Effect of indomethacin on insulin resistance after operation and metabolic response to surgical injury in patients with gastrointestinal tumor

Abstract

Objective To investigate the effect of indomethacin on insulin resistance and metabolic response to surgical injury in patients with gastrointestinal tumor.Methods Fifty-eight cases with gastric cancer or colon cancer were divided into an indomethacin group (n =28) and a control group (n =30).All the operations were performed under general anesthesia.Patients in both groups were given parenteral nutrition 24 hours after operation for 5 ～ 7 days.The patients in the indomethacin group were treated with indomethacin suppository ( 100 mg/12 h).Fasting blood glucose (FBG),fasting serum insulin (FINS),creatinine (Cr),blood urine nitrogen (BUN),triglyceride (TG),free fatty acid (FFA) and C-reactive protein (CRP) of the two groups were detected on the day before operation,and 24,72,120 hours after operation.Insulin resistance index (HOMA-IR) was calculated by using the homeostasis model assessment (HOMA).The vital signs were observed in 72 hours after operation.Results The vital signs in the indomethacin group were more steady.The levels of FBG,FINS,and InHOMA-IR of the control group 24 hours and 72 hours after operation were higher than before operation ( all P =0.000) and those of the indomethacin group ( all P ＜0.01 ).In both of the two groups,the levels of Cr,BUN,TG,and FFA were higher than those before operation,but declined over time.All the indexes in the indomethacin group 120 hours after operation decreased significantly compared with the levels 24 hours after operation ( all P =0.000 ),as well as with the levels in the control group 120 hours after operation ( all P ＜ 0.05 ).No significant difference was found in the level of CRP between the two groups and between before and after operation.Conclusion Indomethacin could reduce the postoperative stress hyperglycemia and insulin resistance in patients with gastrointestinal tumor. Key words: Indomethacin; Gastrointestinal tumor; Insulin resistance; Metabolism