The Role of Alanine and Glutamine in Steroid-Induced Nitrogen Wasting in Man

1977 ◽  
Vol 53 (3) ◽  
pp. 215-220 ◽  
Author(s):  
D. G. Sapir ◽  
T. Pozefsky ◽  
J. P. Knochel ◽  
M. Walser

1. Administration of dexamethasone, 8 mg/day (0·02 mmol/day), for 5 days to normal subjects produced negative nitrogen balance, due to early and sustained increases in urinary urea nitrogen excretion. 2. In eight subjects ingesting 0·9–1·6 g of protein day−1 kg−1 body weight the cumulative increment in urea nitrogen excretion averaged + 12·5 g (sem 2·8, P < 0·01) over the 5 days of glucocorticoid administration. 3. Increases in urinary urea nitrogen excretion could be related to both plasma alanine and blood glutamine changes by using a multiple regression equation. 4. These results suggest that corticosteroids induce increased release of alanine and glutamine by peripheral tissues, which may augment urea formation and negative nitrogen balance. 5. The correlation between increments in urea nitrogen excretion and increases in plasma arginine remains unexplained.

2007 ◽  
Vol 293 (5) ◽  
pp. G1061-G1067 ◽  
Author(s):  
Carole Rougé ◽  
Clotilde Des Robert ◽  
Alexander Robins ◽  
Olivier Le Bacquer ◽  
Christelle Volteau ◽  
...  

To determine whether circulating citrulline can be manipulated in vivo in humans, and, if so, whether citrulline availability affects the levels of related amino acids, nitric oxide, urinary citrulline, and urea nitrogen, 10 healthy volunteers were studied on 3 separate days: 1) under baseline conditions; 2) after a 24-h treatment with phenylbutyrate (0.36 g·kg−1·day−1), a glutamine “trapping” agent; and 3) during oral l-citrulline supplementation (0.18 g·kg−1·day−1), in randomized order. Plasma, erythrocyte (RBC), and urinary citrulline concentrations were determined by gas chromatography-mass spectrometry at 3-h intervals between 1100 and 2000 on each study day. Regardless of treatment, RBC citrulline was lower than plasma citrulline, with an RBC-to-plasma ratio of 0.60 ± 0.04, and urinary citrulline excretion accounted for <1% of the citrulline load filtered by kidney. Phenylbutyrate induced an ∼7% drop in plasma glutamine ( P = 0.013), and 18 ± 14% ( P < 0.0001) and 19 ± 17% ( P < 0.01) declines in plasma and urine citrulline, respectively, with no alteration in RBC citrulline. Oral l-citrulline administration was associated with 1) a rise in plasma, urine, and RBC citrulline (39 ± 4 vs. 225 ± 44 μmol/l, 0.9 ± 0.3 vs. 6.2 ± 3.8 μmol/mmol creatinine, and 23 ± 1 vs. 52 ± 9 μmol/l, respectively); and 2) a doubling in plasma arginine level, without altering blood urea or urinary urea nitrogen excretion, and thus enhanced nitrogen balance. We conclude that 1) depletion of glutamine, the main precursor of citrulline, depletes plasma citrulline; 2) oral citrulline can be used to enhance systemic citrulline and arginine availability, because citrulline is bioavailable and very little citrulline is lost in urine; and 3) further studies are warranted to determine the mechanisms by which citrulline may enhance nitrogen balance in vivo in humans.


2004 ◽  
Vol 47 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Ivan Moreira ◽  
Alessandro Luis Fraga ◽  
Diovani Paiano ◽  
Gisele Cristina de Oliveira ◽  
Cláudio Scapinello ◽  
...  

