Weightlessness as an accelerated model of nutritional disturbances

Food intake and eating patterns, body functions and composition are significantly altered by short-duration space flight. Prolonged missions lasting weeks or months further aggravate these changes, and are responsible for acute or chronic physical impairments at return to ground conditions. Current projects of missions to Mars, resulting in 2 years of microgravity conditions, stress the critical need for the development of optimal nutritional programs and physical countermeasures to prevent body mass and function alterations. This review outlines ground models of microgravity simulation, summarizes the major effects of weightlessness on body composition, protein metabolism, hormonal pattern, and muscle function, and addresses contradictory findings related to the oxidative stress secondary to space flight. Potential countermeasures, such as nutrient intake and physical conditioning, as well as areas of interest for future research both in ground and space medicine, are discussed.

Reduced whole-body fat oxidation in women and in the elderly

OBJECTIVE

To test the hypothesis that the increase in fat mass observed with aging might be related to a decrease in whole-body fat oxidation.

SUBJECTS AND MEASUREMENTS

Forty volunteers had measurements of sleeping and 24 h substrate oxidation in calorimetric chambers, body composition with the (18)O dilution technique, VO(2)max, and fiber composition analysis from a biopsy of vastus lateralis. They were divided into 10 young women, 10 young men, 10 elderly women and 10 elderly men.

RESULTS

Sleeping fat oxidation and 24 h fat oxidation were lower in women than in men and in elderly than in young participants. Sleeping fat oxidation was correlated to fat-free mass and energy balance (multivariate analysis). Twenty four hour fat oxidation was correlated to total energy expenditure and energy balance (multivariate analysis). After adjustment for differences in these factors, sleeping and 24 h fat oxidation were no longer different between age and sex groups. None of the parameters of macronutrient metabolism was correlated with muscle fiber composition.

CONCLUSION

Our data suggest that fat oxidation is lower in elderly subjects. This difference could favour fat mass gain if fat intake is not adequately reduced. Differences in fat-free mass and in total energy expenditure appear to participate in the reduction in fat oxidation. International Journal of Obesity (2001) 25, 39-44

Net energy value of non-starch polysaccharide isolates (sugarbeet fibre and commercial inulin) and their impact on nutrient digestive utilization in healthy human subjects

The energy value of NSP has been expressed as their metabolizable energy (ME) content. The aim of the present study was to determine whether differences in ME and net energy (NE) contents were similar for insoluble and soluble NSP. Nine healthy young men were offered three diets according to a Latin-square design (3 x 3) with three repetitions: diet C (control), diet B (control + 50 g sugarbeet fibre/d) and diet I (control + 50 g commercial inulin/d). After a 16 d adaptation period to NSP isolate, food intake was controlled (duplicate meal method) and faeces and urine were collected for 8 d. A period of 60 h was devoted to measurement of energy expenditure (EE) by whole-body indirect calorimetry. NSP-isolate ingestion induced significant increases in the number of defecations and stool weight resulting from increases in water, DM and microbial mass excretion. After deduction of microbial N, differences in faecal N excretion between diets were not significantly different. Urinary N excretion was slightly decreased by sugarbeet fibre or commercial inulin ingestion but the N balances for the diets were not significantly different. Diet energy, N and lipid apparent digestibilities decreased by only 1-2%. Commercial inulin was entirely fermented and fermentability of sugarbeet fibre averaged 0.886 (SD 0.117). Sugarbeet fibre and commercial inulin ME values averaged 10.7 (SD 1.2) and 13.0 (SD 2.3) kJ/g DM respectively. NSP-isolate ingestion caused significant (sugarbeet) and nonsignificant (inulin) increases in daily EE. The maintenance NE contents of sugarbeet fibre and inulin averaged 5.0 (SD 5.0) and 11.9 (SD 1.3) kJ/g DM respectively. Differences in maintenance NE contents of NSP isolates were much greater than differences in ME values.

Oxidative stress status and antioxidant status are apparently not related to carotenoid status in healthy subjects

Several lines of evidence suggest that carotenoids may have a beneficial effect on health as a result of their antioxidant properties. In addition to beta-carotene, five other carotenoids are recovered in noticeable amounts from human plasma and tissues. Although the effect of beta-carotene on in vivo lipid peroxidation has been documented, few data are available on the effects of the other carotenoids. We evaluated the ability of the main human carotenoids to reduce lipid peroxidation by determining the correlations between plasma carotenoid concentration and plasma antioxidant capacity (in 79 healthy volunteers) and between carotenoid status and breath pentane excretion (in a subgroup of 24 subjects). Carotenoid intake was assessed by means of a 3-day food recall. Carotenoid status was evaluated by measurement of beta-carotene, lycopene, lutein/zeaxanthin, and alpha-carotene in plasma and buccal mucosal cells. Antioxidant status was evaluated by measurement of the total antioxidant capacity of the plasma. Oxidative stress status was evaluated by breath pentane measurements. Food recall data and the carotenoid concentrations in plasma and buccal mucosal cells showed that the subjects had normal carotenoid intake and normal carotenoid status. The total antioxidant capacity of the plasma was not related to the concentration of any specific carotenoid. The level of expired air pentane was not related to the carotenoid status of the subjects. These results show that normal concentrations of carotenoids in plasma and tissues are not correlated with these clinical markers of antioxidant and oxidative stress status.

