Fat metabolism following traumatic stress

Lipids metabolism can change after traumas such as operation or injury. The process is comprised of accelerated hydrolysis of triglyceride in adipose tissue, accelerated absorption of fatty acids by extra-hepatic tissue, improved lipid oxidation rate, and augmented re-esterification of fatty acids in liver and adipose tissue. Mechanisms of lipid mobilization include sympathetic stimulation, insulin resistance, and inflammation. However, lipid absorption by liver and intestine is inhibited after trauma. Through post-trauma nutritional support, glucose 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-traumatic 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.