Miss Nilanjana Tewari

Title: Do differences in body composition, distribution and physiology of muscle and adipose tissue alter the magnitude of postoperative insulin resistance and inflammation in patients undergoing major surgery?

Project Start Date: 1 August 2011

Completion Date: 12 October 2015

Summary:

Up to 3 million surgical procedures are performed annually in Britain. Although patients may undergo the same operation, some patients go on to develop greater degrees of inflammatory-stress (how ‘sick’ patients get after surgery) than others. This results in certain patients developing marked inflammation and so-called ‘insulin resistance’. Insulin resistance means the body does not respond appropriately to important hormones. This is important as the degree of insulin resistance the body develops determines how rapidly patients recover and whether they develop serious complications after surgery. We do not know why these ‘stress’ responses after major surgery differ so greatly between patients, but think this occurs due to the make-up and function of the body’s muscle and fatty tissues.

By studying and understanding these mechanisms we will be able to identify patients at risk of developing marked ‘stress-responses’ and better improve their preparation prior to surgery thereby improving the outcomes of thousands of patients undergoing major surgery.

The proposed study will investigate:

1) The roles that different types of muscle and fat in the body (for example muscles/fat in the thigh versus muscles/fat in the abdomen) play in the development of inflammatory-stress and insulin resistance. This is of importance as in the UK patients undergoing surgery are becoming more obese,

2) Identifying better ways of predict the development of inflammatory-stress and insulin resistance in surgical patients. This would allow us to select those patients whom we know will develop marked inflammatory-stress and insulin resistance, and optimize their preparation prior to surgery.