Clinical study of insulin resistance for patients after selective abdominal surgery CHEN Hong*, LI Fei , JIA Jian-guo, et al. *Department of General Surgery, Xuan Wu Hospital of Capital Medical University, Beijing 100053, China Corresponding author: CHEN Hong, E-mail: chenhong@medmail.com.cn Abstract Objective To investigate the risk factors of insulin resistance(IR) after selective abdominal surgery and the mechanism of IR induced by surgery. Methods Fourteen-patients including five male and nine female after selective abdominal surgery between March 2006 and June 2006 at Xuan Wu Hospital of Capital Medical University were studied. Fasting blood glucose, fasting plasma insulin, plasma TNF-α and IL-6 were tested for selective surgery patients on one day before, during and one day after surgery. Insulin resistance index (HOMA-IR) and the index of insulin secretion (HOMA-β) were calculated with homeostasis model assessment (HOMA). Insulin receptor and GLUT4 mRNA expression in skeletal muscle were assessed before and at the end of operation. Results Significant differences were found in fasting blood glucose, fasting plasma insulin, plasma TNF-α and IL-6 of pre-operative 1 day, during operation and post-operative 1 day (P <0.001). A significant elevation of HOMA-IR level was found on post-operative 1 day compared to that before surgery in all patients (P <0.001). However there was no significant difference in HOMA-β among the same two points of time (P=0.103). The result of RT-PCR showed that the expression of GLUT4 mRNA in muscle of patients at the end of operation reduced significantly compared with preoperation (P<0.001). ISI showed negative correlation with operative time(r=-0.736,P <0.001), blooding during operating (r=-0.594,P=0.032) and post-operative TNF-α(r=-0.641,P =0.018). R2 of the equation was 0.687. Conclusion Insulin resistance occurs in selective abdominal surgery patients. The defective site was at postreceptor, and the decrease of content and action of GLUT4 may play an important role in its mechanism. To control the intensity of surgery is helpful for decreasing IR.