The effects of increasing lysine levels on nitrogen balance of pigs fed on low protein diets were evaluated. Four treatments (diets) containing lysine levels (0.8, 1.0 1.2 and 1.4%) were applied to 12 starting (20.0 ± 1.8 kg) barrow pigs. Methionine, threonine and tryptophan were kept constant to the lysine ratio in all diets. Feces and urine were collected during a 5-day period. Nitrogen output in urine (NOU), total nitrogen output (TNO), nitrogen retention (NR), net protein utilization (NPU), biological value or feed protein (BVFP), urine urea nitrogen (UUN), and plasma urea nitrogen (PUN) were determined. PUN showed high negative correlations with BVFP (-0.84), NPU (-0.76), and NR (-0.78) and a positive correlation (0.79) to NOU. Lowest nitrogen excretion and the best use of diet protein were obtained with 1.1% total lysine level. PUN is efficient to indicate amino acid for pigs.


1970 ◽  
Vol 21 (3) ◽  
pp. 501 ◽  
Author(s):  
KH McIntyre

A series of five roughage rations providing increasing amounts of nitrogen (6.8, 16.8, 23.5, 37.3, and 46.3 g/day) and some changes in dry matter intakes (720, 710, 704, 1056, and 1408 g/day) was offered to sheep. The first four rations were given hourly and the fifth ad libitum. Urine outputs, urine total nitrogen, urine urea nitrogen, and urea clearance values increased with nitrogen intakes. Water intakes were linearly related to dry matter intakes. Plasma urea nitrogen and rumen ammonia levels both increased linearly to about 30 mg/100 ml, but did not increase further on higher levels of nitrogen intake. At these levels of intake both plasma urea nitrogen and rumen ammonia levels were no longer related to urine nitrogen excretion rates. The results are discussed in relation to the role of the kidney tubules in nitrogen excretion in the sheep.


1996 ◽  
Vol 114 (3) ◽  
pp. 1156-1161 ◽  
Author(s):  
Heitor Pons Leite ◽  
Werther Brunow de Carvalho ◽  
Mauro Fisberg

In a prospective study, with the objective of determining the metabolic profile, response to nutrient supply, and role of nutritional and metabolic assessment parameters in children admitted to a pediatric ICU, 11 patients in the age group 2-12 were studied. The assessment was carried out during the first 72 hours of admission, and again seven days later, and included the following parameters: caloric supply; nitrogen supply; prealbumin serum level; urinary urea nitrogen; nitrogen balance and creatinine-height index. The evolution of the parameters in the two stages of the study showed the following results: The urinary urea nitrogen median value at admission was 7.5 g/m² of corporeal surface, and did not present significant changes seven days later. There was a significant increase in caloric supply from 42.9 to 70,3 kcal/kg, and in nitrogen supply, from 4.7 to 10.2 g/m² of corporeal surface p 0.01 . The level of nitrogen balance rose from - 5.6 to 2.5 g/24h (p<0.03), and that of prealbumin, from 16.7 to 26.3 mg/dl (p<0.03). There was a significant reduction in the creatinine-height index, from 86.2 percent to 55.0 percent p 0.01. The magnitude of urinary urea nitrogen excretion at admission varied 2.5-13.8 g/m² of corporeal surface. Based on this parameter, it was not possible to establish a characteristic metabolic profile for the conditions studied. Notwithstanding an increase in the protein and caloric supply, prealbumin level and nitrogen balance observed in the second stage of the study, the patients lost muscle mass and entered into a malnutrition process, probably due to intense protein catabolism and the poor response to nutrition supply that occurs in metabolic stress.


