ZINC AND COPPER EXCRETION AND ABSORPTION IN INFANTS WITH OSTOMIES

造口婴儿的锌和铜排泄和吸收

• 批准号: 8166718
• 负责人: STEVEN A ABRAMS
• 金额: $ 1.55万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2010-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8166718
• 关键词: Calories; Ceruloplasmin; Computer Retrieval of Information on Scientific Projects Database; Copper; Data; Enteral Feeding; Enteral Nutrition; Equilibrium; Excretory function; Feces; Funding; Grant; Hour; Ileostomy; Infant; Institution; Intestines; Measures; Metabolism; Operative Surgical Procedures; Ostomy; Output; Patients; Pilot Projects; Population; Premature Infant; Research; Research Personnel; Resources; Serum; Serum zinc level result; Source; Time; Total Parenteral Nutrition; United States National Institutes of Health; Zinc; absorption; design; stable isotope

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We propose to examine the absorption and excretion of zinc and copper in infants with ostomies. This will be accomplished by measuring baseline excretion and serum levels of zinc, copper, and ceruloplasmin, and by utilizing stable isotopes of zinc and copper to measure absorption and excretion. When an infant with an ostomy is receiving primarily total parenteral nutrition (TPN) with minimal or no enteral feeds, we will collect ostomy output for 24 hours to measure zinc and copper excretion, and will measure serum zinc, copper, and ceruloplasmin levels. We will utilize stable isotopes of zinc and copper at two time points: when the infant still has the ostomy and is receiving primarily enteral nutrition without TPN, and lastly, when/if the patient s ostomy is removed with the bowels reanastamosed and the patient is stable on enteral feeds. For the first part of the study, excretion data for zinc will be obtained for ostomy patients. We hypothesize that infants with an ostomy will excrete more zinc in their stools than healthy term or preterm infants without ostomies. For the second part of the study, we will obtain data on zinc absorption, secretion, and excretion through use of stable isotopes. Jalla et al determined that healthy infants retain zinc of 0.4 mg/day. We hypothesize that due to increased zinc losses, the infants in the study will be less positive than the healthy infants in the study by Jalla et al. Our study is designed to be able to detect if the ostomy patients net retention is one-half that described by Jalla (i.e. 0.2 mg/d). We will also obtain data on copper absorption, secretion, and excretion through the use of stable isotopes in the second part of the study. As a pilot study, we do not fully know what to expect regarding copper levels in infants with ostomies, but we hypothesize that they may be less positive than healthy infants without ostomies. Also, we hypothesize that zinc and copper are competitively absorbed in the gut; therefore, infants who receive more zinc may absorb less copper. For the third part of the study, we will obtain data on zinc absorption through the use of stable isotopes after the infant has had surgery to reanastamose the bowel. We hypothesize that there may be continued zinc losses above those documented for healthy infants who have never had an ostomy, but decreased losses compared to when the infant had an ostomy. To determine how the presence of an ileostomy impacts zinc and copper metabolism in infants at three time points: 1) when the infant has an ostomy and is receiving the majority of calories from total parenteral nutrition (TPN); 2) when the infant has an ostomy and is receiving primarily enteral nutrition without TPN; and 3) when/if the infant has a surgery to reconnect the bowel and is receiving primarily enteral nutrition. The primary objective of this study revolves around part 2, the stable isotope portion of zinc and copper absorption, secretion, and excretion in infants with an ostomy. There is currently no data available in this population for zinc balance.

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 我们建议检查造口婴儿对锌和铜的吸收和排泄。这将通过测量基线排泄量和血清锌、铜和铜蓝蛋白水平，并通过利用锌和铜的稳定同位素来测量吸收和排泄来实现。当造口婴儿主要接受全肠外营养(TPN)，只需少量或不经肠道喂养时，我们将收集造口输出量24小时，以测量锌和铜的排泄，并测量血清锌、铜和铜蓝蛋白水平。我们将在两个时间点利用稳定的锌和铜同位素：当婴儿仍在造口并正在接受主要的肠内营养而不使用全胃肠外营养时，以及当/如果患者S造口切除并重新吻合肠道且患者的肠道喂养稳定时。 在研究的第一部分，将获得造口患者的锌排泄数据。我们推测，与健康的足月儿或未造口的早产儿相比，造口婴儿的粪便中锌的排泄量更大。 在研究的第二部分，我们将通过使用稳定的同位素获得锌的吸收、分泌和排泄的数据。Jalla等人确定，健康的婴儿每天保留0.4毫克的锌。我们假设，由于锌丢失的增加，研究中的婴儿将不会像Jalla等人研究中的健康婴儿那样阳性。我们的研究旨在能够检测造口患者的净保留量是否是Jalla所描述的一半(即0.2 mg/d)。在研究的第二部分，我们还将通过使用稳定同位素获得铜的吸收、分泌和排泄的数据。作为一项先导性研究，我们并不完全知道造口婴儿的铜水平会有什么变化，但我们推测，与健康的未造口婴儿相比，他们的铜水平可能不那么阳性。此外，我们假设锌和铜在肠道中被竞争性吸收；因此，摄入更多锌的婴儿可能吸收更少的铜。 在研究的第三部分，我们将通过使用稳定同位素获得婴儿在接受肠道再通手术后锌的吸收数据。我们假设，与从未做过造口的健康婴儿相比，可能有持续的锌丢失，但与造口时相比，损失减少了。 为了确定回肠造口对婴儿锌和铜代谢的影响在以下三个时间点：1)当婴儿进行造口并且正在接受大部分热量来自全肠外营养(TPN)；2)当婴儿进行造口并且正在接受主要的肠内营养而不使用TPN；以及3)当/如果婴儿接受了重新连接肠道的手术并且正在接受主要的肠内营养。 这项研究的主要目标是围绕第二部分，即造口婴儿体内锌和铜的稳定同位素部分的吸收、分泌和排泄。目前在这一人群中没有关于锌平衡的数据。