# Metabolic Phenotyping During Stress Hyperglycemia in Cardiac Surgery Patients

> **NIH NIH K23** · EMORY UNIVERSITY · 2022 · $191,484

## Abstract

Project Summary
Research: Stress hyperglycemia is common in the perioperative period and is associated with increased risk of
postoperative mortality. Counterregulatory hormones and inflammatory mediators appear to modulate the acute
biological response to stress; however, the pathophysiological pathways that result in stress hyperglycemia and
its link to poor clinical outcomes are not well understood. Comprehensive metabolic profiling (metabolomics)
represents a novel tool to examine metabolic changes during stress conditions. The current approach to treat
hyperglycemia with insulin has major limitations including high resource utilization and high risk of hypoglycemia.
The overarching hypotheses of this research proposal are that: 1) Stress-hyperglycemia is associated with
changes in unknown and known metabolites (i.e. branched-chain amino acids, acylcarnitines, ceramides) and
path-specific biomarkers (representing inflammation,!coagulation, cell stress, and immune modulation) in the
perioperative period in cardiac surgery patients, and 2) with a low risk of iatrogenic hypoglycemia, exposure to a
long acting glucagon like peptide-1 receptor agonist (GLP-1 RA) will ameliorate the hyperglycemic and
inflammatory response to surgical stress. Using comprehensive metabolic profiling methods, this study will
provide new insights into the mechanisms underlying the metabolic and inflammatory responses to surgical stress
(Aim 1). This study will also examine whether exposure to a long acting GLP-1 RA can improve glycemic control
and ameliorate the inflammatory response to acute surgical stress (Aim 2). These findings will provide proof-of
principle to support the use of novel therapies to prevent and manage stress hyperglycemia in the inpatient
setting. Candidate and Environment: The candidate for this K23 award is Francisco J Pasquel, MD, MPH, a
highly qualified endocrinologist at Emory University committed to developing a career as an independently funded
translational researcher. The goal of this proposal is to provide the candidate with additional advanced mentored
training to develop expertise in mechanistic aspects of the metabolic response to stress and the design and
execution of complex clinical studies. Key components of the training plan include: 1) mentorship from
investigators with expertise in metabolomics, biomarkers, and clinical trials; 2) learning skills in bioinformatics,
metabolomics!and network analysis, and grant writing through advanced coursework; 3) hands-on experience
metabolomics research, and design/execution of a nested case-control study and a clinical trial; and 4)
participation in scholarly activities to develop independent research projects, and formulate NIH applications. To
successfully achieve his goals, the candidate has assembled a multidisciplinary and committed group of Mentors,
all of whom have successfully mentored junior investigators, have a strong track record of independent funding,
and are internationally re...

## Key facts

- **NIH application ID:** 10464910
- **Project number:** 5K23GM128221-05
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Francisco J Pasquel
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $191,484
- **Award type:** 5
- **Project period:** 2018-09-20 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10464910

## Citation

> US National Institutes of Health, RePORTER application 10464910, Metabolic Phenotyping During Stress Hyperglycemia in Cardiac Surgery Patients (5K23GM128221-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10464910. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*