Glutamine supplement with parenteral nutrition decreases whole body proteolysis in low birth weight infants |
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Authors: | Kalhan Satish C Parimi Prabhu S Gruca Lourdes L Hanson Richard W |
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Institution: | Schwartz Center for Metabolism and Nutrition, MetroHealth Medical Center, Department of Pedatrics and Biochemistry, CaseWestern Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. satish.kalhan@case.edu |
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Abstract: | OBJECTIVES: To examine the effect of supplemental glutamine (0.6 g.kg -1 .d -1 ) on whole body protein/nitrogen and glutamine kinetics in low birth weight (LBW) infants receiving parenteral nutrition in the immediate neonatal period. STUDY DESIGN: Premature infants < or =32 weeks gestation with a birth weight from 694 to 1590 g were randomly assigned to either a glutamine-supplemented group (n = 10) or to a control group (n = 10). Tracer isotope studies were performed when the infants were 6 to 7 days old and had been receiving an amino acid intake of approximately 3.0 g.kg -1 .d -1 for at least 3 days. Whole body glutamine and nitrogen kinetics were measured with 5-15N]glutamine, 2H5]phenylalanine, 1-13C, 15 N]leucine, 15N2]urea, and GC-mass spectrometry. RESULTS: Supplemental glutamine was associated with a lower rate of appearance of glutamine ( P = .003), phenylalanine ( P = .001), and leucine C ( P = .003). There was no significant difference in leucine N turnover, urea turnover and plasma cortisol, and C-reactive protein levels in the 2 groups. CONCLUSION: Parenteral glutamine supplement in LBW infants was associated with lower whole-body protein breakdown. Because the decrease in whole body proteolysis is associated with protein accretion, parenteral glutamine supplement may be beneficial in selected populations of LBW infants. |
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Keywords: | BCAA Branched chain amino acids CRP C-reactive protein KIC α-ketoisocaproic acid LBW Low birth weight Ra Rate of appearance TPN Total parenteral nutrition |
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