Taurine status and response to intravenous taurine supplementation in adults with short-bowel syndrome undergoing long-term parenteral nutrition: a pilot study.
Taurine deficiency in patients on long-term parenteral nutrition may be involved in cholestasis. We aimed to assess plasma taurine and tauro-conjugated bile acids in adults with short-bowel syndrome and their response to intravenous taurine. Thirty-two adult patients, who had been on taurine-free parenteral nutrition for a mean of 59 (SE 14) months for short-bowel syndrome, were studied retrospectively. In a second study, a subgroup of ten patients with chronic cholestasis received taurine-enriched (6.0 (SE 0.6) mg/kg per d) parenteral nutrition for 55 (SE 13) months. Post-absorptive plasma taurine and bile acid concentrations were measured and liver function tests routinely sampled. At baseline, plasma taurine was lower in patients with a jejunal length of less than 35 cm (group A, n 16) than in those with a jejunal length of 35 cm or more (group B, n 16): 43 (SE 3) v. 58 (SE 4) micromol/l (P=0.01). The groups were no different in terms of chronic cholestasis (12/16 v.13/16 patients), total bile acids (26 (SE 13) v.14 (SE 5) micromol/l) or the ratio of tauro-conjugated:glyco-conjugated bile acids (5 (SE 2) v.8(SE 4)%, usual range 30-60%). After supplementation, there was an increase in plasma taurine level (63 (SE 8) v. 43 (SE 4), P=0.007) but was no change in either total bile acids or the ratio of tauro-conjugated: glyco-conjugated bile acids. There was a significant decrease in aspartate aminotransferase level. Long-term parenteral nutrition for short-bowel syndrome is associated with an impaired tauro-conjugation of bile acids (enterohepatic pool), irrespective of plasma taurine level (systemic pool) and despite long-term taurine intravenous supplementation.
Schneider
Stéphane M
SM
AP-HP Saint-Lazare Hospital, Gastroenterology and Nutrition Support Unit, Paris, France. stephane.schneider@unice.fr
Joly
Françoise
F
Gehrardt
Marie-France
MF
Badran
Abdul M
AM
Myara
Anne
A
Thuillier
François
F
Coudray-Lucas
Colette
C
Cynober
Luc
L
Trivin
François
F
Messing
Bernard
B
D000328:Adult; D000596:Amino Acids / Q000032:analysis; D001647:Bile Acids and Salts / Q000097:blood; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000209:etiology / Q000628:therapy; D002908:Chronic Disease; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007583:Jejunum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D012778:Short Bowel Syndrome / Q000097:blood / Q000150:complications / Q000473:pathology / Q000628:therapy*; D013654:Taurine / Q000008:administration & dosage / Q000097:blood* / Q000172:deficiency
D000596:Amino Acids; D001647:Bile Acids and Salts; D013654:Taurine