Effects Of Preoperative Oral Carbohydrate On Pancreatic Beta Cell Function In Patients Undergoing Radical Gastrectomy:a Randomized Clinical Study

Objective:To investigate the impact of preoperative oral carbohydrate on function of pancreatic β cell in radical gastrectomy patientsMethods:60patients underwent radical gastrectomy were randomly divided into the oral carbohydrate groups and oral placebo group. Resting energy expenditure was detected4hours preoperatively and24hours postoperatively.Trial group administrated orally carbohydrate and control group placebo2-3hours before surgery. The blood glucose, serum insulin level and insulin resistance index (HOMA-IR) were detected in two groups, The ultrastructural changes of the pancreas were observed under electron microscope. The activity of SOD, MDA and CAT’of pancreatic tissue was measured respectively.Results:There were no significant differences between the two groups in the preoperative blood level of glucose, insulin and insulin resistance index (p>0.05); After surgery, blood glucose (9.32±1.31mmol/L vs7.64±0.78mmol/L, P=0.026), insulin (30.72±6.66U vs16.72±3.88U, P=0.034), insulin resistance index (12.68±3.13vs5.68±1.40, P=0.003) and REE (1458.21±168.54Kcal/d vsl341.00±110.28Kcal/d, P=0.046) increased obviously, There were a significant difference between trial and control group (P<0.05); Compared with the control group, pancreatic tissue MDA activity reduced significantly (1.45±0.31mmol/L vs1.00±0.36mmol/L);SOD (41.57±5.02U/mL vs57.30±4.88U/mL) and CAT level (31.88±5.50U/L vs44.34±7.33U/L) elevated obviously in trial group, there were significant difference between them (P<0.05). Preoperative oral placebo group showed the number of islet cells decreased and mitochondria, endoplasmic reticulum swelled obviously.Conclusions:Preoperative oral carbohydrates can singnificantly improve postoperative beta cell function in patients underwent radical gastrectomy. The mechanisms may be related to protection of the mitochondrial structure and function, decreasing the body’s resting energy expenditure, reducing levels of oxidative stress in pancreatic tissue and improving insulin resistance.