Borel M J, Williams P E, Jabbour K, Hibbard J C, Flakoll P J
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
Am J Physiol. 1997 Jan;272(1 Pt 1):E36-44. doi: 10.1152/ajpendo.1997.272.1.E36.
The effect of chronic hypocaloric parenteral infusions of amino acids (AA) vs. dextrose (D) on protein homeostasis after a generalized metabolic stress was examined. Multicatheterized mongrel dogs were metabolically challenged by a 4-day fast and then administered a 4-day intravenous infusion of saline (S, n = 8), D (n = 8), or isocaloric AA (n = 7). Although nitrogen balance (g.kg.1.day-1) was similarly negative with S (-0.37 +/- 0.05), D (-0.28 +/- 0.03), and AA (-0.37 +/- 0.04) during the fasting period, it was less negative (P < or = 0.05) with AA (-0.06 +/- 0.04) than with D (-0.20 +/- 0.03) or S (-0.23 +/- 0.04) during nutrient infusion. AA resulted in net hindlimb uptake and D in net hindlimb release of essential AA (570 +/- 261 vs. -248 +/- 59 nmol.kg-1.min-1). Whereas S and D infusions led to net hindlimb muscle protein loss (-37 +/- 24 and -89 +/- 33 micrograms.kg-1.min-1, respectively, P < or = 0.05 vs. AA), parenteral AA resulted in net deposition (169 +/- 62 micrograms.kg-1.min-1) as measured using L-[ring-2H5]phenylalanine. Thus hypocaloric parenteral D infusion after a metabolic stress does not favor nitrogen conservation, because net whole body nitrogen loss, skeletal muscle protein catabolism, and hindlimb AA release were not blunted compared with S infusion. Conversely, hypocaloric AA infusion preserves whole body and muscle protein stores.
研究了慢性低热量肠外输注氨基酸(AA)与葡萄糖(D)对全身代谢应激后蛋白质稳态的影响。对多导管杂种犬进行4天禁食以引发代谢应激,然后给予4天的静脉输注生理盐水(S,n = 8)、葡萄糖(D,n = 8)或等热量氨基酸(AA,n = 7)。尽管在禁食期间,S(-0.37±0.05)、D(-0.28±0.03)和AA(-0.37±0.04)的氮平衡(g·kg⁻¹·d⁻¹)同样为负,但在营养输注期间,AA(-0.06±0.04)的负平衡程度低于D(-0.20±0.03)或S(-0.23±0.04)(P≤0.05)。AA导致必需氨基酸的后肢净摄取,而D导致必需氨基酸的后肢净释放(570±261对-248±59 nmol·kg⁻¹·min⁻¹)。S和D输注导致后肢肌肉蛋白质净损失(分别为-37±24和-89±33μg·kg⁻¹·min⁻¹,与AA相比P≤0.05),而肠外AA输注导致净沉积(169±62μg·kg⁻¹·min⁻¹),使用L-[环-²H₅]苯丙氨酸进行测量。因此,代谢应激后低热量肠外输注葡萄糖不利于氮的保留,因为与输注生理盐水相比,全身净氮损失、骨骼肌蛋白质分解代谢和后肢氨基酸释放并未减弱。相反,低热量氨基酸输注可保留全身和肌肉蛋白质储备。