Albumin synthesis in premature infants: determination of turnover with [15N]glycine.

Albumin turnover was studied in seven small premature infants who received a constant infusion of [15N]glycine for 60-72 h. Gas chromatography-mass spectrometry was used to measure the rate of appearance of [15N]glycine in albumin isolated from the blood. By comparing the linear increment of [15N]glycine in blood albumin with plateau labelling of urinary [15N]hippurate, which was assumed to reflect intrahepatic isotopic abundance in [15N]glycine, the fractional synthetic rate for albumin was found to be 0.09-0.177 day-1 (mean +/- SD = 0.122 +/- 0.041 day-1). The absolute synthesis rate for albumin was 0.3 +/- 0.099 g/dl plasma X day-1 and the total plasma synthetic rate was 117.6 +/- 37.0 mg/kg X day-1. The glycine flux was 326.0-927.7 mumol/kg X h-1 (mean +/- SD 516.7 +/- 218.4 mumol/kg hr-1). The percentage of the glycine flux incorporated into albumin in the total vasculature was 0.425 +/- 0.344. The fractional synthetic rate and the absolute synthetic rate for albumin in these small premature infants are much higher than values obtained in healthy young adults studied with a similar methodology. The relatively low serum albumin concentrations typical of premature infants appear to be referable to more rapid turnover of a small plasma pool rather than a diminution in the rate of albumin synthesis.