Inflammation and insulin resistance genes are activated by surgery

This interesting paper recently published in the Journal of Clinical Endocrinology & Metabolism describes one of the reasons why support when undergoing a surgical procedure is so important (and links to the risks for delirium and accelerated dementia after surgery in the elderly). The authors set out to investigate the...

"...mechanisms behind postoperative insulin resistance and impaired glucose utilization..."

They shrewdly analyzed the expression of 21 target genes in abdominal adipose (fat) tissue from samples taken at the beginning and end of patients undergoing abdominal surgery. What did the data show?

"After surgery, both sc [subcutaneous] and omental adipose tissue mRNA levels of genes involved in the IL6 and nicotinamide phosphoribosyltransferase pathways were increased, whereas mRNA levels of insulin receptor substrate 1 and adiponectin were reduced. TNF pathway genes were differently regulated between sc and omental adipose tissue, and glucose transporter 4 mRNA levels were decreased only in omental adipose tissue."

In other words, surgery elicits a shift in genetic expression that favors insulin resistance and inflammation. The authors conclude:

"The transcriptional output of pivotal inflammatory and insulin signaling pathway genes is altered after surgery...This could be of importance for the metabolic aberrations associated to postsurgical complications..."

This helps to understand why patients who are lucky enough to receive adjunctive support for the insulin and inflammatory signaling pathways and receptors recover faster and with less complications.