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Query: UMLS:C0162275 (ketonuria)
 553 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A glucid-lipid and protein compound nutriment: Trive 1000 was administered to 53 patients during the first three postoperative days in varying doses: -1.000 ml per day to a first group -1.500 ml per day to a second group. The local tolerance was quite good. However, a few accidents of a general character were noted: they were due to a great extent to a non-observance of the rules of preservation. A study of the glucides, in Sorbitol form, showed a good assimilation of the substratum. Glycemia remaining within normal, no glycosuria or ketonuria could be observed. The assimilation of the proteins seemed on the whole satisfactory. No important rise in the blood urea was noted. Nitrogen balances showed that, thanks to this nutriment, almost half of them were positive during the post-aggressive period. The more important the dose of Trive 1000, the more positive the nitrogen balances were. The administration of lipids did not reveal any significant change in the total lipids, triglycerides or cholesterol. A study of the graphic record of lipid levels showed chylomicrons twice. On the opposite, lipoproteins were hardly modified apart from a significant in pre-beta lipoproteins. The quantitative analysis of amino-acids proved interesting. A comparative study of amino-acids both in blood and urine before and after the administration of Trive 1000 showed very little variations in connection with essential amino-acids. If the proportions in the blood of non-essential amino-acids were comparatively but little modified before and after the treatment, on the oppostie, the urinary clearance rate of the same amino-acids after treatment was far more variable and often quite important as far as certain amino-acids were concerned.
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PMID:[Contribution to the study of Trive 1000]. 0 20

Four patients from a larger group of 18 patients receiving dextrose-free isotonic (3%) amino acid solution as nutritional support, form the basis of this report. An additional seven patients received intravenous isotonic (5%) dextrose as their sole support in the postoperative period following major elective surgery (average nitrogen balance = -12.3 +/- 2.7 g). All patients were well-nourished as determined by anthropometric measurements. The nonseptic patients receiving infusions of isotonic amino acids demonstrated an improvement in nitrogen balance (= delta 8.5 +2, P less than 0.001) when compared to the postoperative use of 100 to 150 g of glucose. However, sepsis produced a decreased net utilization of the infused crystalline amino acids such that nitrogen balance was similar to the intravenous glucose group (- 10.6 +/- 2.1). This septic response was associated with decreased plasma free fatty acid concentrations and the absence of starvation ketosis and ketonuria. While the nitrogen balance was not different in the septic and the dextrose control groups, deficiencies in plasma amino acid concentrations were observed in the group receiving intravenous infusion of glucose.
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PMID:Effect of deep surgical sepsis on protein-sparing therapies and nitrogen balance. 40 78

A protein-sparing modified fast (PSMF), which is a total fast modified by the intake of 1.2-1.4 gm. protein per kilogram ideal body weight (IBW), fluids ad libitum, and vitamin and mineral supplementation, allows effective control of carbohydrate metabolism and hunger. It reduces serum glucose and insulin concentrations in obese diabetic patients and increases free fatty acid and ketone body concentrations; ketonuria appears within 24-72 hours. When this fast was applied to seven obese adult-onset diabetics who were receiving 30-100 units of insulin per day, insulin could be discontinued after 0-19 days (mean, 6.5). In the three patients who had extensive nitrogen-balance studies, balance could be maintained chronically by 1.3 gm. protein per kilogram IBW, despite the gross caloric inadequacy of the diet. The PSMF was tolerated well in an outpatient setting after the initial insulin-withdrawal phase had occurred in the hospital. Significant improvements in blood pressure, lipid abnormalities, parameters of carbohydrate metabolism, and cardiorespiratory, symptoms were associated with weight loss and/or the PSMF. For diabetics with some endogenous insulin reserve, the PSMF offers significant advantages for weight reduction, including preservation of lean body mass (as reflected in nitrogen balance) and withdrawal of exogenous insulin.
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PMID:Nitrogen metabolism and insulin requirements in obese diabetic adults on a protein-sparing modified fast. 127 1

