Effect of Ketone Bodies on Hyperglycemia and Lactic Acidemia in Hemorrhagic Stress

Abstract

Background: To investigate the effect of hyperketonemia on altered glucose metabolism under stress conditions, we infused sodium D‐3‐hydroxybutyrate (3‐OHB) into rats in hemorrhagic hypotension and evaluated the plasma concentration of substrates related to glucose metabolism. Methods: Three groups of anesthetized rats (weight, 280 g to 320 g) were bled acutely, and their mean arterial pressures were maintained at 40 mm Hg. From 1 hour before hemorrhage to the end of the experiment, rats in the first group (n = 10) were infused with 3‐OHB at a rate of 30 μmol/kg·min (3‐OHB group), those in the second group (n = 10) received glucose and sodium bicarbonate (glucose group), and the remaining 10 rats received only sodium bicarbonate and no energy substrates (control group). Sodium bicarbonate was used to control the alkalizing effect of 3‐OHB. Results: Hyperketonemia(1158± 30 μmol/L ‐ 1618 ± 154 μmol/L) occurred only in the 3‐OHB group. Hyperglycemia and lactic acidemia during hemorrhagic shock were suppressed significantly compared with the control group. Plasma concentration of alanine was also lower compared with the control group. In the glucose group, although plasma lactate concentration was lower, plasma glucose concentration was not suppressed, and plasma alanine concentration was higher in comparison with the control group during hemorrhagic shock. There was no significant difference in plasma insulin concentration among the three groups. Conclusions: These results suggest that administered 3‐OHB may suppress glycolysis during hemorrhagic shock. (Journal of Parenteral and Enteral Nutrition 18:442–446, 1994)