Author(s):  
Zurriyani Zurriyani ◽  
Jusri Ichwani ◽  
Novira Widajanti

BackgroundNitrogen balance is the method used to assess the protein adequacy. A negative nitrogen balance means that the body suffers from protein energy malnutrition.ObjectiveTo determine the risk factors that associated with nitrogen balance in the elderly patients who were inpatient in IRNA Internal Medicine Dr.Soetomo Hospital.MethodsThe experimental design of the research used was analytic observational with the cross-sectional design. The study was conducted of 50 elderly patients. Risk factors measured were protein intake using food recall and nitrogen excretion that expressed in Urea Nitrogen Urine (gr / 24 h). The nitrogen balance was derived from the difference between nitrogen intake and nitrogen excretion in 24 hours. Bivariate data analysis using Chi square or exact fisher test, while multivariate data analysis using logistic regression test.ResultsIn bivariate analysis, risk factors significantly associated with negative nitrogen balance were decreased renal function (LFG <90 ml / min / 1.73 m2), prolonged bed rest> 7 days and malnutrition. Other risk factors not significantly associated with negative nitrogen balance were diabetes mellitus, random blood sugar> 180 mg / dl, hypoalbumin and CRP> 6 mg / dl. In multivariate analysis showed the decrease of renal function and duration of bed rest > 7 days was significant.ConclusionThe decreased renal function and bed rest for more than 7 days was a risk factor for protein malnutrition in elderly patients.


1967 ◽  
Vol 69 (1) ◽  
pp. 25-31 ◽  
Author(s):  
A. R. Abou Akkada ◽  
H. El Sayed Osman

1. Nine successive trials with three adult desert rams were carried out, with the aim of using ruminal ammonia or blood urea concentration as an index of the nutritive value of the proteins in the various types of forage grown in irrigated parts of the northern Sudan.The change in the ruminal ammonia and blood urea concentration were considerably higher 3 h after feeding on leguminous forages than on the non-legumes. Among legumes, lubia and lubia hay produced the highest concentrations of both rumen ammonia and blood urea. Feeding the rams on berseem hay reduced the concentrations of ruminal ammonia and blood urea to levels below those given by feeding on fresh berseem.3. Most of the nitrogen excretion from leguminous forages was in the form of urinary nitrogen whereas for grasses faecal nitrogen made up the bulk of the nitrogen excreted. Berseem hay gave the highest nitrogen retention, followed by the butterfly pea and fresh berseem. Lubia and lubia hay gave the lowest nitrogen retention. The desert grasses produced a negative nitrogen balance when offered to the desert rams.


1979 ◽  
Vol 30 (2) ◽  
pp. 321 ◽  
Author(s):  
DD Phillips ◽  
DM Walker

Preruminant male crossbred lambs, aged 2–5 days at the start of the experiment, were used in five experiments to determine the sequence of limiting amino acids in milk replacers containing groundnut protein isolate (GPI) as the sole source of protein. Experiment 1. Eight lambs were each given eight diets in an 8 x 8 change-over design. The diets contained GPI, unsupplemented with amino acids, to provide from 0.10 to 0.45 of the total energy as protein. Experiment 2. Eight lambs were used in two 4 x 4 change-over designs. The protein energy concentration of the diets after supplementation with amino acids was 0.22. In both experimental designs the GPI was supplemented with Met, Lys and Thr as a group in one diet. In experiment 2a each of these amino acids was added singly in successive diets, while in experiment 26 one of the amino acids was omitted in turn from the mixture. Experiment 3. Six lambs were each given six diets based on GPI, supplemented with Met and Lys, at six levels of protein energy (0,100-0.225) in a 6 x 6 change-over design. Experiment 4. Eight lambs were used in an 8 x 8 change-over design. The protein energy concentration of the eight diets was 0.12 after supplementation with a group of amino acids that included Met, Lys, Thr, Val, Leu, Isol, Try and Phe. In successive diets Thr, Val, Leu, Isol, Try and Phe were omitted singly and, in the final diet, these six amino acids were omitted as a group. In experiments 1-4 the dietary periods were of 3 or 4 days. Nitrogen balances were estimated and plasma urea nitrogen concentrations (PUN) measured on the last day of each dietary period. Experiment 5. Six lambs, in two equal groups, were used in a conventional balance experiment, with a 5-day preliminary and a 6 day collection period. One group was given an unsupplemented low protein diet based on GPI, the other group had a similar diet supplemented with Met, Lys and Thr. The protein energy concentration in both diets was 0.10. The sequence of limiting amino acids in GPI (based on a 1 day nitrogen balance) was Met, Lys (equally first limiting at a protein energy concentration of 0.22), Thr, Try (equally third limiting at a protein energy concentration of 0.12). A 1-day nitrogen balance (or urinary urea nitrogen excretion in experiment 4) was a more sensitive indicator of the protein quality of a diet than PUN concentrations. The 1 day collection period gave a similar estimate of nitrogen balance to that determined in the conventional 6 day balance experiment.