Nitrogen (N) sparing and even equilibrium have been achieved in obese subjects with all-protein weight-reducing very low energy diets (VLED) apparently independently of the content of essential amino acids. This study assessed whether the metabolic response observed at week 3 of an all-protein VLED with 46% of amino acids (aa) as essential was modified during week 4, when consuming a protein source that provided 16% of amino acids as essential. Six healthy obese subjects (BMI: 35.3 +/- 1.3 kg/m2, weight 90 +/- 9 kg) were given a 1.72 MJ (400 kcal) all protein (93 g) VLED and a multi-vitamin-mineral supplement daily for four weeks. During weeks 1 to 3, the protein was casein-soy (46% essential aa) and during week 4, tryptophan- and methionine-supplemented collagen hydrolysate (16% essential aa). At week 3, decreases in plasma glucose, insulin, cholesterol, blood pH and bicarbonate, and increases in plasma free fatty acids, serum urea, uric acid and blood and urine ketones occurred compared to baseline. These adaptations were unchanged at week 4. N balance returned toward equilibrium by day 23 remaining at values close to 0 despite the change in diet composition. Mean negative N balance did not differ between weeks 3 and 4 (-1.1 +/- 0.5 g vs. -0.6 +/- 0.5 g/day) and neither did mean urinary ammonium N excretion (0.71 +/- 0.08 vs. 0.73 +/- 0.07 g/day). Urinary urea N excretion tended to increase with the collagen-based diet reflecting the greater proportion of N in this protein source (18 vs. 15%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The metabolic response to two very low energy diets (VLED) of differing amino acid composition during weight reduction. 133 70

In a randomized clinical study 30 patients with high risk surgical procedures were distributed to receive either standard fluid-therapy (n = 14) or an isotonic amino acid solution (n = 16) during five days. The patients were evaluated pre- and postoperatively using: anthropometric parameters: body weight, biceps and triceps skinfold thickness, and mid arm circumference; biochemical parameters: albumin, prealbumin, transferrin, retinol-binding protein, total iron-binding capacity, and cholesterol; and delayed cutaneous hypersensitivity. Clinical outcome and complications were also recorded. Positive ketonuria was obtained soon in the treatment group after 24 h. Mean daily nitrogen balance was better in the protein sparing group (-3.8 g vs -9.3 g) p less than 0.02. No differences were observed between both groups in the postoperative plasma protein levels. There were no significant differences in delayed cutaneous reactivity nor anthropometric parameters between both groups; and mortality and morbidity were similar. The present study lends little support for substituting the routine D5W and saline postoperative fluid regime. No clinical advantage of amino acids over standard fluids could be appreciated indicating that the much less expensive conventional solutions should not be replaced by amino acids, at least in routine postoperative cases.
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PMID:A randomized trial on the effect of isotonic amino acid infusion on postoperative complications and short life plasma protein concentrations. 354 26

The metabolic effects of oral ingestion of minute quantities of carbohydrate during prolonged starvation were studied in nine obese subjects. Measurements were made during a control period of total starvation, during the ingestion of 7.5 g carbohydrate daily, and finally during the ingestion of 15.0 g carbohydrate daily. Daily ketoacid excretion fell after carbohydrate ingestion and was significantly correlated (r = 0.62, P < 0.01) with the amount of carbohydrate administered. Despite this fall in ketoacids, the concentration of blood ketoacids, plasma free fatty acids, and serum insulin remained constant throughout the study. Urinary ammonium excretion, closely correlated with ketoacid output (r = 0.95, P < 0.001), also fell significantly after carbohydrate ingestion. No significant changes were present in extracellular or urinary pH. Urea nitrogen excretion did not change when urinary ammonium output fell. These results indicate that: the excretion of ketoacids and ammonium in starving man is exquisitely sensitive to minute amounts of ingested carbohydrate; the change in ketonuria appears to be due to increased renal ketoacid reabsorption after carbohydrate ingestion; and the nitrogen-sparing effect of reducing renal ammonium output in starvation can be dissociated from nitrogen sparing occurring because of changes in urine urea excretion.
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PMID:The effect of carbohydrates on ammonium and ketoacid excretion during starvation. 505 66

The effects of late pregnancy on metabolic fuels, liver composition, gluconeogenesis, and nitrogen metabolism have been examined in fed and fasted rats. Plasma free fatty acid (FFA) and immunoreactive insulin (IRI) are greater and glucose and ketones are lower in fed 19-day pregnant than they are in agematched virgin rats. A 48 hr fast elicits greater increases in FFA and ketones and more profound reductions in glucose in the pregnant rats and obliterates the differences in IRI. Fetal weight is not modified by such fasting but maternal weight losses exceed that of the nongravid rats. Livers from rats 19 days pregnant contain more and larger hepatocytes. Per mumole hepatic deoxyribonucleic acid (DNA)-phosphorus, water and protein are more abundant, whereas glycogen is unaffected. Livers from fed pregnant rats contain more lipid phosphorus and less neutral lipid fatty acid. After a 48 hr fast, hepatic steatosis supervenes in gravid animals due to accumulated neutral fat. The contents of hepatic acetyl-coenzyme A (CoA) and citric acid are not different in fed pregnant and virgin rats but are greater in the pregnant rats after fasting. Formation of glucose-(14)C and glycogen-(14)C from administered pyruvate-(14)C are the same in fed pregnant and virgin rats, but greater in the pregnant ones after a 24 or 48 hr fast. Pregnancy does not affect creatinine excretion, and urinary urea is not different in fed pregnant, virgin, and postpartum animals. Contrariwise, more nitrogen, potassium, and phosphorus are excreted by the pregnant animals during a 2 day fast. The increment in urinary nitrogen is due largely to urea on the 1st day, whereas heightened ammonia accounts for half the increase on the 2nd and correlates with the enhanced ketonuria. Muscle catabolism, gluconeogenesis, and diversion to fat are activated more rapidly and to a greater degree when food is withheld during late gestation in the rat. These catabolic propensities are restrained in the fed state. The capacity for "accelerated starvation" may confer survival benefit upon an intermittently eating mother in the presence of a continuously feeding fetus.
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PMID:Carbohydrate metabolism in pregnancy. VI. Plasma fuels, insulin, liver composition, gluconeogenesis, and nitrogen metabolism during late gestation in the fed and fasted rat. 535 39

