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首页> 外文期刊>American Journal of Physiology >Effect of intravenous amino acids on glutamine and protein kinetics in low-birth-weight preterm infants during the immediate neonatal period.
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Effect of intravenous amino acids on glutamine and protein kinetics in low-birth-weight preterm infants during the immediate neonatal period.

机译：新生婴儿静脉内氨基酸对低出生体重早产儿谷氨酰胺和蛋白质动力学的影响。

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摘要

Glutamine may be a conditionally essential amino acid in low-birth-weight (LBW) preterm neonates. Exogenously administered amino acids, by providing anaplerotic carbon into the tricarboxylic acid cycle, could result in greater cataplerotic efflux and glutamine de novo synthesis. The effect of dose and duration of amino acid infusion on glutamine and nitrogen (N) kinetics was examined in LBW infants in the period immediately after birth. Preterm neonates (<32 weeks gestation, birth weights 809-1,755 g) were randomized to initially receive either 480 or 960 micromol x kg(-1) x h(-1) of an intravenous amino acid solution for 19-24 hours, followed by a higher or lower amino acid load for either 5 h or 24 h. Glutamine de novo synthesis, leucine N, phenylalanine, and urea kinetics were determined using stable isotopic tracers. An increase in amino acid infusion from 480 to 960 micromol x kg(-1) x h(-1) for 5 h resulted in decreased glutamine de novo synthesis in every neonate (384.4 +/- 38.0 to 368.9 +/- 38.2 micromol x kg(-1) x h(-1), P < 0.01) and a lower whole body rate of proteolysis (P < 0.001) and urea synthesis (P < 0.001). However, when the increased amino acid infusion was extended for 24 h, glutamine de novo synthesis increased (369.7 +/- 92.6 to 483.4 +/- 97.5 micromol x kg(-1) x h(-1), P < 0.001), whole body rate of proteolysis did not change, and urea production increased. Decreasing the amino acid load resulted in a decrease in glutamine rate of appearance (R(a)) and leucine N R(a), but had no effect on phenylalanine R(a). Acutely stressed LBW infants responded to an increase in amino acid load by transiently suppressing whole body rate of glutamine synthesis, proteolysis, and oxidation of protein. The mechanisms of this transient effect on whole body proteinitrogen metabolism remain unknown.
机译：谷氨酰胺可能是低出生体重（LBW）早产儿的有条件必需氨基酸。通过向三羧酸循环中提供无抗药性碳，外源施用的氨基酸可导致更高的抗发药性外排和谷氨酰胺从头合成。在出生后立即检查LBW婴儿中氨基酸输注的剂量和持续时间对谷氨酰胺和氮（N）动力学的影响。早产新生儿（小于32周，出生体重809-1,755 g）被随机分配，最初接受480或960 micromol x kg（-1）xh（-1）的静脉氨基酸溶液19-24小时，然后5小时或24小时的较高或较低的氨基酸负载量。使用稳定的同位素示踪剂确定了谷氨酰胺从头合成，亮氨酸N，苯丙氨酸和尿素的动力学。氨基酸注入量从480微摩尔x kg（-1）xh（-1）增加到5小时导致每个新生儿的谷氨酰胺从头合成减少（384.4 +/- 38.0到368.9 +/- 38.2微摩尔x kg （-1）xh（-1），P <0.01）和较低的全身蛋白水解率（P <0.001）和尿素合成（P <0.001）。但是，当增加的氨基酸输注时间延长24小时时，谷氨酰胺从头合成增加（369.7 +/- 92.6至483.4 +/- 97.5 micromol x kg（-1）xh（-1），P <0.001）人体蛋白水解率没有变化，尿素产量增加。减少氨基酸负荷导致谷氨酰胺外观（R（a））和亮氨酸N R（a）降低，但对苯丙氨酸R（a）没有影响。急性应激的LBW婴儿通过瞬时抑制谷氨酰胺合成，蛋白水解和蛋白质氧化的整体速率来应对氨基酸负荷的增加。这种瞬时作用于全身蛋白质/氮代谢的机制仍然未知。

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