Purpose Of Review: Despite increasing evidence that critically ill patients have lower energy requirements than expected, most guidelines continue to recommend elevated caloric requirements in these patients, particularly in septic patients. This practice leads to liver dysfunction when artificial nutrition is employed and worsens the prognosis of these patients. This review is focused on recent developments in the pathogenesis of artificial nutrition associated liver dysfunction in critically ill patients.
Recent Findings: The liver plays a pivotal role in managing nutritional substrates, and it is involved in the inflammatory response to injury and sepsis. The landmark phenomenon is insulin resistance and changes in the metabolic fates of glucose and fat. Glucose and lipids can act as toxics synergistically with inflammation to induce liver dysfunction. There are experimental evidences that insulin resistance in critically ill patients can share the same biochemical mechanisms and metabolic fates involved in insulin resistance of type 2 diabetes mellitus and metabolic syndrome. Furthermore, steatosis is also a common feature in both clinical pictures
Summary: The pathogenesis of artificial nutrition associated with liver dysfunction is related to overfeeding and sepsis with a pathophysiology, similar to metabolic syndrome and type 2 diabetes. Changing nutritional strategies and adding new drugs will prevent, in part, liver dysfunction in these patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/MCO.0b013e3283252f9e | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Protein prenylation in mechanotransduction: implications for disease and therapy.
Trends Pharmacol Sci
January 2025
Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. Electronic address:
The process by which cells translate external mechanical cues into intracellular biochemical signals involves intricate mechanisms that remain unclear. In recent years, research into post-translational modifications (PTMs) has offered valuable insights into this field, spotlighting protein prenylation as a crucial mechanism in cellular mechanotransduction and various human diseases. Protein prenylation, which involves the covalent attachment of isoprenoid groups to specific substrate proteins, profoundly affects the functions of key mechanotransduction proteins such as Rho, Ras, and lamins.
View Article and Find Full Text PDFTension-induced organelle stress: an emerging target in fibrosis.
Trends Pharmacol Sci
January 2025
Department of Surgery, University of California, San Francisco, San Francisco, CA, USA; Center for Bioengineering and Tissue Regeneration, University of California, San Francisco, San Francisco, CA, USA; UCSF Helen Diller Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA; Department of Radiation Oncology, Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA.
Fibrosis accounts for approximately one-third of disease-related deaths globally. Current therapies fail to cure fibrosis, emphasizing the need to identify new antifibrotic approaches. Fibrosis is defined by the excessive accumulation of extracellular matrix (ECM) and resultant stiffening of tissue stroma.
View Article and Find Full Text PDFLung Clearance Index: A Sensitive Measure of Airway Function Improvement in Adolescents After Weight Loss from Bariatric Surgery.
Respir Med
January 2025
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Clalit Health Services, Dan Petah Tikva District, Petah Tikva, Israel. Electronic address:
Background: Morbid obesity in adolescents impacts respiratory function, often leading to reduced lung volume and obstructive ventilatory defects. However, standard spirometric values frequently remain within normal ranges.
Objectives: We hypothesized that Lung Clearance Index (LCI) is a more sensitive marker for detecting airway dysfunction in adolescents with morbid obesity than conventional lung function tests.
The Clinical Utility of Incorporating Next-Generation Sequencing Results in the Management Algorithm of Pancreatic Cysts.
Gastrointest Endosc
January 2025
Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:
Background & Aims: Pancreatic cysts often pose challenges in predicting malignant progression. Next-generation sequencing has become an appealing ancillary diagnostic test. The diagnostic performance is well characterized, but the impact on clinical management remains unclear.
View Article and Find Full Text PDFEstimated Glucose Disposal Rate predicts the risk of incident Metabolic dysfunction-associated steatotic liver disease.
Endocr Pract
January 2025
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Objectives: There is a relationship between insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD) and the estimated glucose disposal rate (eGDR) has been reported as a surrogate marker of insulin resistance. This study aimed to investigate the association between eGDR and the incident MASLD, and compare the ability to predict incident MASLD with other insulin resistance markers.
Methods: Retrospective cohort data from a health check-up program were analyzed.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!