Document Detail


Physiologic response to a protein, carbohydrate, fat meal in patients with human immunodeficiency virus who underwent small intestinal enteropathy as characterized by a kinetic model of D-xylose absorption.
MedLine Citation:
PMID:  9437651     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Small intestinal human immunodeficiency virus enteropathy is characterized by profound absorptive dysfunction unrelated to histology or pathogens. Frequently an attempt is made to compensate for this intestinal failure by supplementing nutrient intake with nourishing liquid meals. It is not known how the diminished absorptive function in these patients will respond to this intake. With the use of a D-xylose kinetic model of absorption, we determined the absorptive response of patients with small intestinal enteropathy to an isotonic liquid feeding. METHODS: Seven male patients with acquired immunodeficiency syndrome (AIDS), diarrhea, weight loss, and no detectable pathogens (stool studies and duodenal biopsy) were enrolled. After an overnight fast, the patients were studied on three separate days. On day 1, the patients received 15 g oral D-xylose. On day 2, 10 g i.v. D-xylose was given. On day 3, 15 g oral D-xylose was again given along with 250 mL of a liquid polymeric isotonic diet. Serum and urine collections were obtained to calculate the kinetic rate constants and extent of D-xylose absorption. RESULTS: Mean values for the rate constant for absorption of D-xylose, Ka, (0.26/h; N > 0.65) and the rate constant for nonabsorptive loss, K0' (2.47/h; N < 0.353) were very abnormal before the meal. Mean K0 improved (decreased to 0.66), but Ka and bioavailability, F, did not have a statistically significant change after the meal. The improvement in mean K0 with the meal was much more pronounced in the five subjects with high K0 values before the meal (without meal 3.22: with meal 0.67; p < .05). CONCLUSIONS: (1) An isotonic liquid polymeric diet leads to less nonabsorptive loss of D-xylose, but does not affect the extent of D-xylose absorption in this group as a whole. This is probably due to the meal slowing gastric emptying. (2) Improvement in nonabsorptive loss with a meal is most pronounced when there is excessive nonabsorptive loss, K0, without a meal. (3) Improvement in nonabsorptive losses with a meal might predict which patients will benefit from antimotility agents and continued feedings vs those requiring i.v. hyperalimentation.
Authors:
S J Carlson; J C Deutsch; R M Craig
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  22     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:    1998 Jan-Feb
Date Detail:
Created Date:  1998-02-17     Completed Date:  1998-02-17     Revised Date:  2007-02-21    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  27-30     Citation Subset:  IM; X    
Affiliation:
Northwestern University Medical School, Chicago, IL, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Dietary Sucrose / administration & dosage*
Fasting
Food, Formulated
HIV Infections / complications*,  metabolism
Humans
Infusions, Intravenous
Intestinal Absorption / physiology*
Intestinal Diseases / metabolism*
Intestine, Small / metabolism*
Kinetics
Male
Xylose / administration & dosage,  blood,  metabolism*,  urine
Chemical
Reg. No./Substance:
0/Dietary Sucrose; 0/Xylose; 109320-37-8/Ensure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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