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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Genetically obese (fa/fa) Zucker rats maintain a normal lean body size but deposit excessive amounts of body fat. Preferential use of substrates for lipid synthesis results in inefficient use of dietary nitrogen for protein deposition. Three studies were carried out to determine whether an increased protein requirement caused hyperphagia and whether young Zucker rats preferentially regulated protein or energy intake. Rats were offered isoenergetic diets with nitrogen contents ranging from 4.5 to 53.2 mg/g, or isonitrogenous diets with energy contents of 2.2, 3.3 or 4.2 kcal/g. In both situations obese rats had significantly higher food intakes than lean rats. Within phenotype the rats maintained an almost constant energy intake so that nitrogen intake was proportional to dietary nitrogen concentration. In a third experiment lean and obese rats were given different proportions of their control protein intake by stomach tube. Energy intake was determined by voluntary consumption of a protein-free diet. Within phenotype energy intake was the same for all levels of protein intake. It appears that obese Zucker rats regulate energy intake at an elevated level and that protein intake is determined by dietary nitrogen content. Hyperphagia does not appear to result from a desire to obtain protein.
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PMID:Voluntary food intake of lean and obese Zucker rats in relation to dietary energy and nitrogen content. 335 66

Hyperosmolar hyperglycemic nonketotic diabetic coma after cardiac operations was reviewed in a total of 12 patients from the literature and from my experience in an attempt to determine the clinical features of this condition. Among the unique features of this disease were the following: The mortality is high (42%). The morbidity and mortality are higher in patients with no previous history of diabetes mellitus (67% and 50%) than in those with such a history (33% and 25%). Polyuria is usually a heralding symptom. There is an average time lag of 6 days between the onset of polyuria and the established diagnosis of hyperosmolar hyperglycemic nonketotic diabetic coma. The time lag in patients who died was 7.5 +/- 0.8 days (mean +/- standard error of the mean), significantly longer than in survivors (4.5 +/- 0.8 days). Polyuria usually emerges after the stormy immediate postoperative days have passed (on postoperative day 5.3 on the average). Polyuria is generally regarded as a favorable sign not suggestive of complicating hyperosmolar hyperglycemic nonketotic diabetic coma. Therapies known to precipitate this disorder are continued even after development of polyuria. Gastrointestinal bleeding can be a precipitating factor. Hyperalimentation or elemental diet may cause dehydration and trigger hyperosmolar hyperglycemic nonketotic diabetic coma. A high or rising serum sodium concentration and/or blood urea nitrogen level with polyuria may be a warning sign of this complication. Too hasty correction of the hyperosmolar state can be dangerous. Pulmonary dysfunction may be involved in the symptoms of hyperosmolar hyperglycemic nonketotic diabetic coma.
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PMID:Clinical features of hyperosmolar hyperglycemic nonketotic diabetic coma associated with cardiac operations. 352 Jan 59

Cold-exposed rats exhibit hypermetabolism, hyperphagia, and increased glucose oxidation. Their counterregulatory hormone secretion is markedly elevated, while insulin levels fall acutely, gradually returning to basal during acclimation. We assessed both hepatic and peripheral sensitivity to insulin in rats in the basal state and after 5 days of cold (5 C) exposure. The contribution of gluconeogenesis to total glucose turnover was measured and compared to daily urinary corticosterone excretion. Hepatic glucose production was equally suppressed by the infusion of insulin at 1.2 mU/kg X min in both control and cold-acclimated rats, but enhanced hepatic sensitivity to low dose (0.6 mU/kg X min) insulin infusion was only observed after cold exposure. The metabolic clearance of glucose was elevated with cold stress and was insensitive to the infusion of insulin at either level. Insulin resistance was not observed. Urinary excretion of corticosterone and urea nitrogen were markedly increased, but creatinine excretion was unchanged, suggesting that the concurrent increase in gluconeogenesis resulted from increased protein intake rather than increased catabolism of muscle protein.
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PMID:Enhanced hepatic insulin sensitivity and peripheral glucose uptake in cold acclimating rats. 389 63

