Document Detail


The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants: a randomized controlled trial.
MedLine Citation:
PMID:  16931609     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as reflected by decreased intestinal permeability. The aim of our study was to investigate whether glutamine-enriched enteral nutrition in VLBW infants enhances the normal decrease in intestinal permeability, as measured by the sugar absorption test (SAT). METHODS: In a double-blind, randomized, placebo-controlled trial, VLBW infants (gestational age <32 weeks or birth weight <1,500 g) received enteral glutamine supplementation (0.3 g/kg/d) or an isonitrogenous placebo supplementation (alanine) between days 3 and 30 of life. Intestinal permeability, determined from the urinary lactulose/mannitol (L/M) ratio after an oral dose of lactulose and mannitol, was assessed at 4 time points: before the start of the study, and at days 7, 14, and 30 of life. RESULTS: At least 2 SATs were performed in 45/52 (86%) and 45/50 (90%) infants in the glutamine-supplemented and control groups, respectively. Baseline patient and nutrition characteristics were not different between the groups. There was no effect of glutamine-enriched enteral nutrition on the decrease of the L/M ratio between the start and end of the study (p = .78). In both treatment groups, median urinary lactulose concentrations decreased (p < .001), whereas median urinary mannitol concentrations increased (p = .003). CONCLUSIONS: Glutamine-enriched enteral nutrition does not enhance the postnatal decrease in intestinal permeability in VLBW infants. Any beneficial effect of glutamine may involve other aspects of intestinal integrity; for example, modulation of the intestinal inflammatory response.
Authors:
Anemone van den Berg; Willem P F Fetter; Elisabeth A M Westerbeek; Ina M van der Vegt; Hilda R A van der Molen; Ruurd M van Elburg
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  30     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:    2006 Sep-Oct
Date Detail:
Created Date:  2006-08-25     Completed Date:  2006-12-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  408-14     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Neonatology, VU University Medical Center, Amsterdam, The Netherlands. a.vandenberg@vumc.nl
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MeSH Terms
Descriptor/Qualifier:
Double-Blind Method
Enteral Nutrition*
Female
Glutamine / pharmacokinetics*,  pharmacology
Humans
Infant Nutritional Physiological Phenomena*
Infant, Newborn
Infant, Very Low Birth Weight*
Intestinal Absorption / drug effects*,  physiology
Lactulose / diagnostic use,  urine
Male
Mannitol / diagnostic use,  urine
Permeability / drug effects
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
4618-18-2/Lactulose; 56-85-9/Glutamine; 69-65-8/Mannitol

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


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