PMID- 30603637
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220331
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 6
IP  - 23
DP  - 2018 Dec
TI  - Preoperative short-term fasting protects liver injury in patients undergoing 
      hepatectomy.
PG  - 449
LID - 10.21037/atm.2018.10.64 [doi]
LID - 449
AB  - BACKGROUND: Our previous study demonstrated that preoperative short-term fasting 
      attenuates mice hepatic ischemia/reperfusion injury (IRI), which greatly piqued 
      our interest in verifying if fasting produces similar protective effects in 
      patients undergoing hepatectomy. METHODS: Eighty patients with liver tumors were 
      randomized into control (Ctrl, n=40, preoperative fasting for 6 h) or fasting 
      group (Fasting, n=40, preoperative fasting for 24 h). Serum was collected at 
      pre-operation (Pre-Op), post-operation 1 day (POD-1), post-operation 3 days 
      (POD-3), and post-operation 7 days (POD-7). Liver tissue was removed from the 
      resected specimen. RESULTS: Sixty-three patients were eventually enrolled, with 
      33 in Ctrl and 30 in Fasting group. Our data showed that 24 h fasting effectively 
      attenuated elevated sALT and sAST levels after operation (P<0.05), but serum 
      total bilirubin was significantly lower at only POD-3 (P<0.05); and serum albumin 
      was not markedly different in either of the groups. Interestingly, 24 h fasting 
      partially attenuates expression of pro-inflammatory cytokine (TNF-alpha) and improves 
      oxidative stress (MDA and SOD). Our data further showed short-term fasting 
      triggered Nrf2 signaling pathway. CONCLUSIONS: This study demonstrates 
      preoperative short-term fasting effectively improves clinical outcomes and 
      markedly attenuates inflammatory responses and oxidative stress in patients 
      undergoing hepatectomy, and Nrf2 signaling pathway may play a key role in fasting 
      against inflammatory responses and oxidant stress.
FAU - Zhan, Chuanfei
AU  - Zhan C
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
FAU - Dai, Xinzheng
AU  - Dai X
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
FAU - Shen, Gefengqiang
AU  - Shen G
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
FAU - Lu, Xu
AU  - Lu X
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
FAU - Wang, Xuehao
AU  - Wang X
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
FAU - Lu, Ling
AU  - Lu L
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
FAU - Qian, Xiaofeng
AU  - Qian X
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
FAU - Rao, Jianhua
AU  - Rao J
AD  - Hepatobiliary/Liver Transplantation Center, The First Affiliated Hospital, 
      Nanjing Medical University, Nanjing 210029, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC6312820
OTO - NOTNLM
OT  - Short-term fasting
OT  - hepatectomy
OT  - inflammatory cytokines
OT  - nuclear factor erythroid-derived 2-related factor 2 signaling (Nrf2 signaling)
OT  - oxidative stress
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2019/01/04 06:00
MHDA- 2019/01/04 06:01
PMCR- 2018/12/01
CRDT- 2019/01/04 06:00
PHST- 2019/01/04 06:00 [entrez]
PHST- 2019/01/04 06:00 [pubmed]
PHST- 2019/01/04 06:01 [medline]
PHST- 2018/12/01 00:00 [pmc-release]
AID - atm-06-23-449 [pii]
AID - 10.21037/atm.2018.10.64 [doi]
PST - ppublish
SO  - Ann Transl Med. 2018 Dec;6(23):449. doi: 10.21037/atm.2018.10.64.