The fluxes of arginine and citruiline through plasma and the rate of conversion of labeled citrulline to arginine were estimated in two pilot studies (with a total of six adult subjects) and in a dietary study with five healthy young men. These latter subjects received an L-amino acid-based diet that was arginine-rich or arginine-free each for 6 days prior to conduct, on day 7, of an 8-hr (first 3 hr, fast; final 5 hr, fed) primed continuous intravenous infusion protocol using L- [guandno-93C]arginine, L-[5,5-2H2]citrulline, and L- [5,5,5-2H31leucine, as tracers. A pilot study indicated that citrulline flux was about 20% higher (P < 0.05) when determined with [ureido-13C]citrulline compared with [2H2Jcitruline, indicating recycling of the latter tracer. Mean citruilin fluxes were about 8-11 pmol kg'lhr'1 for the various metabolic/diet groups and did not differ significantly between fast and fed states or arginine-rich and arginine-free periods. Arginine fluxes (mean ± SD) were 60.2 ± 5.4 and 73.3 ± 13.9 jAmol kg"l hr'1 for fast and fed states during the arginine-rich period, respectively, and were significantly lowered (P < 0.05), by 20-40%, during the arginine-free period, especially for the fed state, where this was due largely to reduced entry of dietary arginine into plasma. The conversion of plasma citruiline to arginine approximated 5.5 ,umol*kg'l-hr-1 for the various groups and also was unaffected by arginine intake. Thus, endogenous arginine synthesis is not markedly responsive to acute alterations in arginine intake in healthy adults. We propose that argmine homeostasis is achieved largely via modulating arginine intake and/or the net rate of arginine degradation.The physiological needs by tissues and organs for arginine are met via the endogenous synthesis of arginine and/or arginine supplied by the diet. For the U.S. population the latter amounts to about 5.4 g daily per capita (1). The rates of endogenous arginine synthesis in the immature rat (2, 3), guinea pig (4), cat (5, 6), dog (7-9), chicken (10), rabbit (11), and pig (12) of nitric oxide (16) and of creatine and its participation as arginyl-tRNA in the process of ubiquitin-dependent protein degradation (17). Therefore, we have begun to use stableisotope tracer techniques to explore, noninvasively, kinetic and regulatory aspects ofarginine metabolism in adult human subjects (18,19). Here we report results of a study in young men who were given for 7 days an arginine-rich diet and then, for another 7 days, an arginine-free diet. Our kinetic model involves L-[guanidino-13C]arginine and L-[5,5-2H2]citrulline as tracers, to estimate plasma arginine and citrulline fluxes as well as the rate of transfer of plasma citrulline into the arginine pool. From the present findings, and our recent studies (19), we propose an integrative scheme of body arginine homeostasis and balance, which defines the metabolic basis for the conditional indispensability of dietary arginine under various pathophysiological conditions (1, 13, 14). MATERIALS AND METHOD...

The validity of tracer-derived estimates of whole-body leucine balance was investigated. Seven healthy young adult subjects received an adequate protein diet for 6 d; at 1800 on the last day, L-[1-13C]leucine and [15N-15N]urea were given as primed, continuous intravenous infusions for 24 h. Subjects were in a fasting state for the first 12 h and at 0600 on day 7 they then received hourly 10 equal meals to achieve a fed state. Total leucine intake (diet plus tracer) was 89.4 mg.kg-1.d-1. Mean daily leucine oxidation was equivalent to 89.5 +/- 3.3 mg leucine/kg. The predicted daily oxidation rate, from measurements made during the last hour of the fast and the fifth hour of the fed period, was 91.2 +/- 5.8 mg/kg (P = 0.25 from measured). Measured and predicted whole-body leucine balances were 0.76 +/- 2.99 and -0.98 +/- 5.54 mg/kg, respectively (P = 0.25). Urea production exceeded urea excretion by 20%; daily protein oxidation was the same when estimated from leucine oxidation or nitrogen excretion. Thus, the tracer-balance concept is valid, and reliable predictions of total daily leucine oxidation and whole-body leucine balance can be obtained from short-term measurements of leucine oxidation during fasted and fed states.

