Nutritional therapy improves growth and protein status of children with a urea cycle enzyme defect.
BACKGROUND
Poor growth has been described in patients with urea cycle enzyme defects treated with protein-restricted diets, while protein status is seldom reported.


OBJECTIVE
To assess the effects of nutritional therapy with a medical food on growth and protein status of patients with a urea cycle enzyme defect.


METHODS
A 6-mo multicenter outpatient study was conducted with infants and toddlers managed by nutrition therapy with Cyclinex-1 Amino Acid-Modified Medical Food with Iron (Ross Products Division, Abbott Laboratories, Columbus, OH). Main outcome variables were anthropometrics and plasma amino acids (selected), albumin, and transthyretin concentrations.


RESULTS
Seventeen patients completed the study. Mean (+/-SE) baseline age was 11.30+/-3.20 months (median 4.40 months; range 0.22-38.84 months). Length and weight z-scores increased significantly during the 6-month study. Head circumference increased, but not significantly. Three patients were stunted and two were wasted (-2.0 z-score) at baseline while at study end, only one patient was both stunted and wasted. The majority of patients increased in length, head circumference, and weight z-scores during study. Mean (+/-SE) plasma albumin concentration increased from 34+/-2g/L at baseline to 38+/-1g/L at study end. Plasma transthyretin increased from a mean (+/-SE) of 177+/-13 mg/L at baseline to 231+/-15 mg/L at study end. No correlation was found between plasma NH(3) concentrations and medical food intake. Plasma NH(3) concentration was positively correlated with the percentage of Food and Agriculture Organization/World Health Organization/United Nations recommended protein ingested.


CONCLUSIONS
Intakes of adequate protein and energy for age result in anabolism and linear growth without increasing plasma NH(3) concentrations. Medical food intakes did not correlate with plasma NH(3) concentrations.
Acosta
Phyllis B
PB
Ross Products Division, Abbott Laboratories, Columbus, OH, USA. pja1933@aol.com
Yannicelli
Steven
S
Ryan
Alan S
AS
Arnold
Georgianne
G
Marriage
Barbara J
BJ
Plewinska
Magda
M
Bernstein
Laurie
L
Fox
Joyce
J
Lewis
Vyonne
V
Miller
Marvin
M
Velazquez
Antonio
A
D000596:Amino Acids / Q000008:administration & dosage / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism; D001827:Body Height; D002675:Child, Preschool; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008661:Metabolism, Inborn Errors / Q000178:diet therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D009752:Nutritional Status; D011228:Prealbumin / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism; D014508:Urea / Q000378:metabolism*; D015430:Weight Gain
D000596:Amino Acids; D001798:Blood Proteins; D004044:Dietary Proteins; D011228:Prealbumin; D012709:Serum Albumin; D014508:Urea