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Major elective abdominal surgery acutely impairs lower limb muscle pyruvate dehydrogenase complex activity and mitochondrial function

Atkins, Ryan; Constantin-Teodosiu, Dumitru; Varadhan, Krishna K.; Constantin, Despina; Lobo, Dileep N.; Greenhaff, Paul L.

Authors

Ryan Atkins

Dumitru Constantin-Teodosiu

Krishna K. Varadhan

Despina Constantin

DILEEP LOBO dileep.lobo@nottingham.ac.uk
Professor of Gastrointestinal Surgery



Abstract

© 2020 The Author(s) Background & aims: This post hoc study aimed to determine whether major elective abdominal surgery had any acute impact on mitochondrial pyruvate dehydrogenase complex (PDC) activity and maximal mitochondrial ATP production rates (MAPR) in a large muscle group (vastus lateralis -VL) distant to the site of surgical trauma. Methods: Fifteen patients undergoing major elective open abdominal surgery were studied. Muscle biopsies were obtained after the induction of anesthesia from the VL immediately before and after surgery for the determination of PDC and maximal MAPR (utilizing a variety of energy substrates). Results: Muscle PDC activity was reduced by >50% at the end of surgery compared with pre-surgery (p < 0.05). Muscle MAPR were comprehensively suppressed by surgery for the substrate combinations: glutamate + succinate; glutamate + malate; palmitoylcarnitine + malate; and pyruvate + malate (all p < 0.05), and could not be explained by a lower mitochondrial yield. Conclusions: PDC activity and mitochondrial ATP production capacity were acutely impaired in muscle distant to the site of surgical trauma. In keeping with the limited data available, we surmise these events resulted from the general anesthesia procedures employed and the surgery related trauma. These findings further the understanding of the acute dysregulation of mitochondrial function in muscle distant to the site of major surgical trauma in patients, and point to the combination of general anesthesia and trauma related inflammation as being drivers of muscle metabolic insult that warrants further investigation. Clinical trial registration: Registered at (NCT01134809).

Citation

Atkins, R., Constantin-Teodosiu, D., Varadhan, K. K., Constantin, D., Lobo, D. N., & Greenhaff, P. L. (2020). Major elective abdominal surgery acutely impairs lower limb muscle pyruvate dehydrogenase complex activity and mitochondrial function. Clinical Nutrition, https://doi.org/10.1016/j.clnu.2020.07.006

Journal Article Type Article
Acceptance Date Jul 6, 2020
Online Publication Date Jul 14, 2020
Publication Date Jul 14, 2020
Deposit Date Jul 16, 2020
Publicly Available Date Jul 15, 2021
Journal Clinical Nutrition
Print ISSN 0261-5614
Electronic ISSN 1532-1983
Publisher Elsevier
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1016/j.clnu.2020.07.006
Keywords Nutrition and Dietetics; Critical Care and Intensive Care Medicine
Public URL https://nottingham-repository.worktribe.com/output/4769765
Publisher URL https://www.sciencedirect.com/science/article/pii/S0261561420303538