Glutamine supplement with parenteral nutrition decreases whole body proteolysis in low birth weight infants

• Published in: The Journal of pediatrics 2005-05, Vol.146 (5), p.642-647
• Main Authors: Kalhan, Satish C., Parimi, Prabhu S., Gruca, Lourdes L., Hanson, Richard W.
• Format: Article
• Language: English
• Subjects: Amino Acids - blood; Biological and medical sciences; Birth Weight; C-Reactive Protein - metabolism; Diseases of mother, fetus and pregnancy; General aspects; Gestational Age; Glutamine - metabolism; Glutamine - therapeutic use; Gynecology. Andrology. Obstetrics; Humans; Hydrocortisone - blood; Infant, Low Birth Weight; Infant, Newborn; Kinetics; Medical sciences; Nitrogen - metabolism; Parenteral Nutrition; Pregnancy. Fetus. Placenta; Proteins - metabolism
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2005.01.022

To examine the effect of supplemental glutamine (0.6 g.kg −1.d −1) on whole body protein/nitrogen and glutamine kinetics in low birth weight (LBW) infants receiving parenteral nutrition in the immediate neonatal period. Premature infants ≤32 weeks gestation with a birth weight from 694 to 1590 g were randomly assigned to either a glutamine-supplemented group (n = 10) or to a control group (n = 10). Tracer isotope studies were performed when the infants were 6 to 7 days old and had been receiving an amino acid intake of approximately 3.0 g.kg −1.d −1 for at least 3 days. Whole body glutamine and nitrogen kinetics were measured with [5- 15N]glutamine, [ 2H 5]phenylalanine, [1- 13C, 15N]leucine, [ 15N 2]urea, and GC-mass spectrometry. Supplemental glutamine was associated with a lower rate of appearance of glutamine ( P = .003), phenylalanine ( P = .001), and leucine C ( P = .003). There was no significant difference in leucine N turnover, urea turnover and plasma cortisol, and C-reactive protein levels in the 2 groups. Parenteral glutamine supplement in LBW infants was associated with lower whole-body protein breakdown. Because the decrease in whole body proteolysis is associated with protein accretion, parenteral glutamine supplement may be beneficial in selected populations of LBW infants.