[Changes in glucose, fat and hormone balance induced by the postoperative administration of alanine solution]

Seven patients undergoing cholcystektomy received a 5 pevcent solution of alanine (90 mg/kg/h) during a period of 8 hours on the 1. postoperative day. Stimulation of gluconeogenesis was observed with increase of glucose from 5,9 +/- 0,2 to 6,3 +/- 0,2 mmol/l. Initially the level of ketone bodies decreased (acetoacetate 70 +/- 23 to 17 +/- 6 mumol/l) but again increased to start values during infusion of alanine. Insulin increased twofold from 7,6 +/- 1,4 microU/ml to 14,6 +/- 4,0, and had a constant level during infusion as did glucagon, which increased from 561 +/- 70 to 608 +/- 74 pg/ml. Nitrogen balance during infusionsperiod was almost zero (0,04 +/- 0,09 g/h minus) showing a significant difference to balances calculated from periods before and after infusion of alanine (0,57 +/- 0,07 and 0,53 +/- 0,06 g/h deficit respectively). Direct influence on peripheral glucose alanine cycle and increased gluconeogenetic substrate seem to be responsible for the nitrogen sparing effect of alanine.