| The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 16931609 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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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:
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Created Date: 2006-08-25 Completed Date: 2006-12-19 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7804134 Medline TA: JPEN J Parenter Enteral Nutr Country: United States |
Other Details:
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Languages: eng Pagination: 408-14 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Division of Neonatology, VU University Medical Center, Amsterdam, The Netherlands. a.vandenberg@vumc.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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