The effect of disease, drug, and diet on whole body protein metabolism in adolescents with Crohn disease and growth failure

Motil, Kathleen J.; Grand, Richard J.; Maletskos, C.J.; Young, Vernon R.

doi:10.1016/s0022-3476(82)80056-5

Cited by 90 publications

(42 citation statements)

References 18 publications

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“…Adults and children with CD have an estimated total energy expenditure increased by 200 kcal/day [12, 13, 14]. In a paediatric study we found a significant decrease in the resting energy expenditure (by 10%) after surgery without any significant change in the PCDAI, suggesting that it was the result of the inflammatory mass removed by surgery [15].…”

Section: Increased Nutrient Requirementsmentioning

confidence: 99%

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Growth in Paediatric Crohn’s Disease

et al. 2002

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Growth failure (GF) is one of the major complications affecting children with inflammatory bowel disease. The faltering is temporary in 40–50% of cases and prolonged in 10–20% in Crohn’s disease (CD). Such failure is rare in children with ulcerative colitis (5%). This complication is often associated with retarded bone development and delayed onset of sexual maturation. The delayed linear growth has a variety of causes including insufficient intake due to anorexia and the inflammatory process with increased energy and protein expenditure. Other factors are increased intestinal loss, secondary hypopituitarism and treatment with steroids. Therapeutic strategies of CD in children have changed this last decade by introducing new therapeutic agents such as topic steroids, immunosuppressors, anti-TNF (antibody and notably in children enteral nutrition which has shown its efficacy in inducing remissions of active CD, restoring nutritional status and stimulation of linear growth. The results of a recent prospective multicentric study over 2 years in 82 CD show that severe GF (–2 SD) is initially present in 15% (n = 12), among them 11 remain < –2SD after 2 years of follow-up. Six patients who were on the normal range initially increased their GF during the follow-up (< –2SD) (total 21% < –2SD (n = 17) at 2 years). At inclusion in this group there was no difference in growth velocity, used of steroids, enteral nutrition or severity of CD as compared to the group with no GF. It suggests that new treatment strategy should be developed in the future for this specific complication of paediatric CD.

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Section: Increased Nutrient Requirementsmentioning

confidence: 99%

“…This report reviews the data concerning growth failure in paediatric CD [1, 2, 3, 4, 5, 6], how it comes about [3, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21]and the effect of new therapeutic strategies [22, 23, 24, 25, 26, 27, 28, 29, 30, 31]. …”

Section: Introductionmentioning

confidence: 99%

Growth in Paediatric Crohn’s Disease

et al. 2002

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“…The average duration of Improvement of nutritional status and normal physical development of children with CD is another crucial target. Most reports suggest that malnutrition and growth retardation in those patients is caused by decreased protein-calorie intake [18][19][20]. Total EN decreases intestinal inflammation and prevents/corrects nutrient deficiencies, with subsequent growth improvement [21,22].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of total enteral nutrition in inducing remission and improving nutritional status in children with moderate to severe Crohn’s disease

Kierkuś

Szymańska²,

Szczepański

et al. 2013

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“…revious studies in children with Crohn disease have shown that growth and accretion of lean body mass are promoted by enteral nutrition (1)(2)(3). The rate of total body protein accretion for synthesis of lean body mass is determined by the balance between total body protein breakdown (proteolysis) and protein synthesis.…”

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confidence: 99%

“…Studies to examine the balance between proteolysis and protein synthesis in response to nutrition in pediatric patients with Crohn disease are scarce (3,9,10), and no pediatric studies have evaluated the effect of feeding on protein turnover while accounting for splanchnic uptake of Leu and Phe. Based on previous studies in adults with inactive Crohn disease, it was hypothesized that adolescents with inactive Crohn disease would be anabolic, decreasing proteolysis and increasing protein synthesis in response to enteral feeding (8).…”

mentioning

confidence: 99%

Acute Effects of Enteral Nutrition on Protein Turnover in Adolescents with Crohn Disease

et al. 2007

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Adults with inactive Crohn disease have been shown to have normal rates of protein turnover when compared with healthy adults. It is not known whether this is true for adolescents with inactive Crohn disease, when rate of protein synthesis must be greater than that of breakdown for normal development. The objective of this study was to determine whether enteral nutrition acutely suppresses proteolysis and increases protein synthesis in adolescents with inactive Crohn disease. Six adolescents (five males/one female; mean age, 15.8 Ϯ 1.9 y; range, 13.2-17.6 y; mean bone age, 14.6 Ϯ 1.8 y; range, 12.5-17 y) participated. Leucine (Leu) and phenylalanine (Phe) kinetics were measured using stable isotopes under fasted and fed conditions during a single study visit. In response to enteral nutrition, the endogenous rates of appearance (R a ) of Leu and Phe (reflecting proteolysis) decreased significantly by 40%. The percentages of splanchnic uptake of Leu and Phe were 35 Ϯ 10% and 13 Ϯ 12%, respectively. Under fed conditions, utilization of Phe for protein synthesis increased significantly. We conclude that in clinically stable adolescents with Crohn disease, enteral nutrition promotes anabolism by suppressing proteolysis and increasing protein synthesis. Rates of suppression of proteolysis were similar to those reported previously in normal children. (Pediatr Res 61: 356-360, 2007)

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The effect of disease, drug, and diet on whole body protein metabolism in adolescents with Crohn disease and growth failure

Cited by 90 publications

References 18 publications

Growth in Paediatric Crohn’s Disease

Growth in Paediatric Crohn’s Disease

The efficacy of total enteral nutrition in inducing remission and improving nutritional status in children with moderate to severe Crohn’s disease

Acute Effects of Enteral Nutrition on Protein Turnover in Adolescents with Crohn Disease

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