The end-product method of measuring whole-body protein turnover: a review of published results and a comparison with those obtained by leucine infusion.

The present review summarizes the results of all published papers on whole-body protein turnover in man measured by [15N]glycine and the end-product method using both urea and ammonia. It begins with a short account of the underlying assumptions and the justification for the use of [15N]glycine. The results are then compared with those of a large sample of measurements by the 'gold standard' precursor method with continuous infusion of [13C]leucine. The pros and cons of the two methods are compared and it is suggested that there is a place for further work by the less invasive end-product method, particularly for population studies of the genetic, environmental and functional determinants of whole-body rates of protein synthesis.

Relationship of maternal protein turnover and lean body mass during pregnancy and birth length.

Epidemiological evidence shows that small size at birth is associated with an increased risk of developing cardiovascular and metabolic disease in adult life. We have examined the relationships between size at birth and maternal body composition and protein turnover in normal pregnant women. A group of 27 multiparous Caucasian women with singleton pregnancies were studied at around 18 and 28 weeks' gestation. Body composition was determined by anthropometry, and whole-body protein turnover was estimated by using a single oral dose of [(15)N]glycine and the end-product method. The baby's weight and length were measured within 48 h of birth. Mothers with a greater lean body mass had higher rates of protein turnover at 18 weeks' gestation. This association was largely accounted for by differences in the mother's visceral, rather than muscle, mass. Mothers who had higher protein turnover at 18 weeks' gestation had babies that were longer at birth. After adjustment for the duration of gestation and the baby's sex, 26% of the variation in length at birth was accounted for by maternal protein synthesis at 18 weeks' gestation. Maternal protein intake was not associated with the baby's birth length. Thus the mother's ability to nourish her fetus is influenced by her body composition and her rate of protein turnover. Dietary intake does not adequately characterize this ability.

Whole body protein turnover can be measured non-invasively in women using the end product method with [15N]glycine to show changes with the menstrual cycle and pregnancy.

OBJECTIVES: To assess the effect of the menstrual cycle and pregnancy on whole body protein turnover. DESIGN AND SUBJECTS: Whole body protein turnover was determined using oral [15N]glycine in normal women from enrichment measured in urine at days 7 and 14 of the menstrual cycle and in pregnant women at 17-20 weeks and 30-32 weeks gestation. RESULTS: Nitrogen flux was 38.2 (5.8) mg N/kg/h using a single dose and 31.1+/-4.1 mg N/kg/h with prime-intermittent doses-the same as in men using the same methods. Nitrogen flux around the time of ovulation, 32.3 (8.2) mg N/kg/h, was greater than at day 7, 26.8 (3.0) mg N/kg/h (P<0.05). For women taking the contraceptive pill flux at day 7, 22.7 (0.2) mg N/kg/h, and day 14, 21.3 (2.1) mg N/kg/h, were similar, but were lower at day 14 than for women not taking the pill (P<0.05). Protein synthesis increased between mid and late pregnancy (1.7-2.0 g N/h; P=0.012), but not when expressed in relation to body weight CONCLUSIONS: Protein turnover can be measured reproducibly in women using a non-invasive method, provided care is taken to standardize the conditions, and especially the duration over which urine is collected. There is an increase around the time of ovulation when hormonal levels are at their highest and during pregnancy the results obtained are similar to those reported using [13C]leucine. SPONSORSHIP: University of Southampton and Medical Research Council.