Effect of Severe Burn Injury on Substrate Cycling by Glucose and Fatty Acids
Abstract
Increases in metabolic rate and core temperature are common responses to severe injury. We have investigated the hypothesis that these responses are due to increases in substrate cycling. A substrate cycle exists when opposing, nonequilibrium reactions catalyzed by different enzymes are operating simultaneously. At least one of the reactions must involve the hydrolysis of ATP. Thus, a substrate cycle both liberates heat and increases energy expenditure, yet there is not net conversion of substrate to product. In studies in volunteers (n = 18) and in patients with severe burns who were in a hypermetabolic state (n = 18), we used stable-isotope tracers to quantify substrate cycling in the pathways of glycolysis and gluconeogenesis and a cycle involving the simultaneous breakdown and synthesis of stored triglyceride (triglyceride-fatty acid cycle). The total rates of triglyceride-fatty acid and glycolytic-gluconeogenic cycling were elevated in the patients by 450 and 250 percent, respectively (P less than 0.01). An infusion of propranolol in the patients greatly reduced triglyceride-fatty acid cycling but did not affect gluconeogenic-glycolytic cycling. We conclude that increased substrate cycling contributes to the increased thermogenesis and energy expenditure following severe burns and that the increased triglyceride-fatty acid cycling is due to beta-adrenergic stimulation.
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Triglyceride/fatty acid cycling is involved in the thermogenesis associated with burn injuries, cancer cachexia, and after exercise.
“This cycling is involved in the thermogenesis associated with burn injuries 26, cancer cachexia 27, and after exercise 28.”
From Cellular bioenergetics as a target for obesity therapy (2010) · cites this paper as [26]
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- Authors
- Wolfe, R. R., Herndon, D. N., Jahoor, F., Miyoshi, H., & Wolfe, M.
- Affiliations
- The University of Texas Medical Branch at Galveston (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1987-08-13
- Volume
- 317
- Issue
- 7
- Pages
- 403-408
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W1999017023
- Cited by
- 467
- References
- 23
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 6 · 2023: 5 · 2022: 2 · 2021: 8 · 2020: 9 · 2019: 8 · 2018: 10 · 2017: 10 · 2016: 8 · 2015: 9 · 2014: 7 · 2013: 10 · 2012: 13
- FWCI
- 15.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 33952, DK34817)
- National Center for Research Resources (RR 00073)
- Topics
- Health Sciences › Medicine › Epidemiology › Burn Injury Management and Outcomes
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Adipose Tissue and Metabolism
- Keywords
- severe burns, substrate cycling, hypermetabolism, energy expenditure, thermogenesis, glycolysis, gluconeogenesis, propranolol, beta-adrenergic stimulation, ATP hydrolysis, glucose metabolism, fatty acid metabolism
- MeSH terms
- Adolescent, Adult, Body Temperature Regulation, Burns, Child, Child, Preschool, Energy Metabolism, Fatty Acids, Gluconeogenesis, Glucose, Glycolysis, Humans, Propranolol, Triglycerides
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