Glutamine metabolism in children with short-bowel syndrome: a stable isotope study.
Because glutamine is thought to be a major fuel for developing gut, we tested the hypothesis that extensive small-bowel resection alters whole-body glutamine metabolism in vivo. Eleven infants and children who had undergone extensive small intestinal resection (residual bowel length: 35 +/- 13 cm; mean +/- SD) and four control infants received 4-h primed, continuous i.v. infusions of L-[(1-13C]leucine and L-[2-15N]glutamine in the postabsorptive state. The appearance rates of glutamine and leucine into plasma were determined from stable isotope enrichments in plasma at steady state. We observed the following: 1) Regardless of intestinal status, leucine and glutamine fluxes were higher in infants than values previously reported for adults. 2) Small-bowel resection was associated with a reduction in glutamine appearance rate (568 +/- 124 mumol.kg lean body mass-1.h-1 in short-bowel syndrome infants versus 816 +/- 149 mumol.kg lean body mass-1.h-1 in control infants; p < 0.05). 3) In contrast, leucine appearance rate was unaltered in short-bowel syndrome patients. The findings suggest that the small intestine plays a prominent role in glutamine metabolism in human infants.
Service de Gastroentérologie et Nutrition, Hôpital Necker-Enfants-Malades, Paris, France.
R
R
Hankard
O
O
Goulet
C
C
Ricour
M
M
Rongier
V
V
Colomb
D
D
Darmaun
D000328:Adult; D002247:Carbon Isotopes; D002648:Child; D002675:Child, Preschool; D005973:Glutamine / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000378:metabolism; D007700:Kinetics; D007930:Leucine / Q000378:metabolism; D009587:Nitrogen Isotopes; D012778:Short Bowel Syndrome / Q000378:metabolism*
D002247:Carbon Isotopes; D009587:Nitrogen Isotopes; D005973:Glutamine; D007930:Leucine