Sepsis alters skeletal muscle energetics and membrane function.

Surgery. 1991;110(2):318-25; 325-6

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Plain language summary

Polycystic ovary syndrome (PCOS) is an endocrine disorder found in approximately 6.5% of reproductive-age women. It is often associated with obesity, insulin resistance and menstrual irregularity. Insulin inhibits the production of sex hormone binding globulin (SHBG) and stimulates ovarian P450c17 alpha activity and androgen production. This study aimed to add to the research on dietary interventions for PCOS. The intervention was three 16 day eucaloric diets, which were either enriched with mono saturated fatty acids (MUFAs) (17% energy) or low in carbohydrate (43% energy). The three intervention periods were separated by 3 week wash out periods and included 11 women. The study found that the low carbohydrate diet decreased fasting insulin, but no impact on testosterone, LH, FSH or DHEA. The researchers concluded that a modest reduction in insulin may over time, improve endocrine outcomes in those with PCOS.

Abstract

The effects of sepsis on skeletal muscle energetics and membrane function are poorly understood, and the time course of changes in energy metabolism are unclear. To clarify these relationships, high energy phosphate ratios, intracellular pH, and phosphocreatine breakdown rates were measured in vivo in the gastrocnemius muscle of adult male Wistar rats after cecal ligation and puncture or sham operation with 31P magnetic resonance spectroscopy. Adenosine triphosphate (ATP) concentration and Na(+)-K+ ATPase and creatine kinase activities were determined in vitro. Within 24 hours, Na(+)-K+ ATPase activity increased by 60% in rats with cecal ligation and puncture, all of which had positive bacterial cultures, as compared to none of the sham-operated controls. Phosphocreatine/ATP ratios decreased by 20% in association with a quantitatively similar increase in phosphocreatine breakdown (9.7 +/- 0.5 vs 11.9 +/- 0.5 mumoles/gm wet wt/sec; p = 0.01). ATP concentrations were maintained, and intracellular pH did not change significantly. In this model, changes in phosphocreatine breakdown were not related to total creatine kinase activity, which did not change significantly, or increases in adenosine 5'-diphosphate (ADP) concentration (62 +/- 8 vs 92 +/- 8 mumols/L; p = 0.02). Thus, in early sepsis before a measurable decrease in pH occurs, ATP is utilized at an increased rate to help maintain ionic balance and/or to support other metabolic processes. Phosphocreatine stores are used to buffer ATP concentrations.

Lifestyle medicine

Fundamental Clinical Imbalances : Hormonal
Patient Centred Factors : Mediators/Low carbohydrate diet
Environmental Inputs : Diet
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Blood
Bioactive Substances : Low carbohydrate

Methodological quality

Allocation concealment : Not applicable

Metadata

Nutrition Evidence keywords : Low carbohydrate