WHOLE-BODY PROTEIN PARAMETERS IN PREMATURE-INFANTS - A COMPARISON OF DIFFERENT N-15 TRACER SUBSTANCES AND DIFFERENT METHODS

[N-15]glycine, [N-15]leucine, and [N-15]yeast protein thermitase hydrolysate (YPTH) as tracers for investigating the protein turnover rates in premature infants were studied in nine human milk-fed neonates (born after 32 to 34 wk of gestation) by paired comparison of the tracers. The N-15 enrichment of total urinary nitrogen and ammonia after administration of a single oral dose of N-15 was measured by emission spectrometry. Flux rates were calculated using a three-compartment model and the ammonia end product method. The mean whole-body protein synthesis rates, as determined by the three-compartment model derived from the three N-15 tracers, differed significantly (p < 0.01) among [N-15]glycine (15.9 g/kg/d), [N-15] leucine (9.1 g/kg/d), and N-15-YPTH (5.9 g/kg/d). When the corresponding rates were determined from the excretion of label in ammonia, the results showed the opposite tendency; the lowest apparent synthesis rates were found after [N-15]glycine (7.5 g/kg/d), followed by [N-15]leucine (14.4 g/kg/d), and the highest figure resulted after [N-15] YPTH (16.7 g/kg/d). The results of this comparison substantiate the assumption that there are methodologic errors in connection with the use of different tracers and models for the calculation of whole-body protein parameters in preterm infants, with respect to the main requirement for tracer kinetic studies; the tracer nitrogen must be representative of total amino acid nitrogen. Seen in this light, mixtures of completely labeled amino acids such as YPTH may represent the most reliable tracer substance. On the basis of the data obtained with N-15-labeled YPTH and with total N-15 as the end product, there is no major difference in the order of magnitude of the protein flux between preterm and full-term infants.