Energy and protein metabolism in malnutrition due to nonneoplastic gastrointestinal diseases
| Autor: | A. Rimbert, Franck Carbonnel, M. Rongier, Joseph Koziet, Dominique Darmaun, Jehan François Desjeux, Bernard Messing, F. Thuillier, Odile Rigal |
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| Rok vydání: | 1995 |
| Předmět: |
medicine.medical_specialty
Calorie Gastrointestinal Diseases Endocrinology Diabetes and Metabolism Glutamine Protein metabolism Biology Body Mass Index chemistry.chemical_compound Endocrinology Leucine Internal medicine medicine Humans Resting energy expenditure Serum Albumin Body Weight Protein turnover Proteins Calorimetry Indirect Keto Acids Nutrition Disorders Retinol-Binding Proteins Skinfold Thickness C-Reactive Protein chemistry Turnover Energy Metabolism Body mass index |
| Zdroj: | Metabolism: clinical and experimental. 44(9) |
| ISSN: | 0026-0495 |
| Popis: | Although a reduction in both energy expenditure and protein turnover has been demonstrated in starved volunteers, few metabolic data are available for patients in whom malnutrition is due to nonneoplastic gastrointestinal diseases. Chronically malnourished, unstressed adult patients with nonneoplastic gastrointestinal diseases (body mass index, 15.8 ± 2.5 kg/m 2 , n = 13) and healthy control subjects (n = 10) were studied in the postabsorptive state using indirect calorimetry, as well as substrate fluxes of l [1- 13 C]leucine, l -[2- 15 N ]glutamine (seven patients and six controls), and d [6,6- 2 H 2 ]glucose (seven patients and eight controls). Resting energy expenditure (REE) expressed in kilocalories per 24 hours was significantly lower in patients than in controls; REE expressed per unit of fat-free mass (FFM) was not significantly different in both groups. Whole-body leucine turnover, oxidation, and nonoxidative disposal rates, based on either 13 C-leucine or 13 C-α-ketoisocaproic acid (KIC) enrichments, and glucose turnover rate were not significantly different between malnourished patients and controls. Moreover, glutamine turnover was increased by 28% in malnourished patients as compared with normal volunteers (429.8 ± 86.8 v 334.9 ± 15.9 μmol/kg/h, P = .02). These results suggest that hypometabolic adaptation, although previously documented in starved volunteers, is not operative during states of chronic malnutrition due to gastrointestinal disease. The increase in glutamine turnover rate might represent an adaptative mechanism to malnutrition for preservation of visceral mass or function. |
| Databáze: | OpenAIRE |
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