Effect of severe undernutrition and subsequent refeeding on gut mucosal protein fractional synthesis in human subjects.
OBJECTIVE
Undernutrition has been associated with gut mucosal atrophy, impaired absorption, and increased permeability. This study investigated the effect of severe undernutrition and subsequent refeeding on gastric and duodenal mucosal protein fractional syntheses (MPFS).


METHODS
MPFS was investigated in the gastric body, antrum, and duodenum of 23 severely undernourished patients by means of (14)C-leucine incorporation into tissue protein and repeated after a period of refeeding. Results were evaluated in comparison with a group of 22 healthy controls and presented as mean +/- standard error of the mean.


RESULTS
The mean body index of the undernourished patients was 13.29 +/- 0.33 kg/m(2) versus 22.67 +/- 0.63 kg/m(2) in the controls (P < 0.001). MPFS in the controls and undernourished patients were similar (gastric body, 36.49 +/- 2.88 versus 33.41 +/- 3.08%/d; gastric antrum, 25.51 +/- 2.20 versus 24.95 +/- 2.32%/d; duodenum, 25.90 +/- 2.58 versus 25.49 +/- 1.99%/d). After refeeding, the body mass index of the undernourished patients increased to 15.87 +/- 0.44 kg/m(2) (P < 0.001). The MPFS increased significantly (gastric body, 51.80 +/- 8.12%/d, P < 0.05; gastric antrum, 33.44 +/- 3.66%/d, P < 0.05; duodenum, 46.27 +/- 8.02%/d, P < 0.01), with the MPFS of the duodenum significantly greater than the control values (P = 0.01).


CONCLUSIONS
Despite severe undernutrition, MPFS of the gastric body, antrum, and duodenum remained similar to control values. Enteral feeding resulted in a significant increase in MPFS, indicating a trophic response.
Winter
Trevor A
TA
Division of Digestive Disease and Nutrition, University of Kentucky, Lexington, Kentucky, USA. winter@uky.edu
O'Keefe
Stephen J
SJ
Callanan
Marie
M
Marks
Tessa
T
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002247:Carbon Isotopes; D016022:Case-Control Studies; D004386:Duodenum / Q000378:metabolism; D004750:Enteral Nutrition; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism* / Q000502:physiology; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000502:physiology; D007930:Leucine / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000503:physiopathology* / Q000628:therapy*; D014176:Protein Biosynthesis / Q000187:drug effects* / Q000502:physiology; D011706:Pyloric Antrum / Q000378:metabolism; D016896:Treatment Outcome
D002247:Carbon Isotopes; D007930:Leucine