Protein and energy substrate metabolism in AIDS patients

Stein, T. P.; Nutinsky, C.; Condoluci, David; Schluter, M. D.; Leskiw, M. J.

doi:10.1016/0026-0495(90)90136-z

Cited by 84 publications

(24 citation statements)

References 22 publications

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“…5; Macallan et al 1995~). Several other studies have found similar results with increased whole-body protein turnover (Lieberman et al 1994;Rakotoambinina et al 1996;Bemeis et al 1997), although in one study, protein turnover was reduced (Stein et al 1990). …”

Section: )mentioning

confidence: 58%

Metabolic abnormalities and wasting in human immunodeficiency virus infection

Macallan

1998

Proc. Nutr. Soc.

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Section: )mentioning

confidence: 58%

Metabolic abnormalities and wasting in human immunodeficiency virus infection

Macallan

1998

Proc. Nutr. Soc.

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“…An increased whole body protein turnover has been reported in the postabsorptive state in HIV-infected patients compared with healthy control subjects (11,17,26,48). In contrast, a decrease in whole body protein turnover has been observed in the fed state in some (31,40) but not all studies (26,39), which suggests that there is an altered response to food intake.…”

mentioning

confidence: 65%

Whole body leucine flux in HIV-infected patients treated with or without protease inhibitors

Prod'homme¹,

Rochon²,

Balage³

et al. 2006

American Journal of Physiology-Endocrinology and Metabolism

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The present study was carried out to assess the effects of protease inhibitor (PI) therapy on basal whole body protein metabolism and its response to acute amino acid-glucose infusion in 14 human immunodeficiency virus (HIV)-infected patients. Patients treated with PIs (PIϩ, 7 patients) or without PIs (PIϪ, 7 patients) were studied after an overnight fast during a 180-min basal period followed by a 140-min period of amino acid-glucose infusion. Protein metabolism was investigated by a primed constant infusion of L-[1-13 C]leucine. Dual-energy X-ray absorptiometry for determination of fat-free mass (FFM) and body fat mass measured body composition. In the postabsorptive state, whole body leucine balance was 2.5 times (P Ͻ 0.05) less negative in the PIϩ than in the PIϪ group. In HIV-infected patients treated with PIs, the oxidative leucine disposal during an acute amino acid-glucose infusion was lower (0.58 Ϯ 0.09 vs. 0.81 Ϯ 0.07 mol ⅐ kg FFM Ϫ1 ⅐ min Ϫ1 using plasma [ 13 C]leucine enrichment, P ϭ 0.06; or 0.70 Ϯ 0.10 vs. 0.99 Ϯ 0.08 mol ⅐ kg FFM Ϫ1 ⅐ min Ϫ1 using plasma [ 13 C]ketoisocaproic acid enrichment, P ϭ 0.04 in PIϩ and PIϪ groups, respectively) than in patients treated without PIs. Consequently, whole body nonoxidative leucine disposal (an index of protein synthesis) and leucine balance (0.50 Ϯ 0.10 vs. 0.18 Ϯ 0.06 mol ⅐ kg FFM ⅐ Ϫ1 ⅐ min Ϫ1 in PIϩ and PIϪ groups respectively, P Ͻ 0.05) were significantly improved during amino acid-glucose infusion in patients treated with PIs.

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“…The findings of the present study, together with several previous studies that have demonstrated increased turnover in HIV infection [26,27], suggest that increased turnover is also a feature of sub-acute and chronic infection. However, one study of HIV infection [28] and another of tuberculosis [29] found reduced or normal protein turnover. The reason for the variability in chronic infection is unknown, although severe malnutrition may attenuate the response to infection [24], and variations in cytokine secretion may also play a role, as discussed below.…”

Section: Discussionmentioning

confidence: 97%

Protein and energy metabolism in chronic bacterial infection: studies in melioidosis

et al. 2000

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Chronic infection is often accompanied by a wasting process, the metabolic basis of which is not fully understood. The aims of the present study were to measure protein and energy metabolism in patients with melioidosis (a serious and antibiotic-refractory Gram-negative bacterial infection which is endemic in South-East Asia) in order to define the metabolic abnormalities that might contribute to wasting. Whole-body protein turnover was measured using the [(13)C]leucine technique, both in the fasted state and while consuming a high-energy meal. Resting energy expenditure was measured by indirect calorimetry, and total energy expenditure by the bicarbonate/urea method. Results were normalized for fat-free mass, as estimated from skinfold thickness. Protein turnover was increased in melioidosis patients compared with healthy controls during fasting (170.9 compared with 124.1 micromol x kg(-1) x h(-1); P=0.04), but the net rate of catabolism (22.2 compared with 20.5 micromol x kg(-1) x h(-1); P=0.77) and the anabolic response to feeding were similar in the two groups. Resting energy expenditure was higher in melioidosis patients compared with controls (191.4 and 157.3 kJ x kg(-1) x day(-1) respectively; P=0.04), but total energy expenditure (measured in a separate group of eight patients with melioidosis) was low (192.1 kJ x kg(-1) x day(-1)). In conclusion, this study found no evidence of metabolic causative factors, such as accelerated net protein catabolism during fasting, a blunted anabolic response to feeding or increased daily energy expenditure, and therefore suggests that reduced energy intake is the prime cause of wasting. The observed normal response to feeding should encourage nutritional approaches to prevent wasting.

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Protein and energy substrate metabolism in AIDS patients

Cited by 84 publications

References 22 publications

Metabolic abnormalities and wasting in human immunodeficiency virus infection

Metabolic abnormalities and wasting in human immunodeficiency virus infection

Whole body leucine flux in HIV-infected patients treated with or without protease inhibitors

Protein and energy metabolism in chronic bacterial infection: studies in melioidosis

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