Stein T P, Buzby G P, Gertner M H, Hargrove W C, Leskiw M J, Mullen J L
Am J Physiol. 1980 Oct;239(4):G280-G287. doi: 10.1152/ajpgi.1980.239.4.G280.
We studied the effect of parenteral nutrition with amino acids and hypertonic glucose on protein synthesis and liver fat metabolism. Patients with operable gastrointestinal tract malignancies were divided into two groups. Group I ate the hospital diet ad libitum for the 7-10 days preceding surgery. Group II were given adjuvant parenteral nutrition (APN) for 7-10 days prior to the surgical removal of the tumor. Daily nutrient intake and nitrogen balance were determined. [15N[glycine (1-2 g) was infused at a constant rate for 12-18 prior to surgery. During surgery, blood, liver, and muscle specimens were taken for 15N analysis. Fractional protein synthesis rates were estimated by the method of Garlick et al. (Biochem. J. 136: 935-945, 1973). The fat content and distribution pattern in the liver was determined by gas chromatography-mass spectrometry. The following results were found. 1) APN increaed the albumin synthesis rate. 2) The fraction of linoleate in the total liver fatty acids were reduced by 75% in the APN patients. 3) Some of the APN patients developed fatty livers during the study. When the APN patients were subdivided on the basis of whether they had fatty livers, it was found that only those patients who did not accumulate fat showed an improvement in their plasma albumin concentration during the period of parenteral nutrition.
我们研究了氨基酸和高渗葡萄糖肠外营养对蛋白质合成及肝脏脂肪代谢的影响。将可手术治疗的胃肠道恶性肿瘤患者分为两组。第一组在手术前7 - 10天随意食用医院饮食。第二组在手术切除肿瘤前7 - 10天接受辅助肠外营养（APN）。测定每日营养摄入量和氮平衡。手术前12 - 18小时以恒定速率输注[15N]甘氨酸（1 - 2克）。手术期间，采集血液、肝脏和肌肉标本进行15N分析。采用Garlick等人的方法（《生物化学杂志》136: 935 - 945, 1973）估算蛋白质合成率。通过气相色谱 - 质谱法测定肝脏中的脂肪含量和分布模式。结果如下：1）APN提高了白蛋白合成率。2）APN患者肝脏总脂肪酸中亚油酸的比例降低了75%。3）部分APN患者在研究期间出现了脂肪肝。当根据是否患有脂肪肝对APN患者进行细分时，发现只有那些没有脂肪蓄积的患者在肠外营养期间血浆白蛋白浓度有所改善。
