Glutamine supplement with parenteral nutrition decreases whole body proteolysis in low birth weight infants.
OBJECTIVE
To examine the effect of supplemental glutamine (0.6 g.kg -1 .d -1 ) on whole body protein/nitrogen and glutamine kinetics in low birth weight (LBW) infants receiving parenteral nutrition in the immediate neonatal period.


METHODS
Premature infants < or =32 weeks gestation with a birth weight from 694 to 1590 g were randomly assigned to either a glutamine-supplemented group (n = 10) or to a control group (n = 10). Tracer isotope studies were performed when the infants were 6 to 7 days old and had been receiving an amino acid intake of approximately 3.0 g.kg -1 .d -1 for at least 3 days. Whole body glutamine and nitrogen kinetics were measured with [5-15N]glutamine, [2H5]phenylalanine, [1-13C, 15 N]leucine, [15N2]urea, and GC-mass spectrometry.


RESULTS
Supplemental glutamine was associated with a lower rate of appearance of glutamine ( P = .003), phenylalanine ( P = .001), and leucine C ( P = .003). There was no significant difference in leucine N turnover, urea turnover and plasma cortisol, and C-reactive protein levels in the 2 groups.


CONCLUSIONS
Parenteral glutamine supplement in LBW infants was associated with lower whole-body protein breakdown. Because the decrease in whole body proteolysis is associated with protein accretion, parenteral glutamine supplement may be beneficial in selected populations of LBW infants.
Kalhan
Satish C
SC
Schwartz Center for Metabolism and Nutrition, MetroHealth Medical Center, Department of Pedatrics and Biochemistry, CaseWestern Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. satish.kalhan@case.edu
Parimi
Prabhu S
PS
Gruca
Lourdes L
LL
Hanson
Richard W
RW
D000596:Amino Acids / Q000097:blood*; D001724:Birth Weight; D002097:C-Reactive Protein / Q000378:metabolism; D005865:Gestational Age; D005973:Glutamine / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007700:Kinetics; D009584:Nitrogen / Q000378:metabolism; D010288:Parenteral Nutrition; D011506:Proteins / Q000378:metabolism*
D000596:Amino Acids; D011506:Proteins; D005973:Glutamine; D002097:C-Reactive Protein; D009584:Nitrogen; D006854:Hydrocortisone