Impact of SARS CoV2 on post-hospital recovery of carbohydrate and muscle metabolism: role of endothelial injury

项目总结/摘要 这项提案测试了新的假设，即既存糖尿病（或新的应激性高血糖症）， COVID-19介导的微血管损伤的全身性影响，并通过持续的 高血糖症和糖尿病相关的持续性内皮损伤。我们的长期目标是了解 COVID-19感染对碳水化合物代谢和糖尿病的感染后后果 并发症胰岛和骨骼肌的有效灌注减少可能有助于后 COVID-19感染的感染后遗症，如胰岛素分泌和胰岛素作用减少以及疲劳。 该提案的目的是研究COVID-19感染对后 住院期间碳水化合物和骨骼肌代谢，并测试相关性， 高血糖和弥漫性内皮损伤与这些晚期终点。 假设：COVID-19有害地影响碳水化合物代谢和骨骼肌功能 由于全身灌注异常，在糖尿病中更糟;这些患者住院后恢复 在高血糖症和内皮损伤的情况下，这些参数将减慢。 SA#1：检验COVID-19损害胰岛素分泌和作用以及 在持续性高血糖和/或弥漫性内皮损伤的情况下， 损伤胰岛素分泌减少与系统性胰岛素抵抗对COVID-19的相对贡献 介导的高血糖症是未知的，也是导致代谢障碍的因素。根据这一目标进行的研究将 评估弥漫性内皮损伤和代谢异常与糖代谢的关系 有和没有糖尿病住院后使用口服葡萄糖耐量试验。 SA# 2：检验骨骼肌功能障碍和弥漫性内皮损伤减缓骨骼肌生长的假设 COVID-19后的恢复。没有关于COVID-19后功能状态恢复或骨骼肌的数据 比较糖尿病患者和非糖尿病患者的功能。这些实验将检查住院后 肌肉氧化通量，胰岛素作用和灌注，并探讨这些参数，葡萄糖 COVID-19住院后糖尿病患者和非糖尿病患者的特征和内皮损伤。 影响：拟议研究的成功执行将提供有关COVID恢复的新信息- 19关于碳水化合物代谢和虚弱。这些数据可以告知住院后血糖 管理，以减轻COVID-19对糖尿病患者的长期影响。

Project Summary/Abstract This proposal tests the novel hypothesis that pre-existing diabetes (or new stress hyperglycemia), exacerbates the systemic impact of COVID-19-mediated microvascular injury and slows recovery via persistence of hyperglycemia and diabetes related persistent endothelial injury. Our long-term goal is to understand the post-infection consequences of COVID-19 infection on carbohydrate metabolism and diabetes complications. Decreased effective perfusion of the islets and skeletal muscle may contribute to the post- infection sequelae of COVID-19 infection such as decreased insulin secretion and insulin action and fatigue. The goal of this proposal is to examine the short-term impact of COVID-19 infection on post- hospitalization carbohydrate and skeletal muscle metabolism, and to test the correlation of hyperglycemia and diffuse endothelial injury with these late endpoints. Hypothesis: COVID-19 deleteriously impacts carbohydrate metabolism and skeletal muscle function due to systemic perfusion abnormalities, worse in diabetes; post-hospitalization recovery of these parameters will be slowed in the context of hyperglycemia and endothelial injury. SA#1: Test the hypothesis that COVID-19 impairs insulin secretion and action and that post- hospitalization recovery is slowed in the context of persistent hyperglycemia and/or diffuse endothelial injury. The relative contribution of decreased insulin secretion versus systemic insulin resistance to COVID-19 mediated hyperglycemia is unknown, as are the factors contributing to dysglycemia. Studies under this aim will evaluate the relationship of diffuse endothelial injury and dysglycemia to carbohydrate metabolism in people with and without diabetes post-hospitalization using an oral glucose tolerance test. SA# 2: Test the hypothesis that dysglycemia and diffuse endothelial injury slow skeletal muscle recovery post COVID-19. No data exist on post COVID-19 functional status recovery or skeletal muscle function comparing people with and without diabetes. These experiments will examine post-hospitalization muscle oxidative flux, insulin action and perfusion and explore the correlation of these parameters, glucose profiles and endothelial injury in people with and without diabetes post COVID-19 hospitalization. Impact: Successful execution of the proposed studies will provide new information on recovery from COVID- 19 with regards to carbohydrate metabolism and frailty. These data may inform post-hospitalization glycemic management to lessen the long-term consequences of COVID-19 in people with diabetes.