The objectives of this study were to determine the ability of enteral hyperalimentation to meet the caloric and protein requirements in acute severe head injury, and to study the effect of increasing protein intake on nitrogen balance. This consecutive series of 20 patients suffered acute severe head injury and remained comatose for at least 24 hours. They were all without other major injuries, and were treated with steroids. These patients were randomly placed in two comparable treatment groups: one group was fed with an enteral formula containing 14% of its calories as protein and the other group received a formula containing 22% protein calories. Feedings were advanced to replace 140% of caloric expenditure measured by indirect calorimetry, averaging 3500 kcal/24 hr. Balance periods of the targeted intake were 7 days in duration, and were begun during the 1st week after injury for 65% of patients and in the 2nd week after injury for 35% of patients. The lower protein group received an average of 26.8 gm/24 hr of nitrogen, equivalent to 188 gm of protein, and the higher protein group 34.3 gm/24 hr, equivalent to 231 gm of protein. Nitrogen balance was -9.2 +/- 6.7 gm/24 hr in the lower protein group and -5.3 +/- 5.0 gm/24 hr in the higher protein group, but the difference did not reach statistical significance because of sample size and variability in extent of catabolism among patients. Despite the hyperalimentation, there was a mean negative cumulative nitrogen balance of 200 gm by the 2nd week after injury, and only three patients achieved net nitrogen equilibrium for the 7-day balance period. Despite enteral hyperalimentation, the patients' weight fell by 15% in the 2nd week, serum albumin was often decreased, and creatinine-height index decreased over time but remained in a normal range. Monitoring urinary urea nitrogen, which has been advocated as a generally available technique for measuring urinary nitrogen concentration, was found to be a poor measure of urinary nitrogen excretion. This work has demonstrated: 1) that high caloric and protein feedings may be delivered for prolonged periods enterally for most patients in the acute phase of head injury with few metabolic complications, and 2) that increasing the nitrogen content of feedings from 14% to 22% may somewhat improve nitrogen retention, although nitrogen equilibrium is seldom achieved.
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PMID:Enteral hyperalimentation in head injury. 391 45

In acutely ill patients nitrogen balance is often assessed clinically from measurements of protein intake and urinary urea nitrogen. We have utilized urea kinetic modeling to measure urea generation rates, protein catabolic rates and nitrogen balance in 19 acutely ill patients with varying degrees of renal dysfunction and have studied the effect of varying caloric intake on protein balance during a period of fixed protein intake. In patients with measured creatinine clearances equal to or greater than 50 ml/min there was a highly significant correlation between nitrogen balance estimates derived from urea kinetic modeling and those obtained from urinary urea nitrogen (R = 0.939; p less than 0.001). When creatinine clearance measurements were between 20 to 50 ml/min the correlation between the two estimates was poorer (R = 0.337; p less than 0.001). In patients whose creatinine clearance was below 20 ml/min the correlation between measurements was worse still (R = 0.229; p less than 0.002). To determine the effects of increasing caloric intake on protein catabolic rate seven acutely ill patients were studied. When caloric intake was increased from 27.8 to 34.2 kcal/kg/day while on a fixed protein intake of 1.27 g/kg/day there was a significant fall in protein catabolic rate from 1.39 to 0.99 g/kg/day (p less than 0.002). As urea kinetic modeling takes into account changes in blood urea nitrogen, extrarenal losses of urea and the urinary urea pool, it is the preferred method for measuring protein balance in acutely ill patients particularly those with poor renal function. Serial monitoring of protein catabolic rates permits easy continuous assessment of the effect of increasing caloric intake on protein sparing during parenteral hyperalimentation.
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PMID:Use of urea kinetics in the nutritional care of the acutely ill patient. 392 32

Plasma fibronectin has been suggested as a possible marker for nutritional repletion or depletion. This study was undertaken to evaluate the usefulness of plasma fibronectin in patients who received intense nutritional support. Twenty-seven patients referred to our Nutritional Support Services were followed for 3 to 5 wk; 22 received parenteral hyperalimentation alone, two received enteral alone, and three received a combination of both. Plasma fibronectin, serum albumin, serum transferrin, total lymphocyte counts, and 24-hr urine nitrogen balance studies were performed weekly; anthropometric measurements were performed every other week. Plasma fibronectin concentration, measured by laser nephelometry, showed a significant rise (p less than 0.005) in all patients after 1 wk of nutritional therapy; however, there was no significant difference among the subsequent weeks. Plasma fibronectin did not correlate with nitrogen balance studies, serum albumin, or total lymphocyte counts. A correlation between serum transferrin and plasma fibronectin was found not to be clinically useful. Thus, plasma fibronectin is sensitive to nutritional repletion after 1 wk of therapy, but is not useful thereafter. The relationship among nutritional status, immunologic function, plasma fibronectin, and other serum proteins are discussed.
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PMID:The clinical evaluation of plasma fibronectin as a marker for nutritional depletion and repletion and as a measure of nitrogen balance. 393 5