Urinary nitrate (NO3) is the stable end product of nitric oxide, which is formed, in turn, from a guanidino nitrogen of arginine. We have conducted two experiments, each in four healthy adult men receiving a low nitrate diet for 7-10 days, to investigate the in vivo conversion of arginine to nitrate.In the first study [guanidino-'5N2, 5,5-2H2]arginine was given on day 7 via a primed continuous intravenous infusion for 8 h. In the second study, the labeled arginine was given for 8 h by the intragastric route on day 7 and by the intravenous route on day 10. Measurement of 1IN03 output in urine collected for 24 h beginning at the time of the arginine tracer infusion revealed a more extensive transfer of 15N when the arginine tracer was given intragastricly. From the comparative labeling of 1IN03 after administration of the tracer arginine via the intragastric and intravenous routes, we estimate that 16% ± 2% of the daily production of nitrate arises from the metabolism of dietary arginine that is taken up during its "first pass" in the splanchnic region. Hence, nitric oxide production occurs, to a measurable extent, in this area in healthy subjects, raising the question as to how various pathophysiological states might alter the relations between exogenous and endogenous sources of arginine as precursors of NO-and the relative contributions made by various organs to whole body (NOB) NO3 formation. These results also raise important questions about the use of nitric oxide synthase inhibitors in animal and human studies.The endogenous synthesis of nitrate by mammals (1, 2) was demonstrated to occur via oxidation of trivalent nitrogen (i.e., amino nitrogen) and to be greatly stimulated by an endotoxin challenge (3). Studies by Marletta and coworkers (4, 5) with murine macrophages disclosed an enzymatic pathway that involved the oxidation of a guanidino nitrogen of L-arginine to nitric oxide (NO-) and its subsequent oxidation and excretion as urinary nitrate (e.g., refs. 6 and 7). Numerous other investigations concerning problems of cardiovascular physiology, neuronal signaling, and endotoxic shock have resulted in the discovery of a large family of NOsynthase enzymes (NOS; EC 1.14.23.-). These NOS include both constitutive and inducible forms and may be membrane bound or cytosolic depending on cell type; the physiological roles of these enzymes have been recently reviewed (8-11). In addition, reports have appeared recently on the isolation and cloning of some of the key genes encoding NOS (12-14), which revealed close sequence similarity to cytochrome P450 reductase (15) and also with functional characteristics of a P450-type hemoprotein (16). Thus, given the apparently large number of isoforms of NOS, their varying distribution in human tissues, and their multiple mechanisms of activation, it is of importance to define the in vivo relationships between arginine metabolism and urinary nitrate in man.In an earlier study, Leaf et al. (6) gave a large oral bolus dose (85 mg-kg-' of body weight) of [15N]arginine t...

There is a 3-fold increased risk of developing overt hypothyroidism with dietary supplementation of 16 mg soy phytoestrogens with subclinical hypothyroidism. However, 16-mg soy phytoestrogen supplementation significantly reduces the insulin resistance, hsCRP, and blood pressure in these patients.

Effects of dietary crude proteins on constituents of plasma and uterine secretions were examined at various stages of the estrous cycle of high producing Holstein cows. Eighteen cows were assigned randomly to isocaloric diets (74% total digestible nutrients) containing either 12 or 23% crude protein (dry matter) on day 40 postpartum. Uterine secretion and coccygeal blood samples were collected at estrus, days 5 and 15 of the first estrous cycle after day 50 postpartum, and at the subsequent estrus. The 23% crude protein diet resulted in higher concentrations of ammonia in blood, urea in blood plasma and uterine secretion, and phosphorus and potassium in plasma. Zinc increased during the estrous cycle in plasma of cows fed 23% crude protein and decreased in cows fed 12% crude protein. Magnesium concentrations in uterine secretions were lower in cows on 23% crude protein. Potassium and phosphorus also were lower in uterine secretions of cows fed 23% crude protein but only during the luteal phase of the estrous cycle. Zinc concentrations in uterine secretions decreased faster during the estrous cycle in cows fed 12% crude protein than in cows fed 23% crude protein. Thus, the crude protein content of the diet altered concentrations in blood of ammonia and concentrations in plasma of urea, phosphorus, potassium, and zinc. Crude protein content of the diet altered concentrations in uterine secretion of urea, magnesium, potassium, phosphorus, and zinc.

