Fat metabolism following traumatic stress / 中华临床营养杂志

ABSTRACT

Lipids metabolism can change after traumas such as operation or injury.The process is com-prised of accelerated hydrolysis of triglyceride in adipose tissue,accelerated absorption of fatty acids by extra-he-patic tissue,improved lipid oxidation rate,and augmented re-esterification of fatty acids in liver and adipose tis-sue.Mechanisms of lipid mobilization include sympathetic stimulation,insulin resistance,and inflammation.How-ever,lipid absorption by liver and intestine is inhibited after trauma.Through post-trauma nutritional support,glu-cose administration improves re-esterification of fatty acids and inhibits lipid oxidation without affecting lipolysis.Fat emulsion infusion inhibits both absorption and secretion of triglyceride in liver.Therefore,clinicians should a-void over-alimentation of glucose and fat to prevent lipid overload,particularly in liver. Intervention of post-trau-matic lipid metabolism improves the outcomes:administration of long-chain triglycerides can prevent exhaustion of essential fatty acids,and administration of cholesterol can improve absorption and oxidation of fat emulsion.