Document Detail


Randomized, controlled study evaluating effects of branched chain amino acids and alpha-ketoisocaproate on protein metabolism after surgery.
MedLine Citation:
PMID:  1555086     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effect of nutritional supplementation with branched chain amino acids or the ketoacid alpha-ketoisocaproate on protein metabolism after surgery was studied in 24 patients with gastrointestinal cancer. They were randomized to receive one of three nutritional regimens. All patients received a balanced amino acid solution and group 1 (n = 8) received no further supplements, group 2 (n = 8) received supplementation with alpha-ketoisocaproate (17 g day-1) and group 3 (n = 8) received a branched chain solution including leucine, isoleucine and valine, corresponding to 3.3 g nitrogen day-1. Plasma albumin, prealbumin, fibronectin and serum urea concentrations, nitrogen balance and 3-methylhistidine release from the leg and its excretion in the urine were measured. Albumin and prealbumin concentrations fell after surgery in all groups, and fibronectin levels fell in group 2 (P less than 0.001). In group 2 there was also a significant increase in serum urea concentration after operation (P less than 0.05). Cumulative nitrogen balance after 3 days was -5.6 g (group 1), -3.8 g (group 2) and -1.7 g (group 3). The release of 3-methylhistidine (nmol 100 g-1 min-1) from the leg after operation, following an overnight fast, was -0.42 (group 1), -0.51 (group 2) and -0.66 (group 3). During infusion the release was -0.56, -0.99 and -0.81, respectively. A balanced amino acid solution with an adequate energy supply has an optimal nitrogen-sparing effect. Branched chain amino acids or alpha-ketoisocaproate did not improve nitrogen balance or reduce protein degradation.
Authors:
S Sandstedt; L Jorfeldt; J Larsson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  79     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-05-04     Completed Date:  1992-05-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  217-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesiology, University Hospital, Linköping, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Amino Acids, Branched-Chain / therapeutic use*
Caproates / therapeutic use*
Female
Gastrointestinal Neoplasms / surgery*
Humans
Keto Acids / therapeutic use*
Male
Methylhistidines / metabolism
Middle Aged
Nitrogen / metabolism
Parenteral Nutrition, Total
Postoperative Period
Proteins / metabolism*
Chemical
Reg. No./Substance:
0/Amino Acids, Branched-Chain; 0/Caproates; 0/Keto Acids; 0/Methylhistidines; 0/Proteins; 368-16-1/3-methylhistidine; 7727-37-9/Nitrogen; 816-66-0/alpha-ketoisocaproic acid

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


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