Comparison of the postprandial plasma vitamin A response in young and older adults

To assess the influence of age on vitamin A intestinal and liver metabolism in humans, the postprandial plasma concentrations of intestinal-originated vitamin A, i.e., retinyl esters, and liver-originated vitamin A, i.e., retinol, were compared in eight young (20-30 years old) and eight elderly (64-72 years old) healthy men. Plasma and chylomicron retinyl esters and retinol concentrations were measured for up to 24 h following the intake of a test meal that contained 23,300 RE retinyl palmitate. The chylomicron retinyl palmitate response (area under the curve) was not significantly different between the two groups, but its peak was slightly delayed (1 h) in the elderly men. The proportion of the different retinyl esters secreted in the chylomicrons was not significantly different between the two groups. The postprandial plasma retinol concentration did not change in the young participants, whereas it significantly increased in the elderly. These results suggest that vitamin A intestinal absorption and retinol intestinal esterification processes are not markedly modified in the elderly, whereas the chylomicron clearance and the regulation of postprandial plasma retinol concentration are apparently altered in these subjects.

Aging and protein metabolism

During aging, there are qualitative and quantitative modifications of proteins in various tissues. In muscle, myofibrillar and mitochondrial proteins are affected, resulting in a loss of strength and, to a lesser degree, endurance. Mechanisms of sarcopenia remain not well known and probably involve loss of motoneurons, muscle disuse and hormonal alterations. Partial prevention of muscle loss is possible by resistance training. In all tissues, and particularly in the brain, oxidative changes in proteins are likely to alter various functions of proteins.

Critical evaluation of the factorial and heart-rate recording methods for the determination of energy expenditure of free-living elderly people

The aim of the present study was to validate against the doubly-labelled water (DLW) technique the factorial method and the heart rate (HR) recording method for determining daily energy expenditure (DEE) of elderly people in free-living conditions. The two methods were first calibrated and validated in twelve healthy subjects (six males and six females; 70.1 (SD 2.7) years) from open-circuit whole-body indirect calorimetry measurements during three consecutive days and during 1 d respectively. Mean energy costs of the various usual activities were determined for each subject using the factorial method, and individual relationships were set up between HR and energy expenditure for the HR recording method. In free-living conditions, DEE was determined over the same period of time by the DLW, the factorial and the HR recording methods during 17, 14 and 4 d respectively. Mean free-living DEE values for men estimated using the DLW, the factorial and the HR recording methods were 12.8 (SD 3.1), 12.7 (SD 2.2) and 13.5 (SD 2.7) MJ/d respectively. Mean free-living DEE values for women were 9.6 (SD 0.8), 8.8 (SD 1.2) and 10.2 (SD 1.5) MJ/d respectively. No significant differences were found between the three methods for either sex, using the Bland & Altman (1986) test. Mean differences in DEE of men were -0.9 (SD 11.8) % between the factorial and DLW methods, and + 4.7 (SD 16.1) % between the HR recording and DLW methods. Similarly, in women, mean differences were -7.7 (SD 12.7) % between the factorial and DLW methods, and + 5.9 (SD 8.8) % between the HR recording and DLW methods. It was concluded that the factorial and the HR recording methods are satisfactory alternatives to the DLW method when considering the mean DEE of a group of subjects. Furthermore, mean energy costs of activities calculated in the present study using the factorial method were shown to be suitable for determining free-living DEE of elderly people when the reference value (i.e. sleeping metabolic rate) is accurately measured.

Postprandial chylomicron and plasma vitamin E responses in healthy older subjects compared with younger ones