During routine pretransfusion testing, the presence of IgG on patient red cells is suggested by a positive autocontrol and confirmed by a positive direct antiglobulin test (DAT) using monospecific anti-IgG sera. Most IgG on patient red cells detected in this manner are of unknown etiology. We recently showed an association between elevated serum globulin levels and positive DAT with unreactive eluate in patients with acquired immunodeficiency syndrome (AIDS). In the present study, we wished to determine whether elevated serum globulin levels contribute to some of the positive DAT encountered in pretransfusion testing of patients without AIDS. 76 patients with positive DAT were compared with 90 controls without IgG detected on their red cells during pretransfusion testing. The rate of elevated serum globulin levels was 75% in positive DAT cases versus 29% in controls (p less than 0.001); the odds ratio was 7.6. Elevated blood urea nitrogen levels occurred in 42% of cases versus 19% of controls (p less than 0.025); the odds ratio was 3.1. Cases and controls were not significantly different with regard to age, sex, race, quinidine usage, or hyperalimentation. Elevated serum globulin and blood urea nitrogen levels are significantly associated with a positive DAT with unreactive eluate in pretransfusion patients.
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PMID:Factors associated with positive direct antiglobulin tests in pretransfusion patients: a case-control study. 404 7

An elemental diet was used to prepare 11 severely debilitated malnourished patients for operation. Indications included: 1) as a substitute for parenteral hyperalimentation when catheter sepsis occurred with the latter; 2) high small fistulae; 3) short bowel syndrome; 4) radiation enteritis; and 5) partial obstruction of the gastrointestinal tract. All patients were converted to a positive nitrogen balance as evidenced by a substantial gain in weight and in serum albumin levels. All tolerated corrective operations without difficulty and their wounds healed per primum.
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PMID:Use of elemental diets to correct catabolic states prior to surgery. 420 17

Prognostic significance of postoperative changes in serum albumin and urea concentrations as well as their ratio was statistically evaluated in 73 patients with suture line leakage of the abdominal alimentary tract. Increase in serum urea was associated with poor prognosis regardless of the site of leakage. Although the serum albumin concentration was poorly correlated to prognosis, its ratio to serum urea was of more prognostic significance than the urea value alone. When the ratio of the serum albumin nitrogen to the urea nitrogen fell below 10, there was a sharp rise in mortality as well as in morbidity, associated with poor local defense reaction, high incidence of spreading peritonitis, severe systemic complications, and decreased tolerance to tube feeding as well as parenteral hyperalimentation. A special therapeutic policy was suggested for the management of leakage in patients with critically low albumin/urea ratios.
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PMID:Prognostic significance of serum albumin urea ratio in suture line leakage of the alimentary tract. 445 83

Metabolism of fat was studied in Sprague-Dowley rats receiving catecholamines as an experimental model of "stressed condition". These rats were fed with intravenous hyperalimentation with glucose only (G-group) or glucose and fat (F-group). Changes in body weight, cumulative nitrogen balance, blood sugar, serum IRI, free fatty acid, and triglyceride content of the liver were determined before and after five days intravenous hyperalimentation. Animals receiving intravenous hyperalimentation but no catecholamines were also subjected to the studies as control group. The following results were obtained from the present studies: In control group, G-group gained much more body weight and spared much more nitrogen than F-group. In catecholamine receiving groups, there was no significant difference of changes in body weight and cumulative nitrogen balance between G-group and F-group. In catecholamine receiving group, triglyceride content of the liver tissue was higher in G-group than in F-group, whereas triglyceride content of the liver tissue in control group was lower in G-group than in F-group. There was a positive correlation between the accumulation of triglyceride in the liver tissue and blood sugar level, or serum IRI level. A negative correlation was found between the accumulation of triglyceride in the liver tissue and plasma free fatty acid level. These results suggest that "stressed condition" induced by the administration of catecholamines enhanced the utilization of fat as an energy source without producing fatty liver.
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PMID:[Experimental studies on the effects of administration of catecholamines on fat metabolism]. 637 83


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