1970 ◽  
Vol 21 (2) ◽  
pp. 345 ◽  
Author(s):  
RF Thornton ◽  
PR Bird ◽  
M Somers ◽  
RJ Moir

The transfer of endogenous nitrogen to the hind-gut digesta of sheep and its relationship with urinary nitrogen excretion were studied concurrently with the estimation of nitrogen balance and of dry matter digestibility in sheep fitted with a re-entrant ileal cannula. Infusion of glucose into the terminal ileum increased the excretion of faecal nitrogen by 1 g/day, while the urinary urea nitrogen excretion decreased by 1 g/day, relative to the respective control levels. Plasma urea nitrogen concentrations remained unchanged. When glucose was infused, the excretion of nitrogen in the faeces was higher than the amount of nitrogen passing the terminal ileum. It is suggested that endogenous urea nitrogen was transferred to the digesta of the hind-gut, where it was incorporated into microbial protein and subsequently excreted in the faeces. The transfer of urea from the blood to either of the fermentative areas of the gut tract is apparently the preferential pathway of urea excretion in ruminants.


1982 ◽  
Vol 60 (3) ◽  
pp. 331-334 ◽  
Author(s):  
Maureen C. Hannaford ◽  
Marc B. Goldstein ◽  
Robert G. Josse ◽  
Mitchell L. Halperin

The purpose of these experiments was to determine if augmented renal ammoniagenesis in chronic metabolic acidosis could increase the negative nitrogen balance during prolonged fasting. To explore this question, rats and rabbits were fasted for up to 10 days because acidosis would markedly augment ammonium excretion in the rat but not in the rabbit. Since the ketoacidosis of fasting was mild in both species (< 2 mM) and ketonuria virtually absent, a hydrochloric acid load was given to stimulate renal ammoniagenesis. Under these conditions, nitrogen balance was significantly more negative during acidosis in the rat but not in the rabbit. This increment in nitrogen excretion appeared as ammonium with no detectable difference in urea nitrogen excretion. Therefore, it appears that if more nitrogen is excreted as ammonium, net protein breakdown increases to furnish the substrate for ammoniagenesis rather than reducing the excretion of the other nitrogenous waste component urea. The implications of these findings will be discussed.


1980 ◽  
Vol 44 (03) ◽  
pp. 146-149 ◽  
Author(s):  
Nicole Ardaillou ◽  
Jeannine Yvart ◽  
Philippe Le Bras ◽  
Marie-José Larrieu

SummaryThe catabolism of human fragment D, (FgD), obtained by plasmin digestion of fibrinogen has been investigated in normal subjects and patients with liver cirrhosis and the results compared with those obtained for fibrinogen (Fg). Fg was labelled with I-125 and Fg D with I-131 using the chloramine T method. The plasma disappearance curves of both labelled proteins fitted a two exponential curve. In controls the plasma clearance rate of Fg D was greater than that of Fg as shown by the marked difference between the half-lives of these two tracers: 8,9 and 83,5 hours for Fg D and Fg respectively. The fractional catabolic rate of Fg D was 3.38 times the plasma pool per day. In nine patients with liver cirrhosis, catabolism of Fg was not modified. In contrast, catabolism of Fg D was significantly reduced with a half life of 13.0 hours and a low fractional catabolic rate. These results suggest the role of the liver in the catabolism of Fg D in man.


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