The effect of ageing on vitamin E bioavailability in humans was assessed by comparing chylomicron and plasma alpha-tocopherol postprandial concentrations after a dose of vitamin E (432 or 937 IU as d1-alpha-tocopherol acetate), in eight young (20-30 years old) and eight healthy elderly men (64-72 years old). The fasting plasma alpha-tocopherol concentration was significantly higher in the elderly (33 +/- 2 mumol L-1) than in the young (22 +/- 2 mumol L-1). In both groups, the plasma and chylomicron alpha-tocopherol postprandial concentrations were significantly, approximately twofold, higher after the 937-IU meal than after the 432-IU meal. For both test meals, the chylomicron alpha-tocopherol areas under the curve were significantly lower in the elderly than in the young subjects: 98.9 +/- 16.5 (young group) vs. 55.3 +/- 7.8 (elderly group) mumol L-1 h for the 937-IU test meal and 60.4 +/- 14.1 (young group) vs. 26.0 +/- 7.6 (elderly group) mumol L-1 h for the 432-IU test meal, whereas the plasma alpha-tocopherol area under the curve was significantly higher in elderly than in young subjects: 337.56 +/- 16.11 (937-IU test meal) vs. 159.81 +/- 35.55 (432-IU test meal) mumol L-1 h in the young group and 709.55 +/- 69.33 (937-IU test meal) vs. 436.39 +/- 41.08 (432-IU test meal) mumol L-1 h in the elderly group. We concluded that (a) the amount of vitamin E appearing in plasma is proportional to the dose ingested (up to 937 IU); (b) the intestinal absorption of vitamin E is not increased, even possibly decreased, in the elderly; and (c) the amount of vitamin E transported by non-chylomicron lipoproteins is apparently higher in the elderly. This suggests that vitamin E postprandial transport is affected by ageing, mainly as the consequence of age-related modifications of lipoprotein metabolism.

Protein degradation and synthesis measured with multiple amino acid tracers in vivo

Whether tracers of different essential amino acids yield the same estimates of body protein turnover is still uncertain. Therefore, we have simultaneously determined leucine (Leu; using [14C]Leu), phenylalanine (Phe; using [13C]Phe), and tyrosine (Tyr; using [2H2]Tyr) rates of appearance (Ra) from proteolysis (PD), as well as Leu and Phe disposal, into protein synthesis (PS) both before and after an anabolic stimulus in healthy volunteers. Protein anabolism was stimulated by insulin plus a branched-chain amino acid-enriched aromatic amino acid-deficient amino acid solution, which increased Leu (from 145 +/- 9 to 266 +/- 10 mumol/l) but decreased Phe (from 57 +/- 2 to 46 +/- 3) and Tyr (from 58.7 +/- 5.5 to 21.0 +/- 2.2) concentrations. Postabsorptive endogenous Leu Ra (2.04 +/- 0.12 mumol.kg-1.min-1), Phe Ra (0.66 +/- 0.03), and Tyr Ra (0.45 +/- 0.06), as well as rates of PS determined with the leucine (1.65 +/- 0.10 mumol.kg-1.min-1) and the phenylalanine tracer (0.57 +/- 0.03), agreed well with the known abundance of these amino acids in body protein(s). After insulin and amino acids, PD was suppressed (P < 0.001) using all tracers. However, although percent suppression of endogenous Leu Ra (-->1.49 +/- 0.10 mumol.kg-1.min-1, 26 +/- 5%) and Phe Ra (-->0.53 +/- 0.02 mumol.kg-1.min-1, -20 +/- 2%) were comparable, endogenous Tyr Ra was suppressed to a larger extent (-->0.23 +/- 0.02 mumol.kg-1.min-1, -46 +/- 3% P = 0.038). PS was stimulated using the Leu (+24 +/- 7%, P < 0.02) but not the Phe (+6 +/- 4%, not significant) data. We conclude that isotopes of different essential amino acid: provide comparable estimates of PD and PS in the postabsorptive state. However, their responses to an anabolic stimulus may differ, possibly depending on exogenous amino acid availability and/or the resulting plasma levels.

Precursor pool for hepatic protein synthesis in humans: effects of tracer route infusion and dietary proteins

The estimation of the hepatic protein synthesis precursor pool was investigated through the measurement of very low-density lipoprotein (VLDL) apolipoprotein (apo)B100 labeling in healthy volunteers. L-[1-13C]leucine and L-[5,5,5-2H3]leucine were administered intravenously and intragastrically, respectively. Subjects were continuously fed with isoenergetic meals providing either 16% protein or no protein. The labeling of leucine incorporated into VLDL apoB100 (leucine-apoB) was lower than plasma leucine or alpha-ketoisocaproate (KIC) enrichments with the intravenous tracer. By contrast, with the oral tracer, leucine-apoB enrichment was higher than either plasma free leucine or KIC labeling. The KIC and leucine-apoB enrichments relative to plasma leucine enrichment were not affected by protein intake. Albumin or fibrinogen synthesis rates were similar whatever the administration route of the tracer when leucine-apoB was used to indicate the precursor, which was not the case for plasma leucine or KIC. The present data suggest that leucine-apoB enrichment represents a reliable indicator of the hepatic precursor pool for protein synthesis. The effect of dietary protein on the calculated rates of albumin and fibrinogen synthesis is also reported in relation to the choice of the precursor.

