American Journal of Clinical Nutrition, Vol 32, 1597-1611, Copyright © 1979 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Changes in nitrogen balance of depleted patients with increasing infusions of glucose

DH Elwyn, FE Gump, HN Munro, M Iles and JM Kinney

Depleted patients were maintained on intravenous infusions of amino acids and glucose with constant N intake (173 mg/kg body weight), and three different levels of energy intake (15.4, 37.6, and 58.5 kcal/kg) given sequentially for 4 days each. Changes in N balance were abrupt and maximal in 1 to 2 days. Maximal changes in N balance preceded, and were not dependent on maximal changes in fat and glucose metabolism. N retention increased 1.7 mg/kcal of increased energy balance, during both hypocaloric and hypercaloric intakes, a value similar to that observed in normal adults. No increase in resting energy expenditure occurred with increasing energy intake during negative energy balance. During positive energy balance resting energy expenditure increased by 1 kcal for each 5 of intake. It seems likely that increasing energy restores mainly that portion of lean body mass associated with fat deposition; and rapid restoration of lean body mass requires high N intakes. At zero energy balance, N balance in these depleted patients was only slightly positive at an intake of 173 mg N per kilogram. This is about twice the intake of N required to maintain zero N balance in normal adults.

This article has been cited by other articles:

				F. R Sattler, N. Rajicic, K. Mulligan, K. E Yarasheski, S. L Koletar, A. Zolopa, B. Alston Smith, R. Zackin, B. Bistrian, and for the ACTG 392 Study Team Evaluation of high-protein supplementation in weight-stable HIV-positive subjects with a history of weight loss: a randomized, double-blind, multicenter trial Am. J. Clinical Nutrition, November 1, 2008; 88(5): 1313 - 1321. [Abstract] [Full Text] [PDF]

				R. Chiolero, P. Schneiter, C. Cayeux, E. Temler, E. Jequier, C. Schindler, and L. Tappy Metabolic and Respiratory Effects of Sodium Lactate During Short IV Nutrition in Critically III Patients JPEN J Parenter Enteral Nutr, July 1, 1996; 20(4): 257 - 263. [Abstract] [PDF]

				W. L. Macias, K. J. Alaka, M. H. Murphy, M. E. Miller, W. R. Clark, and B. A. Mueller Impact of the Nutritional Regimen on Protein Catabolism and Nitrogen Balance in Patients With Acute Renal Failure JPEN J Parenter Enteral Nutr, January 1, 1996; 20(1): 56 - 62. [Abstract] [PDF]

				B. Aguilaniu, S. Goldstein-Shapses, A. Pajon, P. Levy, F. Sarrot, X. Leverve, E. Page, and J. Askanazi Muscle Protein Degradation in Severely Malnourished Patients With Chronic Obstructive Pulmonary Disease Subject to Short-Term Total Parenteral Nutrition JPEN J Parenter Enteral Nutr, May 1, 1992; 16(3): 248 - 254. [Abstract] [PDF]

				K. M. Gil, B. Skeie, V. Kvetan, J. Askanazi, and M. I. Friedman Parenteral Nutrition and Oral Intake: Effect of Glucose and Fat Infusions JPEN J Parenter Enteral Nutr, July 1, 1991; 15(4): 426 - 432. [Abstract] [PDF]

				U. Suchner, M. M. Rothkopf, G. Stanislaus, D. H. Elwyn, V. Kvetan, and J. Askanazi Growth Hormone and Pulmonary Disease: Metabolic Effects in Patients Receiving Parenteral Nutrition Arch Intern Med, June 1, 1990; 150(6): 1225 - 1230. [Abstract] [PDF]

				H. W. Merrick, C. L. Long, G. P. Grecos, R. S. Dennis, and W. S. Blakemore Energy Requirements for Cancer Patients and the Effect of Total Parenteral Nutrition JPEN J Parenter Enteral Nutr, January 1, 1988; 12(1): 8 - 14. [Abstract] [PDF]

				K. A. Dahlstrom, N. Mcintosh, and M. E. Ament A Comparison of Two 20% Lipid Emulsions JPEN J Parenter Enteral Nutr, March 1, 1987; 11(2): 149 - 151. [Abstract] [PDF]

				D. Mcr. Russell, H. L. Atwood, and K. N. Jeejeebhoy Nitrogen versus Muscle Calcium in the Genesis of Abnormal Muscle Function in Malnutrition JPEN J Parenter Enteral Nutr, July 1, 1985; 9(4): 415 - 421. [PDF]

				J. M. Kosanovich, F. Dumler, M. Horst, C. Quandt, J. A. Sargent, and N. W. Levin Use of Urea Kinetics in the Nutritional Care of the Acutely III Patient JPEN J Parenter Enteral Nutr, March 1, 1985; 9(2): 165 - 169. [Abstract] [PDF]

				B. Messing, P.J. Pontal, and J.J. Bernier Metabolic Study during Cyclic Total Parenteral Nutrition in Adult Patients with and without Corticosteroid-induced Hypercatabolism: Comparison with Standard Total Parenteral Nutrition JPEN J Parenter Enteral Nutr, January 1, 1983; 7(1): 21 - 25. [Abstract] [PDF]

				M. A. Mccamish, R. E. Dean, and T. R. Ouellette Response to Dr. Edward J. Quebbeman JPEN J Parenter Enteral Nutr, July 1, 1982; 6(4): 315 - 316. [PDF]

				M. A. Mccamish, R. E. Dean, and T. R. Ouellette Asssessing Energy Requirements of Patients on Respirators JPEN J Parenter Enteral Nutr, November 1, 1981; 5(6): 513 - 516. [Abstract] [PDF]

				H. M. Shizgal and R. A. Forse Total Parenteral Nutrition with Vamin and Intralipid JPEN J Parenter Enteral Nutr, September 1, 1981; 5(5): 391 - 396. [Abstract] [PDF]

				G. Iapichino, M. Solca, D. Radrizzani, M. Zucchetti, and G. Damia Net Protein Utilization During Total Parenteral Nutrition of Injured Critically III Patients: An Original Approach JPEN J Parenter Enteral Nutr, July 1, 1981; 5(4): 317 - 321. [Abstract] [PDF]

				R. J. Merritt, J. M. Ashley, S. E. Siegel, F. R. Sinatra, D. W. Thomas, and D. M. Hays Calorie and Protein Requirements of Pediatric Patients with Acute Nonlymphocytic Leukemia JPEN J Parenter Enteral Nutr, January 1, 1981; 5(1): 20 - 23. [Abstract] [PDF]