Effects of wine intake on postprandial plasma amino acid and protein kinetics in type 1 diabetes.

BACKGROUND

Alcohol may impair protein turnover and insulin sensitivity in vivo.

OBJECTIVE

The acute effects of moderate wine intake on amino acid kinetics and on the fractional synthetic rate (FSR) of albumin and fibrinogen in patients with type 1 diabetes were studied.

DESIGN

Six patients with type 1 diabetes ingested an elementary mixed meal (46 kJ/kg) over 4 h, first without and 3 mo later with approximately 300 mL red wine. Postprandial glucose concentrations were maintained at <10 mmol/L.

RESULTS

Postprandially, the FSR of fibrinogen was approximately 30% greater (21.5 +/- 6.6% compared with 14.1 +/- 3.6% of pool/d; P < 0.01) and glucagon concentrations were approximately 40% greater (103 +/- 20 compared with 61 +/- 13 ng/L; P < 0.015) with wine than without wine. However, the FSR of albumin and the rates of appearance of total and endogenous phenylalanine and leucine were not significantly different between treatments. First-pass splanchnic uptake (in micromol*kg(-1)*min(-1)) of dietary phenylalanine (0.22 +/- 0.02 compared with 0.19 +/- 0.02) and leucine (0.25 +/- 0.04 compared with 0.14 +/- 0.02) were greater with wine (P < 0.05), whereas dietary phenylalanine oxidation was lower with wine, by approximately 25% (0.10 +/- 0.02 compared with 0.14 +/- 0.01 micromol.kg(-1).min(-1); P < 0.05). Selected amino acid concentrations were significantly lower but glutamate concentrations were significantly higher with wine.

CONCLUSIONS

In insulin-infused patients with type 1 diabetes, moderate wine intake with a meal resulted in 1) a higher fibrinogen FSR, glucagon concentration, and first-pass splanchnic uptake of leucine and phenylalanine; 2) lower dietary phenylalanine oxidation; 3) selective changes in plasma amino acid concentrations; 4) and no impairment in endogenous proteolysis and albumin synthesis.