Increased mRNA levels for components of the lysosomal, Ca2+-activated, and ATP-ubiquitin-dependent proteolytic pathways in skeletal muscle from head trauma patients

The cellular mechanisms responsible for enhanced muscle protein breakdown in hospitalized patients, which frequently results in lean body wasting, are unknown. To determine whether the lysosomal, Ca2+-activated, and ubiquitin-proteasome proteolytic pathways are activated, we measured mRNA levels for components of these processes in muscle biopsies from severe head trauma patients. These patients exhibited negative nitrogen balance and increased rates of whole-body protein breakdown (assessed by [13C]leucine infusion) and of myofibrillar protein breakdown (assessed by 3-methylhistidine urinary excretion). Increased muscle mRNA levels for cathepsin D, m-calpain, and critical components of the ubiquitin proteolytic pathway (i.e., ubiquitin, the 14-kDa ubiquitin-conjugating enzyme E2, and proteasome subunits) paralleled these metabolic adaptations. The data clearly support a role for multiple proteolytic processes in increased muscle proteolysis. The ubiquitin proteolytic pathway could be activated by altered glucocorticoid production and/or increased circulating levels of interleukin 1beta and interleukin 6 observed in head trauma patients and account for the breakdown of myofibrillar proteins, as was recently reported in animal studies.

Low-cost measurement of body composition with 18O-enriched water

Total body water (TBW) and body composition are crucial for the estimation of nutritional status in many clinical circumstances. While the measurement of TBW with 18O-enriched water is technically easier than with 2H2O, the cost of 10% 18O-enriched water can be regarded as prohibitive. The aim of this study was to prove that less enriched (i.e. 2%) and cheaper (about 25 ECU per dose per subject, i.e. $30) 18O water can be used to measure TBW. In the 41 subjects studied, isotopic equilibrium was achieved 4 hours after the isotope was administered. Plateau enrichments in urine, saliva, and plasma samples did not differ significantly between 5 and 8 hours after the dose. TBW measurements in 8 of these subjects showed no significant differences, regardless of whether 2% or 10% water was used. We conclude that accurate estimates of TBW and body composition can be obtained with low-cost, 2% 18O-enriched water.

Recombinant human insulin-like growth factor-I enhances whole body protein anabolism and significantly diminishes the protein catabolic effects of prednisone in humans without a diabetogenic effect

To investigate whether recombinant human insulin-like growth factor-I (rhIGF-I) could serve as a protein-sparing nondiabetogenic agent, 21 healthy volunteers (mean age, 25 +/- 1 yr) were studied in 3 similar clinical models: rhIGF-I alone, rhIGF-I and prednisone, and prednisone alone. In study A, 6 subjects received infusions of [14C]leucine and [2H2]glucose before and after 5-7 days of rhIGF-I (100 micrograms/kg, sc, twice daily, followed by 16 h of a 10 micrograms/kg.h continuous sc infusion). The rate of appearance (Ra) of leucine, an estimate of whole body proteolysis, did not change significantly, whereas leucine oxidation decreased (-31 +/- 4%; P = 0.001), hence the nonoxidative leucine disposal (NOLD) increased significantly (P = 0.04). These effects are similar to those reported with high dose hGH. Plasma glucose concentrations did not change despite a significant reduction in circulating insulin concentrations (-58 +/- 11%; P = 0.01) and an increase in the glucose Ra (+12 +/- 5%; P = 0.04). After rhIGF-I treatment, plasma IGF-I, IGF-binding protein-1 (IGFBP-1), and IGFBP-2 all increased significantly, whereas IGFBP-3 did not change. In study B, seven subjects received rhIGF-I combined with oral prednisone (0.8 mg/kg.day) for 5 days. Group C (n = 8) received only prednisone. In group B, both the leucine Ra and oxidation increased (Ra, +7 +/- 3%; oxidation, +45 +/- 13%), but this increase was significantly less than that seen in group C (Ra, +25 +/- 5%; oxidation, 117 +/- 17%; P < 0.005 vs. group B). Group B showed no significant changes in postabsorptive glucose concentrations despite marked reductions in circulating insulin levels, in contrast to the increase in insulin and glucose concentrations observed in group C. In conclusion, 100 micrograms/g rhIGF-I, given twice daily, 1) has GH-like effects on whole body protein metabolism, 2) markedly diminishes the protein catabolic effect of glucocorticosteroids, and 3) is nondiabetogenic in prednisone-treated humans. This agent offers promise in the treatment of protein catabolic states.

Leucine kinetics are different during feeding with whole protein or oligopeptides

