We postulated that dietary protein utilization and body protein metabolism are altered in hyperglycemic individuals with non-insulin-dependent diabetes mellitus (NIDDM). This was tested by estimating the kinetics of protein metabolism in obese NIDDM patients in the hyperglycemic state of isoenergetic feeding and in the normoglycemic state induced by the prolonged use of a very-low-energy diet (VLED) and comparing them with results in obese nondiabetic subjects studied previously. Seven obese subjects with NIDDM (one male, six females, body mass index = 35.8 ± 2.0 kg/m2) were given a 1.7 MJ (410 kcal) all protein (93 g/day) diet derived from hydrolyzed collagen and supplemented with tryptophan and methionine, which provides 16% of its amino acids as essential, a multivitamin and mineral supplement, and 16 mmol KCl for 42 days. During the seven-day isoenergetic diet and at weeks 4 and 6 of the VLED, amino nitrogen (N) flux rate was calculated from the urine [15N]urea enrichment by using the 60-h oral [15N]glycine method to obtain the integrated feeding-fasting metabolism. Rates of synthesis (S) and breakdown (B) were calculated from N flux. At day 7 of the isoenergetic diet, whole-body N flux, S, B, and resting metabolic rate (RMR) were 12–24% greater (P < 0.05) in the NIDDM subjects than observed in nondiabetic obese subjects. Mean plasma glucose decreased (P < 0.05) from the isoenergetic period (14.9 ± 2.4 mM) to 7.2 ± 1.2 mM at week 4 and 6.5 ± 1.1 mM at week 6 of the VLED. RMR declined progressively by 25% at week 5 of the VLED. Corresponding significant (P < 0.05) decreases from isoenergetic feeding to weeks 4 and 6 of the VLED occurred in whole-body N flux (from 51 ± 2 to 42 ± 1 g N/day), in S (from 38 ± 3 to 24 ± 1 g N/day), and in B (from 39 ± 3 to 26 ± 1 g N/day) resulting in net losses (S – B). S – B was significantly more negative (P < 0.05) in NIDDM than in the nondiabetic obese subjects at week 4 (−1.5 ± 0.5 vs. 0.9 ± 0.3 g N/day) but not at week 6 (−1.3 ± 0.4 vs. −0.9 ± 4 g N/day). During the VLED, N balance became less negative with time but never reached equilibrium in NIDDM. Thus, abnormal protein metabolism is present in NIDDM in the isoenergetic fed state with moderate hyperglycemia and persists during a VLED that restores glycemia to near normal.
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Original Articles|
February 01 1994
Effect of NIDDM on the Kinetics of Whole-Body Protein Metabolism Free
Réjeanne Gougeon;
Réjeanne Gougeon
McGill Nutrition and Food Science Centre, Royal Victoria Hospital
Montreal, Quebec
Division of Clinical Nutrition, The Hospital for Sick Children
Toronto, Ontario, Canada
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Paul B Pencharz;
Paul B Pencharz
McGill Nutrition and Food Science Centre, Royal Victoria Hospital
Montreal, Quebec
Division of Clinical Nutrition, The Hospital for Sick Children
Toronto, Ontario, Canada
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Errol B Marliss
Errol B Marliss
McGill Nutrition and Food Science Centre, Royal Victoria Hospital
Montreal, Quebec
Division of Clinical Nutrition, The Hospital for Sick Children
Toronto, Ontario, Canada
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Address correspondence and reprint requests to Dr. Réjeanne Gougeon, McGill Nutrition and Food Science Centre, 687 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1
Diabetes 1994;43(2):318–328
Article history
Received:
April 08 1993
Revision Received:
September 16 1993
Accepted:
September 16 1993
PubMed:
8288057
Citation
Réjeanne Gougeon, Paul B Pencharz, Errol B Marliss; Effect of NIDDM on the Kinetics of Whole-Body Protein Metabolism. Diabetes 1 February 1994; 43 (2): 318–328. https://doi.org/10.2337/diab.43.2.318
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