Growth retardation in children receiving long-term total parenteral nutrition: effects of ornithine α-ketoglutarate

Moukarzel, Adib; Goulet, Olivier; Salas, Juan Rodó; Martí-Henneberg, C; Buchman, Alan L.; Cynober, Luc; Rappaport, R; Ricour, C.

doi:10.1093/ajcn/60.3.408

Cited by 44 publications

(13 citation statements)

References 26 publications

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“…The mean PN protein and energy supplies at the date of study in the group of children who presented with periods of slower growth were about 20% lower than those reported in a previous study in children on long-term PN who also presented with growth retardation [17]: 46 kcal/kg/day and 1.5 g protein/kg/day for the current study versus 58 kcal/kg/day and 2.0 g protein/kg/day respectively, with the same non-protein calorie-to-nitrogen ratio of about 200 kcal/g N.…”

Section: Discussionmentioning

confidence: 73%

Prepubertal Growth in Children with Long-Term Parenteral Nutrition

Colomb

Dabbas-Tyan²,

Goulet³

et al. 2002

Horm Res Paediatr

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In children who depend on long-term parenteral nutrition (PN), a major goal is to obtain optimal growth. The aim of this retrospective study was to analyze growth in children on long-term cyclic nocturnal home PN, over at least 8 years before puberty. Nine boys and 7 girls were studied. Their mean age at the time of study was 11 years with a mean PN duration of 10.5 (8.6–16.4) years. Diseases were short bowel syndrome (5), intractable diarrhea (4), chronic intestinal pseudo-obstruction (4) and long segment Hirschsprung’s disease (3). In each child, periods of at least 2 years were analyzed: either periods of regular growth (R: height gain >50th percentile), or slow growth (S: height gain ≤25th percentile). Results were expressed as mean ± SD. Comparisons were performed using either Student’s test for unpaired data or Wilcoxon’s test for paired data. PN provided a mean of 224 ± 80 mg nitrogen/kg/day and 43 ± 14 kcal/kg/day equivalent to 50% of recommended supplies. At the time of study, the population presented with weight (W) = –0.7 ± 0.8 SD and height (H) = –1.5 ± 1.3 SD. The difference between W and expected W for H (W/H) was significant (p < 0.002). W/H ratio was 105 ± 11%. For the total PN duration, weight gain was +0.2 ± 1.5 SD and height loss was –0.75 ± 1.4 SD. An excess weight gain occurred in parallel with the deflection of height gain. Of the 16 children, regular prepubertal growth was achieved in 4 only. The other 12 showed alternate periods of R and S. In 8 of them, 26.5 years of R and 33.5 years of S were compared, each child being his own control. PN nitrogen and energy supplies were significantly higher during R periods than during S periods. In the absence of any disease or treatment explaining the failure to thrive, inadequate PN supplies, especially in terms of nitrogen supply, are thought to be responsible for a negative nitrogen balance and slowed growth. In case of any deflection away from the individual growth curve, it is recommended to adjust the PN supply early, especially nitrogen supply.

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Section: Discussionmentioning

confidence: 73%

Prepubertal Growth in Children with Long-Term Parenteral Nutrition

Colomb

Dabbas-Tyan²,

Goulet³

et al. 2002

Horm Res Paediatr

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“…The majority of studies investigating the effects of AKG have been conducted in animals, however, in humans, AKG has been shown to increase plasma levels of several hormones such as insulin, growth hormone and insulin-like growth factor I significantly, although the mechanisms responsible are poorly understood 12. Research investigating the effects of AKG on athletic performance is scant and the limited studies that have been conducted have examined the effects of AKG co-ingestion with L-arginine and/or with creatine.…”

Section: α-Ketoglutaratementioning

confidence: 99%

A to Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance—Part 21

Goodman¹,

Peeling

Ranchordas

et al. 2011

Br J Sports Med

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“…below the expected height for age), received 15 g of OKG parenterally in addition to their normal TPN for 5 months and were then studied for an additional 5 months without OKG supplementation (Moukarzel et al, 1994). During the period of OKG supplementation the growth rate increased from 3.8 cm/year to 6.4 cm/year, but during the following control period it was again reduced to 3.6 cm/year.…”

Section: Akg In Combination With Ornithinementioning

confidence: 99%

Perspectives of glutamine and its derivatives as feed additives for farm animals

Pierzynowski¹,

Sjödin²

1998

J. Anim. Feed Sci.

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Glutamine and its derivatives e.g., alpha-ketoglutaric acid (AKG) or ornithine-alpha-ketoglutarate (OKG) are molecules with a central role (via the Krebs cycle) in systemic, intestinal and gut bacterial metabolism. Studies have shown that AKG is a precursor not only of glutamine and arginine, but also of some other keto acids e.g., alpha-ketoisocaproate which in turn is a precursor of hydroxy-methyl-butyrate, which itself is regarded as a protein catabolic protector. Recently it has been postulated that AKG is not only an important energy donor, but that it also functions as an ammonium ion scavenger via transformation to glutamate, ornithine and putrescine and finally to GABA or succinate. Several beneficial effects of AKG have been reported in human medicine e.g., improved patients' recovery following gastrointestinal surgery. On the other hand, is was reported that 100 per cent glutamate metabolism in the first pass in infant pigs' small intestine. In the current presentation we discuss the potential benefits of using glutamine derivatives in human clinical nutrition as well as their role as feed additives in the production of farm animals.KEY WORDS: feed additives, glutamine, alpha-keto-glutarate METABOLIC AND PHYSIOLOGICAL EFFECTS OF GLUTAMINE AND ITS DERIVATIVESIn certain physiological and pathological conditions associated with acute or chronic malnutrition and/or hormonal stress, the human body shows signs of increased protein degradation or decreased protein synthesis, or both (Ahlman et al.,

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Growth retardation in children receiving long-term total parenteral nutrition: effects of ornithine α-ketoglutarate

Cited by 44 publications

References 26 publications

Prepubertal Growth in Children with Long-Term Parenteral Nutrition

Prepubertal Growth in Children with Long-Term Parenteral Nutrition

A to Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance—Part 21

Perspectives of glutamine and its derivatives as feed additives for farm animals

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