To determine if the molecular form of nitrogen intake affects protein metabolism during feeding, 12 normal volunteers received, by continuous nasogastric infusion, a protein or a peptide-based diet. Leucine kinetics (oral [13C]leucine and intravenous [2H3]leucine) were measured during the following three consecutive periods: first carbohydrates and lipids alone, then with either whole casein or oligopeptides in a randomized crossover design, with these two latter periods being isonitrogenous, isocaloric, and of identical amino acid compositions. Leucine concentration, turnover, oxidation, and nonoxidative disposal increased during nitrogen administration (all P < 0.01) and were higher with oligopeptides than with casein (242 +/- 44 vs. 188 +/- 31 mumol/l; 2.75 +/- 0.45 vs. 2.23 +/- 0.31; 1.14 +/- 0.19 vs. 0.82 +/- 0.22 mumol.kg-1.min-1, all P < 0.001; 1.64 +/- 0.32 vs. 1.44 +/- 0.33 mumol.kg-1.min-1, P < 0.05, respectively). Endogenous leucine production was less inhibited by oligopeptides than by casein (0.82 +/- 0.41 vs. 0.38 +/- 0.31 mumol.kg-1.min-1, P < 0.001), whereas splanchnic extractions were similar. Finally, leucine balance was more positive with casein than with oligopeptides (P < 0.001). In conclusion, the response of leucine kinetics to feeding is modified by the molecular form of nitrogen intake, with the oligopeptides inducing a higher oxidation and protein synthesis and a lesser inhibition of protein breakdown.

Differential effects of hyperglycemia and hyperinsulinemia on leucine rate of appearance in normal humans

To determine the independent effects of insulin and glucose on the rate of appearance of leucine in humans, five normal volunteers were studied using a pancreatic clamp with sequential insulin infusions of 1.8, 3.6 and 7.2 pmol kg/min-1. On each of three separate occasions, the plasma glucose level was maintained at 5.0, 9.4 or 14 mM. The rate of appearance of leucine was similar at each insulin infusion rate regardless of the ambient glucose concentration or the glucose infusion rate. These studies demonstrate that during insulin and glucose infusion, insulin, but neither the plasma glucose concentration nor the rate of glucose utilization, primarily regulates leucine flux (a reflection of endogenous whole body proteolysis) in normal humans.

Whole body protein turnover measured with 13C-leucine and energy expenditure in preterm infants

Our study was undertaken in preterm infants to examine the relationship of whole body protein kinetics with protein intake and energy expenditure. Leucine kinetics were determined in seven low birth wt preterm infants fed human milk or human milk enriched with protein (2.5 to 4.3 g protein/kg.d). The infants received a short (4-h) constant infusion of L-[1-13C]leucine and leucine turnover and oxidation were calculated from 13C-plasma leucine and expired 13CO2 enrichments measured by mass spectrometry. Energy expenditure was measured by indirect calorimetry. Nonoxidative leucine disposal (an estimate of protein synthesis) and leucine derived from protein (an estimate of protein breakdown) were, respectively, 2.98 +/- 0.82 and 2.06 +/- 0.74 mumol/kg.min. Whole body protein turnover and deposition, derived from leucine kinetics, were 8.22 +/- 2.31 and 2.17 +/- 0.50 g/kg.d, whereas energy expenditure was 56.3 kcal/kg.day. Protein turnover was correlated with protein intake but not with protein deposition. Energy expenditure was correlated with protein turnover, synthesis, and breakdown but not with protein deposition. These data are in agreement with the fact that protein deposition depends upon protein intake, but they also suggest that an elevated protein deposition is not necessarily the result of a rapid protein turnover or associated with an elevated energy expenditure.

Glucocorticosteroids increase leucine oxidation and impair leucine balance in humans

High-dose glucocorticoid treatment results in protein wasting. To determine whether such therapy affects leucine oxidation in the postabsorptive state and the disposal of dietary amino acids, eight normal subjects were studied twice in random order, once after 5 days of prednisone (20 mg three times daily) and on a second occasion without prednisone as a control. In the postabsorptive state prednisone therapy increased (P less than 0.05) plasma concentrations of leucine, alpha-ketoisocaproate, glucose, insulin, and C-peptide, as well as leucine carbon flux and oxidation calculated by means of isotope dilution techniques and [1-13C]leucine. During infusion of a chemically defined meal, total leucine carbon flux and oxidation increased similarly on both study days, but leucine oxidation was greater (P less than 0.01) during prednisone treatment; net leucine balance became positive on the control day but remained negative or zero on the prednisone study day despite higher (P less than 0.05) plasma insulin concentrations. These studies demonstrate that high-dose glucocorticoid treatment impairs the balance of the essential amino acid leucine in both the postabsorptive and absorptive states in humans.

Effect of epinephrine on the relationship between nonesterified fatty acid availability and ketone body production in postabsorptive man: evidence for a hepatic antiketogenic effect of epinephrine

