Reduced metabolic efficiency in patients with Crohn's disease
| Autor: | Manfred J. Müller, F. W. Schmidt, A. von zur Mühlen, J Körber, H. Canzler, L U Schmidt |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
medicine.medical_specialty Nitrogen balance Nitrogen Physiology Energy balance Biology Weight Gain Inflammatory bowel disease Enteral Nutrition Nutrient Crohn Disease Internal medicine medicine Humans Gastroenterology medicine.disease Dietary Fats Protein catabolism Endocrinology Parenteral nutrition Basal metabolic rate Body Composition medicine.symptom Energy Intake Energy Metabolism Weight gain |
| Zdroj: | Digestive Diseases and Sciences. 38:2001-2009 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Malnutrition is frequently seen in patients with inflammatory bowel disease, and parenteral or enteral nutrition is considered essential in this patient group. However, many patients with Crohn's disease have difficulties in gaining weight in response to overfeeding, suggesting reduced energy retention. Substrate utilization and nutrient balances as well as changes in body composition were followed in 10 patients with Crohn's disease immediately in the course of remission on low-dose steroid treatment, during an eight-day period of continuous enteral nutrition at constant (protocol 1:1.5-fold basal energy expenditure) and increasing (protocol 2:0.5- to 2.0-fold basal energy expenditure) nutrient supply. Energy, substrate, and nitrogen balances all became positive in response to overfeeding. However, fat was predominantly oxidized at an infusion rate of 1.2 g/kg body wt/day, whereas carbohydrates and proteins were effectively stored. A positive energy balance was reached at an energy infusion rate exceeding 31 kcal/kg body wt/day and corresponding substrate supplies of 1.6, 1.7, and 1.1 g/kg body wt/day for carbohydrates, fat, and protein, respectively. Nitrogen balance normalized at a supply of 0.14 g/kg body wt/day, which also reduced myofibrillar protein breakdown. Considering the relative contributions made by these nutrients in the diets, an accumulation of carbohydrates and protein but a depletion in fat became evident from nutrient balances. In fact, body weight increased by 0.12 kg/day, which was explained by an increased extracellular (+0.18 kg/day) and body cell mass (+0.04 kg/day) at reduced fat mass (-0.10 kg/day). Concomitantly, plasma T3 and insulin secretion both increased, whereas sympathetic nervous system activity decreased with overfeeding. This is contrary to data observed in healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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