Growth retardation in children receiving long-term total parenteral nutrition: effects of ornithine alpha-ketoglutarate.
We evaluated the effect of ornithine ketoglutarate (OKG) in reversing abnormal growth in six prepubertal children receiving total parenteral nutrition (TPN) for 5-10 y. They were 1-4 SDs below their expected 50th percentile for height. The energy and nitrogen intakes were unchanged from 8 mo before the beginning of the study until its completion. Two consecutive periods of 5 mo each were studied. OKG (15 g) was added to the parenteral solution during the first period (OKG+) but not during the second period (OKG-). Height velocity (HV) increased (P < 0.05) from a median of 3.8 cm/y to 6.45 cm/y (range 1.8-6.7) during the OKG+ period, and decreased (P < 0.05) to a median of 3.65 cm/y in the OKG- period. Plasma concentrations of insulin-like growth factor 1 (IGF1), glutamine, and glutamate increased (P < 0.05) during the OKG+ period. Variations of IGF1 concentrations correlated with HV variations (r = 0.82, P < 0.005) during both periods. This study demonstrates that OKG is associated with statural growth acceleration and increased IGF1 concentrations.
Moukarzel
A A
AA
Department of Pediatrics, Maimonides Medical Center, Brooklyn, NY.
Goulet
O
O
Salas
J S
JS
Marti-Henneberg
C
C
Buchman
A L
AL
Cynober
L
L
Rappaport
R
R
Ricour
C
C
D000293:Adolescent; D000596:Amino Acids / Q000097:blood; D000886:Anthropometry; D001827:Body Height / Q000187:drug effects; D002648:Child; D005260:Female; D005971:Glutamates / Q000097:blood; D005973:Glutamine / Q000097:blood; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D009952:Ornithine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D011228:Prealbumin / Q000378:metabolism; D012177:Retinol-Binding Proteins / Q000378:metabolism; D054839:Retinol-Binding Proteins, Plasma; D012709:Serum Albumin / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism
D000596:Amino Acids; D005971:Glutamates; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D054839:Retinol-Binding Proteins, Plasma; D012709:Serum Albumin; D014168:Transferrin; D005973:Glutamine; C002118:ornithine alpha-ketoglutarate; D007334:Insulin-Like Growth Factor I; D009952:Ornithine