The effect of epinephrine (EPI) on the transformation of nonesterified fatty acids (NEFA) into ketone bodies (KB) in normal subjects was determined by measuring simultaneously NEFA ([1-13C]palmitic acid) and KB ([3-13C]- or [3,4-13C2]acetoacetate) kinetics at different NEFA levels in the presence of basal (control test) or increased (EPI infusion test) EPI concentrations. During the control test the initial (postabsorptive state) concentrations and turnover rates of NEFA and KB were 476 +/- 47 (+/- SEM) and 4.30 +/- 0.17 mumol kg-1 min-1 (NEFA) and 126 +/- 17 and 2.49 +/- 0.07 mumol kg-1 min-1 (KB). The fraction of NEFA converted into KB was between 11.5-14.6%. Raising NEFA levels to about 650 mumol L-1 (iv infusion of a triglyceride emulsion) resulted in an increase in this fraction to between 26-30.3% (P less than 0.01). When NEFA concentrations were next abruptly raised to high levels (near 3 mmol L-1) by heparin injection this fraction returned to near the initial values (15-19.2%). During the EPI infusion test the initial (postabsorptive) concentrations and turnover rates of NEFA and KB as well as the fraction of NEFA converted into KB (10.5-11.5%) were comparable to the initial values of the control test. Intravenous infusion of EPI (10 ng kg-1 min-1) raised NEFA between 600 and 750 mumol L-1, comparable to values during the triglyceride test, but the fraction of NEFA converted into KB remained between 8.2-12% (P less than 0.05 vs. control test); when NEFA then were raised to even higher values (near 2.5 mmol L-1) by the infusion of a triglyceride emulsion and the injection of heparin, this fraction decreased to between 4-8% (P less than 0.05 vs. initial values of the EPI test and P less than 0.05 vs. the control test). In conclusion, 1) the fraction of NEFA converted into KB appears to depend in part on the NEFA concentration; and 2) the net effect of EPI infusion was to decrease the fraction of NEFA converted into KB.

Determination of steady state and nonsteady-state glycerol kinetics in humans using deuterium-labeled tracer

Using deuterium-labeled glycerol as tracer and gas-liquid chromatography-mass spectrometry techniques for the determination of isotopic enrichment, we have developed a simple and ethically acceptable method of determining glycerol appearance rate in humans under steady-state and nonsteady-state conditions. In normal subjects, the appearance rate of glycerol in the post-absorptive state was 2.22 +/- 0.20 mumol X kg-1 X min-1, a value in agreement with those reported in studies with radioactively labeled tracers. The ratio nonesterified fatty acid (NEFA) appearance rate/glycerol appearance rate ranged from 1.95 to 3.40. In insulin-dependent diabetic patients with a mild degree of metabolic control, the appearance rate of glycerol was 2.48 +/- 0.29 mumol X kg-1 X min-1. The volume of distribution of glycerol, determined by the bolus injection technique, was (mean) 0.306 l X kg-1 in normal subjects and 0.308 l X kg-1 in insulin-independent diabetic patients. To evaluate the usefulness of the method for determination of glycerol kinetics in nonsteady-state conditions, we infused six normal subjects with natural glycerol and calculated the isotopically determined glycerol appearance rate using a single compartment model (volume of distribution 0.31 l X kg-1). During these tests, the expected glycerol appearance rates were successively 5.03 +/- 0.33, 7.48 +/- 0.39, 9.94 +/- 0.34, 7.48 +/- 0.39, and 5.03 +/- 0.33 mumol +/- kg-1 X min-1, whereas the corresponding isotopically determined appearance rates were 4.62 +/- 0.45, 6.95 +/- 0.56, 10.85 +/- 0.51, 7.35 +/- 0.34, and 5.28 +/- 0.12 mumol X kg-1 X min-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Trioctanoin infusion increases in vivo leucine oxidation: a lesson in isotope modeling

We have reported that infusion of trioctanoin in conscious dogs had little effect on leucine oxidation but decreased the rate of appearance (Ra) and interconversion of leucine and its alpha-keto acid, alpha-ketoisocaproate (KIC). To verify that these conclusions were independent of the leucine tracers and isotope models employed, the studies were repeated using [1-14C]leucine and [4,5-3H]KIC rather than [1-14C]KIC and [4,5-3H]leucine. In the present study, leucine oxidation calculated using the plasma [14C]leucine or [14C]KIC specific activities (SA) increased nearly twofold (P less than 0.001) during trioctanoin infusion in direct contrast to our previous results. When the data from either study were analyzed using the plasma SA of the leucine moiety reciprocal to the infused tracer as a potential indicator of the intracellular leucine SA, similar conclusions were obtained from either study: trioctanoin infusion in conscious dogs appears to increase whole-body leucine oxidation and does not decrease proteolysis. These studies challenge the validity of previously used isotope models of leucine metabolism and suggest that the plasma KIC SA during infusion of labeled leucine may most accurately reflect changes in whole-body leucine metabolism.