A diet supplemented with soy protein and isoflavones has been shown to reduce cardiovascular risk factors in postmenopausal women with type 2 diabetes. However, it remains unclear which component is responsible for these effects. Our aim was to determine whether the addition of isoflavones alone modifies cardiovascular disease risk markers in this group of patients. Cardiovascular disease (CVD) is the leading cause of mortality in women in developed countries (1), and women with diabetes are four times more likely to die from CVD than men (2). Among other factors, postmenopausal estrogen depletion, greater insulin resistance, and dyslipidemia (3,4) may contribute to high risk of accelerated CVD.Modification of lifestyle is important to reduce CVD risk factors and delay progression of type 2 diabetes-associated complications. In particular, the addition of oral supplements, such as soy products, as part of a healthy diet has attracted recent interest because of their beneficial effects on lipid profiles (5-10). However, scant information is available on the effects of soy in individuals with type 2 diabetes (11-13), who are at higher risk due to hyperlipidemia, lower HDL levels, and abnormalities in LDL/lipoprotein composition (14). It also remains unclear whether a beneficial effect can be attributed to the soy protein or isoflavones.We have shown that soy protein combined with isoflavones can improve glycemic control, insulin resistance, and lipids in patients with type 2 diabetes (11). Therefore, our aim was to determine if this effect was due to the isoflavone component alone. RESEARCH DESIGN ANDMETHODS -This was a randomized, double-blind, placebo-controlled, crossover study with a 4-week washout period separating the placebo and active phases (12 weeks each). Subjects provided informed consent. Randomization was performed using a random number generator. Thirty-two Caucasian, postmenopausal women with diet-controlled type 2 diabetes (according to World Health Organization criteria) (15) and amenorrhoa (for Ͼ1 year) were recruited. Exclusion criteria were breast/uterine cancer; uncontrolled hypothyroidism; and treatment with oral hypoglycemic agents, insulin, estrogens, or statins initiated Ͻ4 months before the trial.Baseline characteristics are included in Table 1. Six subjects withdrew from the study: one required a cholecystectomy and one a coronary angioplasty, one had an acute attack of polymyalgia rheumatica requiring steroids, and three were unable to comply with study requirements. InterventionThe soy preparation (Essential Nutrition) contained 132 mg isoflavones (53% genistein, 37% daidzein, and 10% glycitein). It was devoid of soluble fiber. The placebo was an identical tablet of microcrystalline cellulose. Compliance was monitored by counting returned medication. Study measurementsVenous blood samples were collected at each visit after a 12-h overnight fast. A1C, glucose, and lipid levels were measured using standard methods. LDL cholesterol was calculated using the Friedewald equation and insulin...

To determine the uptake of dietary arginine and leucine by the splanchnic region, two experiments were carried out, each involving four healthy young adult men who received a diet supplying 1 g protein.kg-1.day-1 for 7 and 10 days before conducting a primed constant tracer infusion protocol. In study 1, subjects received for 8 h (3-h fast; 5-h fed state, achieved by a constant intragastric infusion of the diet formula) L-[5,5-2H2; guanidino-15N2]arginine ([M4]Arg), L-[guanidino-13C]arginine ([13C]Arg), and L-[5,5,5-2H3]leucine ([2H3]Leu) simultaneously by an intragastric infusion on day 7 and a repeat of this protocol on day 10 except with tracer administration given by vein. Plasma arginine fluxes were essentially the same for the two arginine tracers but differed significantly with route of administration. In study 2 the subjects received on day 7 a constant intravenous infusion of [13C]Arg and [2H3]Leu and a simultaneous intragastric infusion of [M4]Arg and [1-13C]leucine. On day 10 the routes of administration of these tracer pairs were reversed. During the fed state in study 1, splanchnic uptake of dietary arginine was 31 +/- 10 and 34 +/- 8%, based on the [13C]Arg and [M4]Arg tracers, respectively, and it was significantly higher (P < 0.01) than for leucine, which was 10 +/- 6%. In study 2, splanchnic uptake of dietary arginine, estimated from a series of tracer-protocol combinations for the fed state, was approximately 38% compared with a lower (P < 0.01) value of approximately 15% for leucine.

Six patients with chronic renal failure (glomerular filtration rate 18 +/- 2 ml/min) underwent two 10-day admissions separated by at least 1 yr of outpatient therapy with a very low-protein diet (VLPD) providing 0.28 g protein.kg-1.day-1 plus an amino acid-ketoacid supplement. During each Clinical Research Center admission, subjects completed a 5-day nitrogen balance (BN), and whole body protein turnover was measured during fasting and feeding using intravenous [1-13C]leucine and intragastric [5,5,5-2H3]leucine. Outpatient dietary protein compliance was very good (25 vs. 20 g protein/day or 125% goal), whereas energy intake was only 69% of goal (24 vs. 35 kcal.kg-1.day-1). During the 16 +/- 2 mo of dietary therapy, there were no changes in serum proteins or anthropometrics. BN after > or = 1 yr of dietary therapy was neutral and did not differ from initial values (+0.46 +/- 0.20 vs. +0.55 +/- 0.19 g N/day). Similarly, rates of whole body protein synthesis, degradation, and leucine oxidation after long-term therapy with the VLPD regimen did not differ from baseline values, and neutral BN was maintained by a marked suppression of amino acid oxidation and postprandial inhibition of protein degradation. This is the first evidence that the compensatory changes in whole body protein turnover activated in response to dietary protein restriction are sustained during long-term therapy.