Document Detail

Wasting and the substrate-to-energy controlled pathway: a role for insulin resistance and amino acids.
MedLine Citation:
PMID:  15094098     Owner:  NLM     Status:  MEDLINE    
Amino acids contained in proteins can be transformed either in glucose precursors or in acetate, the end product of free fatty acid (FFA) oxidation. The dynamics of glucose, FFA, and amino acid competition for entry into the citric acid cycle (tricarboxylic acid [TCA] cycle) are very complex and not fully understood. Conditions where glucose is insufficiently driven to full oxidation are characterized by lowest efficiency in energy production per mole of oxygen consumed. Moreover, acetate provided by oxidation of FFA increases consumption of amino acids as precursors of the oxaloacetate required for condensation with acetate and for maintenance of citrate synthesis. Increased consumption of amino acids in the TCA cycle, if not matched by adequate intake, leads to muscular wasting and cachexia. Therefore, amino acid needs are very complex, and their intake must provide a balanced ratio of glucogenic and ketogenic precursors suitable to trigger entry of glucose to full oxidation and blunt the level of FFA utilization. Optimization of substrate entry into energy production must also be coupled with sufficient availability of amino acids in ratios suitable for maintaining protein synthesis, inhibiting the catabolic drive, and promoting integrity of cellular proteic structures. Alimentary proteins have a content of amino acids that is far from the stoichiometric ratios of essential amino acids required by humans. An amino acid formulation suitable to match energy needs, control carbohydrate and lipid flow into the TCA cycle, and promote protein synthesis in contracting cells is detailed in this article.
Francesco S Dioguardi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  93     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-19     Completed Date:  2004-05-07     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  6A-12A     Citation Subset:  AIM; IM    
Department of Internal Medicine, University of Milan, Milan, Italy.
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MeSH Terms
Amino Acids, Essential*
Cachexia / diet therapy*,  physiopathology*
Dietary Proteins*
Food, Formulated*
Insulin Resistance
Reg. No./Substance:
0/Amino Acids, Essential; 0/Dietary Proteins

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