Insulin resistance in acromegaly: defects in both hepatic and extrahepatic insulin action

Short-term growth hormone excess is associated with impaired hepatic and extrahepatic responses to insulin in the absence of a change in insulin binding. To determine whether similar defects occur after chronic growth hormone excess, insulin dose-response curves for stimulation of glucose utilization and suppression of glucose production and monocyte and erythrocyte insulin binding were determined in five acromegalic patients and six healthy volunteers of comparable age, sex, and obesity. During infusion of insulin, glucose infusion rates required to maintain euglycemia were significantly lower (P less than 0.02 all) in the acromegalic patients than in the control subjects. Suppression of glucose production was impaired in the acromegalic subjects at insulin concentrations in the physiological range but not at insulin concentrations in the supraphysiological range. In contrast stimulation of glucose utilization was decreased in the acromegalic subjects at both physiological and supraphysiological insulin concentrations. Neither monocyte nor erythrocyte insulin binding differed significantly in the acromegalic and control subjects. These data indicate that chronic growth hormone excess is associated with a defect in both hepatic and extrahepatic insulin action. The decrease in glucose utilization at supraphysiological insulin concentrations in the acromegalic subjects and the normal monocyte and erythrocyte insulin binding suggest a postbinding alteration in insulin action.

Use of reciprocal pool specific activities to model leucine metabolism in humans

To investigate in humans whether interconversion of leucine and its alpha-keto acid, alpha-ketoisocaproate (KIC), is rate limiting for leucine metabolism, normal volunteers were infused with independent 3H and 14C labels of leucine and KIC. Total leucine carbon (leucine + KIC) entry into the plasma space determined by using both plasma specific activities (SA) of the infused isotopes or by using either plasma SA of the leucine moieties reciprocal to those being infused (e.g., [3H]KIC and [14C]leucine during [3H]leucine and [14C]KIC infusion) were nearly identical. When [3H]leucine and [14C]KIC were infused, the ratio of 3H/14C radioactivity of leucine in plasma proteins was similar both to the ratio of plasma [3H]KIC SA/[14C]leucine SA and to the ratio of the rate of [3H]leucine/[14C]KIC infused. Estimates of leucine oxidation using expired 14CO2 and the plasma SA of the 14C moiety reciprocal to infused [14C]leucine or [14C]KIC were similar. We conclude that the plasma SA of the leucine moiety reciprocal to infused labeled leucine or KIC may reflect more accurately whole-body leucine metabolism in postabsorptive humans.

Apparent decreased oxidation and turnover of leucine during infusion of medium-chain triglycerides

A potential effector of the protein-sparing adaptation to fasting could be the increased availability of endogenous long-chain fatty acids. Were this hypothesis correct, infusion of medium-chain triglycerides to increase the plasma concentration of medium-chain fatty acids might also result in protein sparing. However, in most in vitro studies in rat muscle, octanoate increases the oxidation of the essential amino acid leucine. Therefore leucine metabolism was assessed with infusions of [3H]leucine and a-[14C]ketoisocaproate ([14C]KIC) before and during an infusion of trioctanoin in conscious dogs. Plasma octanoate increased from less than 30 to 528 microM over the 3 h of infusion. Plasma leucine and KIC concentrations decreased by 65-70% (P less than 0.01) over the first 2 h of infusion. Leucine oxidation, estimated from the expired 14CO2 and the plasma [14C]KIC specific activity, as well as from an open two-pool model, decreased. By use of these isotope models, the rates of leucine coming from and going to protein decreased (P less than 0.05 to P less than 0.01). Interconversion of leucine and KIC estimated from the open two-pool model decreased by 80% (P less than 0.01). These changes were accompanied by a 36% decrease in the plasma concentration of total plasma amino acids. Within the confines of the isotope models employed, these data are consistent with the hypothesis that increased fatty acid oxidation decreases protein turnover and may spare essential amino acids.

Recycling of an amino acid label with prolonged isotope infusion: implications for kinetic studies

To investigate whether recycling of a labeled amino acid would occur after 24 h of infusion, two groups of normal volunteers were infused with [3H]leucine and alpha-[14C]-ketoisocaproate for 4 h and [2H3]leucine for either 4 or 24 h (groups I and II, respectively). Entry of [2H3 )leucine at steady state into the plasma space was indistinguishable from its infusion rate for group I but 30% higher (P less than 0.001) than this rate for group II, demonstrating significant recycling of label. After discontinuation of the infusions, isotope disappearance from the plasma space was followed for 2 h. The 3H and 14C decay data for both groups suggest that plasma leucine and alpha-ketoisocaproate are derived from a single intracellular pool in the postabsorptive state. In group I, the 3H and 2H labels decayed identically; whereas, in group II, the decay of [2H3]-leucine and alpha-[2H3]ketoisocaproate was slower (P less than 0.01) than the decay of [3H]leucine and alpha-[3H]ketoisocaproate, confirming re-entry of label after a 24-h infusion. Therefore kinetic values calculated from models assuming no recycling of labeled amino acids are most likely not quantitative and must be interpreted with care when flux does not change or decreases.

