The effect of ethanol infusion on the altered glucose turnover during bacterial infection

The increased glucose turnover seen during the hypermetabolic, hyperdynamic phase of sepsis is part of the body's defense mechanisms. In contrast, the metabolism of ethanol (ETOH) is known to compromise hepatic gluconeogenesis under certain conditions. This study tested the hypothesis that acute infusion of ETOH inhibits the elevated glucose production that is manifested during infection and thereby alters the normal responses to sepsis. In catheterized conscious rats, ETOH or saline infusion was started 24 hours before the induction of sepsis, and continued throughout the experiment. In vivo glucose kinetics were assessed by the infusion of [6-3H, U-14C]-glucose 24 hours after the induction of sepsis. The characteristic sepsis-induced hyperthermia was prevented in ETOH-infused animals. Sepsis increased the plasma lactate concentration (100%), as well as the rates of glucose appearance ([Ra] 77%), recycling (213%), and metabolic clearance ([MCR] 82%) in saline-infused control animals. In contrast, ETOH infusion prevented the sepsis-induced increase in glucose Ra and markedly attenuated the increase in plasma lactate (49%) and glucose recycling (97%). The infusion of ETOH increased the lactate/pyruvate and beta-hydroxybutyrate (BHBA)/acetoacetate (AcAc) ratio in both septic and nonseptic rats. These results indicate that ETOH administration attenuates the increased glucose production, utilization, and elevated arterial lactate, and prevents the hyperthermic response seen during the hypermetabolic phase of sepsis. Thus, ethanol intoxication alters the normal metabolic responses to sepsis, thereby contributing to the compromised host defenses against the challenging bacteria.