The metabolic response to human growth hormone (HGH) was studied in five obese subjects in the fed state and during prolonged (5-6 wk) starvation. In the fed state (three subjects), HGH induced an elevation in basal serum insulin concentration, a minimal increase in blood and urine ketone levels, and a marked reduction in urinary nitrogen and potassium excretion resulting in positive nitrogen and potassium balance. In prolonged fasting (four subjects), HGH administration resulted in a 2- to 3-fold increase in serum insulin which preceded a 50% elevation in blood glucose. Persistence of the lipolytic effects of HGH was indicated by a rise in free fatty acids and glycerol. The response differed markedly from the fed state in that blood beta-hydroxybutyrate and acetoacetate levels rose by 20-40%, resulting in total blood ketone acid concentrations of 10-12 mmoles/liter, ketonuria of 150-320 mmoles/day, and increased urinary potassium loss. The subjects complained of nausea, vomiting, weakness, and myalgias. Despite a 50% reduction in urea excretion during HGH administration, total nitrogen loss remained unchanged as urinary ammonia excretion rose by 50% and correlated directly with the degree of ketonuria. It is concluded that in prolonged starvation (a) HGH may have a direct insulinotropic effect on the beta cell independent of alterations in blood glucose concentration, (b) persistence of the lipolytic action of HGH results in severe exaggeration of starvation ketosis and interferes with its anticatabolic action by necessitating increased urinary ammonia loss, and (c) failure of HGH to reduce net protein catabolism in starvation suggests that this hormone does not have a prime regulatory role in conserving body protein stores during prolonged fasting.
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PMID:Metabolic response to human growth hormone during prolonged starvation. 554 Jan 76

In 3337 dairy cows, urine was examined for ketone bodies by help of Bililabstix during the first and second phase of lactation and in the eighth to the ninth and a half month of pregnancy; at the same time needed supply of energetic nutrients in 175 summer and 308 winter feed rations was calculated. Intensity and frequency of ketonuria in lactating cows fed winter rations is significantly higher than in those fed green feeds; it decreases significantly with a phase of lactation and with milk production. On the contrary, cows in late pregnancy have higher intensity and frequency of ketonuria (32.9%) when fed green feeds than when fed winter rations (30.7%). In winter feed rations energy input was significantly lower, percentage of deficient feed rations at a relatively broader caloric-protein ratio was higher than in summer season. The highest deficits of energy and digestible nitrogen compounds were observed in cows in the first phase of lactation. Discussion concerns the causes and mechanisms of different ketonuria in groups of dairy cows in relation to deficit of energetic nutrients, caloric-protein ratio, to the level of glycaemia, non-esterified fatty acids in plasma, triglycerides of plasma and to the state of liver function.
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PMID:[Ketonuria in dairy cows]. 681 62

In metabolically healthy volunteers we investigated the influence of long and medium chained triglycerides on the kinetic of the free fatty acids in blood and on protein metabolism. During a three hour infusion of lipid emulsion (infusion rate 120 mg/kg BW X h) consisting of 50% medium and 50% long chained triglycerides we observed a significant increase of the concentrations of the medium chained free fatty acids (caprylic and capric acid), which decreased down to basic values with a half life of 30 minutes immediately after the infusion period. The total concentration of free fatty acids was higher during the infusion of a MCT/LCT mixture than during the infusion of pure LCT. Glucose infused simultaneously reduced the metabolism of the free fatty acids. MCT induced higher ketonemia and ketonuria than LCT, the ketogenesis could be suppressed by additional glucose. Compared to the glycerol control infusion the total nitrogen excretion was reduced under lipid infusion. Beside the lower excretion of Glu + Gln and Ala the excretion of 3-methylhistidine was reduced, which indicates a decreased on muscle protein turnover as referred to increased free fatty acids and the ketone body concentrations respectively.
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PMID:[Effect of lipid infusions on triglyceride and protein metabolism]. 681 32


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