Whole body de novo amino acid synthesis in type I (insulin-dependent) diabetes studied with stable isotope-labeled leucine, alanine, and glycine

Dynamic aspects of whole body alanine and glycine metabolism have been explored in insulin-dependent (type I) diabetic subjects. Using a primed, continuous intravenous (i.v.) infusion of [2H3]alanine and [15N]glycine given simultaneously with [1-13C]leucine, whole body alanine and glycine fluxes and their rates of de novo synthesis were measured in 6 diabetic young men. Subjects were studied in the postabsorptive state, after blood glucose was clamped overnight at 15.2 +/- 0.3 mM, and then, on the following night, at 5.9 +/- 0.2 mM (insulin infusion rates of 0.24 +/- 0.09 and 1.65 +/- 0.20 U/h, respectively). In the normoglycemic state, leucine, alanine, and glycine fluxes averaged 88 +/- 4, 378 +/- 39, and 155 +/- 8 mumol X kg-1 X h-1, respectively. Based on the leucine flux, alanine and glycine de novo synthesis rates were 264 +/- 36 and 67 +/- 8 mumol X kg-1 X h-1. In the hyperglycemic state, leucine flux increased 23% (P less than 0.01), alanine flux rose slightly (+5%) but significantly (P less than 0.05), while alanine de novo synthesis and glycine flux remained unchanged and glycine de novo synthesis decreased by 33% (P less than 0.001). These results show that small alterations in peripheral alanine inflow in the hyperglycemic state reflect increased proteolysis and suggest that increased circulating plasma glucose does not contribute to de novo alanine synthesis in the absence of adequate insulin effect and/or augmented glucose tissue uptake. These observations also reveal the importance of insulin in the maintenance of whole body leucine economy, since a lower rate of insulin administration was associated with an increased rate of leucine oxidation.

Use of t-butyldimethylsilylation in the gas chromatographic/mass spectrometric analysis of physiologic compounds found in plasma using electron-impact ionization

The use of N-methyl-N-(t-butyldimethylsilyl)trifluoroacetamide to prepare the t-butyldimethylsilyl derivatives of a number of organic compounds (selected amino acids, alpha-keto acids, ketone bodies, free fatty acids, urea, glycerol, lactate, and pyruvate) is reported. These derivatives are particularly useful for gas chromatographic/mass spectrometric analysis involving the use of stable isotopes and selected ion monitoring, since a peak of sufficient abundance at 57 mass/charge units below the molecular ion was always present, and was the result of the loss of one t-butyl group. In each case, this fragment contained the entire skeleton of the original compound, which permitted easy analysis using electron-impact ionization of these compounds alone or when labeled with stable isotopes in any nonexchangeable position.

Role of catecholamines in the ketonemic response to somatostatin in normal man

In order to determine if a rise of circulating catecholamines occurs during somatostatin (SRIF) infusion in normal man, and if this increase plays a significant metabolic role, we infused four normal subjects with SRIF (500 micrograms/h) alone or associated with either alpha-(phentolamine) or beta-(propranolol) adrenergic blocking agents. During SRIF infusion, the initial small decrease in blood glucose was followed by a rise of epinephrine from 25-46 ng/liter (range) to 117-143 ng/liter (range) (P less than 0.05) at 80 min and norepinephrine from 204 +/- 16 to 418 +/- 60 ng/liter at 90 min (P less than 0.05). Thereafter, plasma nonesterified fatty acids, blood glycerol, and ketone bodies increased significantly. Phentolamine adjunction modified neither the catecholamines rise, nor the metabolic changes. Propranolol adjunction did not modify the glucose fall and the catecholamine rise, but resulted in blunted increments of fatty acids and glycerol and in an almost complete suppression of the increase of ketone bodies. These results suggest that the enhanced lipolysis and ketogenesis observed during SRIF infusion are not only due to the SRIF-induced insulin deficiency but also in part to a beta-receptor mediated effect of catecholamines.

Horseradish peroxidase transport across rabbit jejunum and Peyer's patches in vitro

Uptake and transport of horseradish peroxidase (HRP) have been observed in both Peyer's patches (PP) and jejunal epithelium (JE), and the quantities transported across each tissue were compared. Steady-state was reached much faster in PP than in JE. In Ringer solution, no significant difference was found between the HRP fluxes conveyed through PP and JE. In the presence of 10 mM glucose, slight net secretion was observed in JE but not in PP. In both tissues, the transport mechanism was shown to be sensitive to metabolic inhibitors. By contrast, in PP, ammonia did not significantly enhance intact HRP fluxes. Intracellular transfer and catabolism were estimated by measuring transepithelial fluxes of tritiated HRP. In PP, fluxes from mucosa to serosa and from serosa to mucosa were both greatly reduced (9.18 +/- 3.9 and 10.5 +/- 5.1 pmol X h-1 X cm-2, respectively) compared with JE (106.02 +/- 16 and 31.3 +/- 9.3). These results indicate that intact HRP fluxes are similar in PP and JE, but that tritiated HRP fluxes (intact plus degraded HRP fluxes) are smaller in PP. Together, these results suggest that the specific characteristics of HRP transport across PP are fast uptake and reduced degradation.