Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients.
Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients.
复制标题
DOI：
10.1016/j.ekir.2018.08.001
复制
发表时间：
2018-11
影响因子：
6
通讯作者：
Burd NA
中科院分区：
文献类型：
--
作者：
van Vliet S;Skinner SK;Beals JW;Pagni BA;Fang HY;Ulanov AV;Li Z;Paluska SA;Mazzulla M;West DWD;Moore DR;Wilund KR;Burd NA
在接受维持性血液透析（MHD）治疗的肾衰竭患者中，骨骼肌丢失是常见的。建议定期摄入富含蛋白质的膳食，以帮助抵消MHD患者的肌肉蛋白质损失，但对这种策略的合成代谢潜力知之甚少。8例MHD患者（年龄：56 ± 5岁;体重指数[BMI]：32 ± 2 kg/m2）和8例非尿毒症对照受试者（年龄：50 ± 2岁; BMI：31 ± 1 kg/m2）接受预充连续L-[环-2H5]苯丙氨酸和L-[1- 13 C]亮氨酸输注，并在非透析日进行血液和肌肉活检采样。参与者食用混合餐（546千卡; 20克蛋白质，59克碳水化合物，26克脂肪），蛋白质以L-[5，5，5 - 2 H3]亮氨酸标记的鸡蛋提供。MHD患者（41 ± 5%）与对照受试者（61 ± 4%; P = 0.03）相比，循环膳食氨基酸利用率降低。与对照组相比，MHD患者基底肌caspase-3蛋白含量升高（P = 0.03），大中性氨基酸转运蛋白1（LAT 1）蛋白含量降低（P = 0.02）。MHD患者的基础肌蛋白合成（MPS）（0.030 ± 0.005%/h）是对照组（0.014 ± 0.003%/h）的102倍（P = 0.01）。MHD患者的进食未能增加MPS（相对于基础值的绝对变化：0.0003 ± 0.007%/h），但在对照组中刺激了MPS（0.009 ± 0.002%/h; P = 0.004）。MHD患者表现出对膳食摄入的肌肉合成代谢抵抗。MHD患者餐后MPS反应减弱可能与基础MPS升高有关，导致混合餐摄入后刺激性上限效应和/或血浆膳食氨基酸利用率降低。
Skeletal muscle loss is common in patients with renal failure who receive maintenance hemodialysis (MHD) therapy. Regular ingestion of protein-rich meals are recommended to help offset muscle protein loss in MHD patients, but little is known about the anabolic potential of this strategy. Eight MHD patients (age: 56 ± 5 years; body mass index [BMI]: 32 ± 2 kg/m2) and 8 nonuremic control subjects (age: 50 ± 2 years: BMI: 31 ± 1 kg/m2) received primed continuous L-[ring-2H5]phenylalanine and L-[1-13C]leucine infusions with blood and muscle biopsy sampling on a nondialysis day. Participants consumed a mixed meal (546 kcal; 20-g protein, 59-g carbohydrates, 26-g fat) with protein provided as L-[5,5,5-2H3]leucine-labeled eggs. Circulating dietary amino acid availability was reduced in MHD patients (41 ± 5%) versus control subjects (61 ± 4%; P = 0.03). Basal muscle caspase-3 protein content was elevated (P = 0.03) and large neutral amino acid transporter 1 (LAT1) protein content was reduced (P = 0.02) in MHD patients versus control subjects. Basal muscle protein synthesis (MPS) was ∼2-fold higher in MHD patients (0.030 ± 0.005%/h) versus control subjects (0.014 ± 0.003%/h) (P = 0.01). Meal ingestion failed to increase MPS in MHD patients (absolute change from basal: 0.0003 ± 0.007%/h), but stimulated MPS in control subjects (0.009 ± 0.002%/h; P = 0.004). MHD patients demonstrated muscle anabolic resistance to meal ingestion. This blunted postprandial MPS response in MHD patients might be related to high basal MPS, which results in a stimulatory ceiling effect and/or reduced plasma dietary amino acid availability after mixed-meal ingestion.
登录
查看更多内容
影响因子：
6.1
作者：
Jimenez-Martin, Estefania;Ruiz, Jorge;Antequera, Teresa
通讯作者：
Antequera, Teresa
影响因子：
19.6
作者：
Bammens, B;Verbeke, K;Evenepoel, P
通讯作者：
Evenepoel, P
影响因子：
3.7
作者：
Jourdan, Marion;Deutz, Nicolaas E. P.;Aussel, Christian
通讯作者：
Aussel, Christian
影响因子：
19.6
作者：
Johansen, KL;Shubert, T;Kent-Braun, JA
通讯作者：
Kent-Braun, JA
影响因子：
7.1
作者：
Beals, Joseph W.;Sukiennik, Richard A.;Burd, Nicholas A.
通讯作者：
Burd, Nicholas A.