Lysine and protein metabolism in the young lactating woman.

Five lactating and five postpartum non-lactating women of similar ages, times postpartum, body weight and height consumed a liquid formula diet that supplied 1.3 g protein and 32 kcal/kg per day (lactating subjects) and 1.1 g protein and 26 kcal/kg per day (non-lactating subjects). Their last meal supplied 25% of the daily intake and was consumed 4 h before they received L-[13C1]lysine (27 mumol/kg) by a single intravenous injection and L-[15N2]lysine (27 mumol/kg) orally. Frequent plasma and breath samples were collected for 6 h during which time they consumed no food. On a separate day, subjects received NaH13CO3 (10 mumol/kg) as a single intravenous dose and breath samples were collected for 6 h. Plasma tracer lysine levels were determined by gas chromatography-mass spectrometry isotope ratiometry, and breath 13CO2 levels were measured by gas-isotope-ratio mass spectrometry. Averaged tracer data for the two groups were fitted to a multicompartmental model of lysine and protein metabolism that partitioned lysine kinetics between a central and two tissue compartments. The tissue compartments had characteristically fast and slow rates of lysine turnover. The results were compared with those previously obtained in nulliparous women. The postpartum state was associated with a reduction in protein turnover in a compartment with a rapid rate of protein turnover and postpartum women catabolized significantly less lysine than nulliparous controls. Lactating women catabolized slightly more lysine than the non-lactating postpartum subjects, especially when lysine catabolism was expressed as a proportion of lysine flux. Lactation was associated with smaller splanchnic and extracellular pools of free lysine and with an increase in the rate constant for absorption of orally administered lysine. Lysine flux was significantly lower in the lactating subjects and this was associated with a decrease in the rate of lysine turnover in the slowly turning over lysine compartment. The results suggest that lactation is associated with a slower rate of protein turnover in a peripheral tissue compartment. We conclude that an intake of 1.3 g protein/kg per day may be inadequate to support the protein needs of lactation and body protein metabolism and may result in metabolic adaptations that maintain lactation at the potential expense of other aspects of maternal protein turnover.

Infused and ingested labeled lysines: appearance in human-milk proteins.

Incorporation of two labeled forms of lysine into human-milk proteins was studied in fasted lactating subjects to determine whether highly labeled proteins could be produced for subsequent nutritional studies and whether the kinetics of milk synthesis could be studied in humans with stable isotope techniques. Five subjects, maintained on formula diets, received L-[13C1]lysine (27 mumol/kg) as an IV bolus and L-[15N2]lysine (27 mumol/kg) as an oral bolus 4 h postprandially. Milk samples were collected at 30, 45, 90, 150, 240, and 360 min. Tracer lysine levels in the hydrolysate of unfractionated milk protein were determined by gas chromatography-mass spectrometry isotope ratiometry. After a delay of at least 45 min, significant labeling of milk protein was detected and reached a maximum at 150 min with cumulative percent does recovery over 6 h of 0.5%. Human-milk proteins can be labeled for nutritional investigations and in vivo kinetics of milk protein synthesis can be studied with stable isotope techniques.

Lysine and protein metabolism in young women. Subdivision based on the novel use of multiple stable isotopic labels.

A multitracer stable isotope study of lysine kinetics was carried out in fasted adult female volunteers to determine whether a multicompartmental model that partitions protein synthesis and breakdown into at least two types of tissue components can be constructed from plasma and breath data. Five female subjects, maintained on formula diets, received L-[13C1]lysine (27 mumol/kg) as an i.v. bolus and L-[15N2]lysine (27 mumol/kg) as an oral bolus 4 h postprandially. Plasma and breath samples were collected for 6 h. On an alternate day, subjects received NaH13CO3 (10 mumol/kg) as an i.v. bolus and breath samples were collected for 6 h. Plasma tracer lysine levels were determined by gas chromatography-mass spectrometry isotope ratiometry, and breath 13CO2 levels were measured by mass spectrometric gas isotope ratiometry. The tracer data could be fitted to a mammillary multicompartmental model that consisted of a lysine central compartment and slow- and fast-exchanging peripheral compartments containing 37, 38, and 324 mumol/kg, respectively. The rates of lysine oxidation, incorporation into protein, and release by protein breakdown were 21, 35, and 56 mmol/kg/h, respectively, in the fast-exchanging compartment, whereas the rates of protein synthesis and breakdown in the slow compartment were both 53 mmol/kg/min. These values corresponded to a whole-body lysine flux of 106 mmol/kg/h. The kinetic parameters were in excellent agreement with reported values obtained by constant-infusion methods. The measurements indicated that it will be possible to detect changes in amino acid pool sizes and protein synthesis and breakdown associated with the mobilization of protein stores from plasma and breath measurements in multitracer stable isotope experiments.

Rapid determination of whole-body bicarbonate kinetics by use of a digital infusion.

Accurate determination of substrate oxidation rates from breath 13CO2 levels often requires information on the bicarbonate status of the subject. We have developed a rapid method to obtain a complete set of bicarbonate kinetic parameters, prime bicarbonate pools with 13C, clamp breath 13CO2 levels rapidly and accurately with predetermined ranges, and provide a steady base-line enrichment of 13C for a subsequent substrate oxidation measurement. The method consists of administering NaH13CO3 intravenously as a combination of a bolus dose, an exponentially decreasing infusion, and a constant infusion. A Harvard model 2729 microprocessor-controlled syringe pump was modified for external control and coupled to a Hewlett-Packard HP-85 desk-top computer to deliver the complex infusion. An infusion algorithm that would rapidly attain and maintain an increase of 50% 13C enrichment of breath CO2 was derived by using the SAAM-27 program to interrogate a three-compartmental model of bicarbonate kinetics in normal, fasted, resting adult subjects. When the method was tested on five adult fasted subjects who had rested for 1.5 h, plateau enrichments were achieved within 10-20 min. The bicarbonate pool sizes and kinetic parameters obtained by compartmental analysis of their 13CO2 data were used to obtain a refined infusion protocol, which resulted in more rapid attainment of plateau enrichments. If carried out immediately before a substrate oxidation test, the method can provide a complete description of bicarbonate kinetics for use in the compartmental and noncompartmental analysis of substrate catabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Good diabetic control - a study in mass delusion.

The terms "diabetic control" and "diabetic management" are not synonymous. Diabetic control implies normal glucose metabolism, typically monitored by periodic determinations of plasma glucose and urine reducing sugar concentrations. A group of 220 diabetic children attending a camp complied 74% of the time with the request to collect and test their urine for URS. Fifty percent of random URS values determined by the children varied from those obtained on the same specimens of urine by laboratory technicians. Good diabetic control defined URS less than 25gm/24 hours was found in 18 of 54 children.