title: Citrulline blood levels as indicators of residual intestinal absorption in patients with short bowel syndrome.
abstract: Plasma citrulline is known to be a marker of absorptive enterocyte mass in humans. We evaluated whether citrulline and other blood amino acids are indicators of residual small intestinal length and therefore potential predictors of dependence on parenteral nutrition in the long term. We studied 25 patients with short bowel syndrome (SBS) after at least 18 months since last digestive circuit modification; 24 of them were again evaluated 1 year later. Ten patients were weaned off parenteral nutrition and 15 were dependent on parenteral nutrition. Fifty-four healthy volunteers (28 women and 26 men) served as controls. Amino acid levels were determined on serum with high-performance liquid chromatography (HPLC) as well as on blood and serum with tandem mass spectrometry analysis. Five amino acids (citrulline, leucine, isoleucine, valine and tyrosine) were significantly lower in all SBS patients than in controls, whereas glutamine, measured only by HPLC, was significantly higher. Nevertheless, only serum citrulline measured with HPLC was significantly related to small bowel length. We conclude that HPLC remains the reference methodology to evaluate blood or serum amino acid levels in adult population with SBS.
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università di Napoli Federico II, Napoli, Italy. nad2005@unina.it
authors.forename: Lidia
authors.initials: L
authors.lastname: Santarpia
authors.forename: Francesca
authors.initials: F
authors.lastname: Catanzano
authors.forename: Margherita
authors.initials: M
authors.lastname: Ruoppolo
authors.forename: Lucia
authors.initials: L
authors.lastname: Alfonsi
authors.forename: Dino Franco
authors.initials: DF
authors.lastname: Vitale
authors.forename: Rita
authors.initials: R
authors.lastname: Pecce
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pasanisi
authors.forename: Franco
authors.initials: F
authors.lastname: Contaldo
authors.forename: Francesco
authors.initials: F
authors.lastname: Salvatore
mesh_terms: D000328:Adult; D000596:Amino Acids / Q000032:analysis / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid / Q000379:methods*; D002956:Citrulline / Q000032:analysis / Q000097:blood*; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007421:Intestine, Small / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012778:Short Bowel Syndrome / Q000097:blood* / Q000378:metabolism / Q000473:pathology / Q000628:therapy
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D002956:Citrulline