Vol. 284, Issue 1, G107-G115, January 2003
Hemorrhage induces the rapid development of hepatic insulin
resistance
Yuchen
Ma1,
Ping
Wang1,2,3,
Joachim F.
Kuebler2,
Irshad H.
Chaudry2,3, and
Joseph L.
Messina1
1 Department of Pathology, Division of Molecular and
Cellular Pathology, 2 Center for Surgical Research and
Department of Surgery, and 3 Department of Physiology
and Biophysics, The University of Alabama at Birmingham,
Birmingham, Alabama 35294
Hyperglycemia is an early metabolic
response to trauma and hemorrhage. The role of hepatic insulin
resistance to the development of this hyperglycemia is not well
understood. The aim of this study was to determine whether the liver
becomes insulin resistant and to identify the particular hepatic
insulin signaling pathways that may be compromised following trauma and
hemorrhage. Male adult rats were bled to a mean arterial pressure of 40 mmHg and maintained at that pressure for 90 min followed by
resuscitation with Ringer lactate. Data showed that trauma and
hemorrhage rapidly induced profound hyperinsulinemia in combination
with significant hyperglycemia, suggesting the development of insulin
resistance. After trauma and hemorrhage, hepatic insulin signaling via
the insulin-induced phosphatidylinositol 3 (PI3)-kinase-Akt pathway was
abolished, whereas ERK1/2 signaling was relatively normal. The
regulation (inhibition) of a hepatic-, insulin-, and the
PI3-kinase-dependent gene, IGF binding protein-1, was also lost. The
present study provides convincing evidence of a rapid onset hepatic
insulin resistance following a combination of trauma and hemorrhage.
liver; shock