Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/82058
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dc.contributor.authorDeane, A.en
dc.contributor.authorRayner, C.en
dc.contributor.authorKeeshan, A.en
dc.contributor.authorCvijanovic, N.en
dc.contributor.authorMarino, Z.en
dc.contributor.authorNguyen, Q.en
dc.contributor.authorChia, B.en
dc.contributor.authorSummers, M.en
dc.contributor.authorSim, J.en
dc.contributor.authorvan Beek, T.en
dc.contributor.authorChapman, M.en
dc.contributor.authorHorowitz, M.en
dc.contributor.authorYoung, R.en
dc.date.issued2014en
dc.identifier.citationCritical Care Medicine, 2014; 42(1):57-65en
dc.identifier.issn0090-3493en
dc.identifier.issn1530-0293en
dc.identifier.urihttp://hdl.handle.net/2440/82058-
dc.description.abstractObjectives: Providing effective enteral nutrition is important during critical illness. In health, glucose is absorbed from the small intestine via sodium-dependent glucose transporter-1 and glucose transporter-2, which may both be regulated by intestinal sweet taste receptors. We evaluated the effect of critical illness on glucose absorption and expression of intestinal sodium-dependent glucose transporter-1, glucose transporter-2, and sweet taste receptors in humans and mice. Design: Prospective observational study in humans and mice. Setting: ICU and university-affiliated research laboratory. Subjects: Human subjects were 12 critically ill patients and 12 healthy controls. In the laboratory 16-week-old mice were studied. Interventions: Human subjects underwent endoscopy. Glucose (30 g) and 3-O-methylglucose (3 g), used to estimate glucose absorption, were infused intraduodenally over 30 minutes. Duodenal mucosa was biopsied before and after infusion. Mice were randomized to cecal ligation and puncture to model critical illness (n = 16) or sham laparotomy (control) (n = 8). At day 5, mice received glucose (100 mg) and 3-O-methylglucose (10 mg) infused intraduodenally prior to mucosal tissue collection. Measurements and Main Results: Quantitative polymerase chain reaction was performed to measure absolute (human) and relative levels of sodium-dependent glucose transporter-1, glucose transporter-2, and taste receptor type 1 member 2 (T1R2) transcripts. Blood samples were assayed for 3-O-methylglucose to estimate glucose absorption. Glucose absorption was three-fold lower in critically ill humans than in controls (p = 0.002) and reduced by a similar proportion in cecal ligation and puncture mice (p = 0.004). In critically ill patients, duodenal levels of sodiumdependent glucose transporter-1, glucose transporter-2, and T1R2 transcript were reduced 49% (p < 0.001), 50% (p = 0.009), and 85% (p = 0.007), whereas in the jejunum of cecal ligation and puncture mice sodium-dependent glucose transporter-1, glucose transporter-2, and T1R2 transcripts were reduced by 55% (p < 0.001), 50% (p = 0.002), and 69% (p = 0.004). Conclusions: Critical illness is characterized by markedly diminished glucose absorption, associated with reduced intestinal expression of glucose transporters (sodium-dependent glucose transporter-1 and glucose transporter-2) and sweet taste receptor transcripts. These changes are paralleled in cecal ligation and puncture mice.en
dc.description.statementofresponsibilityAdam M. Deane, Chris K. Rayner, Alex Keeshan, Nada Cvijanovic, Zelia Marino, Nam Q. Nguyen, Bridgette Chia, Matthew J. Summers, Jennifer A. Sim, Theresia van Beek, Marianne J. Chapman, Michael Horowitz, Richard L. Youngen
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.rightsCopyright: © 2014 by the Society of Critical Care Medicine and Lippincott Williams & Wilkinsen
dc.subjectblood glucose; enteral nutrition; glucose absorption; intensive care; small intestineen
dc.titleThe effects of critical illness on intestinal glucose sensing, transporters and absorptionen
dc.typeJournal articleen
dc.identifier.rmid0020134387en
dc.identifier.doi10.1097/CCM.0b013e318298a8afen
dc.identifier.pubid16553-
pubs.library.collectionAnaesthesia and Intensive Care publicationsen
pubs.verification-statusVerifieden
pubs.publication-statusPublisheden
Appears in Collections:Anaesthesia and Intensive Care publications

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