [I+G]), (b) plasma TG concentration (1.58+/-0.66 [C] vs. 1. 36+/-0.41 mmol/liter [I+G]), and (c) plasma VLDL TG concentration (0. 68+/-0.79 [C] vs. 0.67+/- 0.63 mmol/liter [I+G]). Instead, the high-carbohydrate delivery in conjunction with insulin therapy increased the proportion of de novo-synthesized palmitate in VLDL TG from 13+/-5% (C) to 34+/-14% (I+G), with a corresponding decreased amount of palmitate from lipolysis. In association with the doubling of the secretion rate of de novo-synthesized fatty acid (FA) in VLDL TG during insulin therapy (P > 0.5), the relative amount of palmitate and stearate increased from 35+/-5 to 44+/-8% and 4+/-1 to 7+/-2%, respectively, in VLDL TG, while the relative concentration of oleate and linoleate decreased from 43+/-5 to 37+/-6% and 8+/-4% to 2+/-2%, respectively. A 15-fold increase in plasma insulin concentration did not change the rate of release of FA into plasma (8.22+/-2.86 [C] vs. 8.72+/-6.68 mmol/kg.d-1 [I+G]. The peripheral release of FA represents a far greater potential for hepatic lipid accumulation in burn patients than the endogenous hepatic fat synthesis, even during excessive carbohydrate intake in conjunction with insulin therapy.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.