title: Effect of glutamine on glucose metabolism in children with Duchenne muscular dystrophy.
abstract: OBJECTIVE
  Glutamine is a potent gluconeogenic precursor and stimulates insulin secretion. Glutamine's effect on glucose metabolism in Duchenne muscular dystrophy (DMD) has never been studied. To determine plasma glucose and insulin concentrations measured during and after glutamine administration in DMD boys. We hypothesized that glutamine can modulate whole body glutamine-glucose metabolism in DMD, a genetically determined disease.
  
  
  METHODS
  As secondary endpoints of a randomized crossover trial in 30 prepubertal DMD boys, we measured fasting blood glucose, insulin and the Homeostasis Model Assessment (HOMA) index after daily oral glutamine (0.5 g kg(-1) d(-1)) for 4 months versus placebo. In a separate time series trial in 6 prepubertal DMD boys, we measured the same endpoints as well as plasma glutamine and whole body glucose turnover (Ra,glc) (primed continuous i.v. infusion of d-[6,6-(2)D]glucose), while participants received acute oral glutamine (0.5 g kg(-1) d(-1)) continuously for 5 h.
  
  
  RESULTS
  In the randomized trial, baseline measurements of HOMA correlated with age (r = 0,51, p = 0.007) and percent fat estimated by bioelectrical impedance analysis (BIA) (r = 0.39, p = 0.047). After 4 months glutamine supplementation, we observed no treatment or order effect on HOMA or insulin. During acute glutamine for 5 h (time series trial), plasma glutamine doubled and was associated with increased plasma insulin concentration (10.42 ± 2.54 vs 7.32 ± 1.86, p = 0.05) with no effect on plasma glucose, HOMA or Ra,glc.
  
  
  CONCLUSIONS
  Acute glutamine transiently stimulates insulin secretion in DMD boys, which could be mediated by plasma glutamine concentrations. Fasting insulin concentration and HOMA might provide quantifiable indices of disease progression.
authors.affiliation: INSERM, Centre d'Investigation Clinique 802, Poitiers F-86000, France. guyletellier@yahoo.fr
authors.forename: Guy
authors.initials: G
authors.lastname: Letellier
authors.forename: Elise
authors.initials: E
authors.lastname: Mok
authors.forename: Corinne
authors.initials: C
authors.lastname: Alberti
authors.forename: Arnaud
authors.initials: A
authors.lastname: De Luca
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gottrand
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Cuisset
authors.forename: André
authors.initials: A
authors.lastname: Denjean
authors.forename: Dominique
authors.initials: D
authors.lastname: Darmaun
authors.forename: Régis
authors.initials: R
authors.lastname: Hankard
mesh_terms: D000284:Administration, Oral; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D002648:Child; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D023381:Endpoint Determination; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D005973:Glutamine / Q000008:administration & dosage* / Q000097:blood; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism; D000078790:Insulin Secretion; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D001786:Blood Glucose; D007328:Insulin; D005973:Glutamine; D005947:Glucose