Urinary 3-methylhistidine/creatinine ratio as a clinical tool: Correlation between 3-methylhistidine excretion and metabolic and clinical states in healthy and stressed premature infants |
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Authors: | John H. Seashore Gabor Huszar Edward M. Davis |
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Affiliation: | 1. Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.;2. Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA.;3. Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA. |
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Abstract: | We have investigated the role of the urinary 3-methylhistidine (3MH) excretion, a measure of protein catabolism, in the evaluation of the metabolic state of premature infants. Two-hundred and twenty-two 24 hr urine collections and ratio determinations (expressed as μmoles of 3MH per mg creatinine) were carried out in 36 infants (average gestational age 32.7 ± 0.7 wk, weight 1640 ± 120 grams) and the relationship between the ratios and the metabolic and clinical state has been investigated. Five or more measurements were carried out on each of 19 infants and serial determinations on four of those babies are presented. The urinary ratio of healthy infants with adequate caloric intake and normal growth curve was .148 ± .039 (S.D.) μmol/mg, about 35% higher than the ratio in healthy adults. As long as the premature infants were healthy the degree of prematurity had no effect on the ratio. The relationship between ratio and nitrogen balance was highly significant (p < .001). ratio also correlates very well with the metabolic status of the infants: in the group with normal ratios ≤.175 (.148 + 1 S.D., n = 90) there were four clinically stressed infants (4.4% false negative rate) while in the group with elevated ratios >.225 (.148 + 2 S.D.; n = 79) there were only three clinically well infants (3.8% false positive rate). In comparing the clinical status and ratios, we found that in the group of infants who could not be clearly defined as clinically well or stressed (n = 108) the ratio was more useful than clinical judgment in the prediction of metabolic status. It can be concluded that ratio is a potentially useful clinical tool which describes with high accuracy the clinical and metabolic status of premature infants. This conclusion is further supported by the data of serial determinations. |
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Keywords: | Address reprint requests to Dr. Gabor Huszar Department of Obstetrics and Gynecology Yale University School of Medicine 333 Cedar Street New Haven Connecticut 06510. |
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