Vol. 284, Issue 2, E382-E389, February 2003
Effect of protein restriction on sulfur amino acid catabolism
in insulin-dependent diabetes mellitus
Mazen J.
Hamadeh and
L. John
Hoffer
Lady Davis Institute for Medical Research, Jewish
General Hospital, Montreal, Quebec, Canada H3T 1E2
Persons with conventionally
treated insulin-dependent diabetes mellitus (IDDM) appear to be
impaired in their ability to reduce fed-state urea production
appropriately in response to dietary protein restriction (Hoffer LJ,
Taveroff A, and Schiffrin A. Am J Physiol 272: E59-E67,
1997). To determine whether these conclusions apply to whole body
sulfur amino acid (SAA) catabolism, we used samples from this protocol
to measure daily urinary sulfate excretion and fed-state sulfate
production after a high-protein test meal before and after dietary
protein restriction. Eight normal subjects and six IDDM subjects
treated with twice-daily intermediate- and short-acting insulin
consumed a mixed test meal containing 0.50 g protein/kg after
adaptation to 4 days of high protein intake (1.28 g protein/kg body wt)
and again after 5 days of dietary protein restriction (0.044 g/kg).
Adaptation to protein restriction decreased daily urinary sulfate and
urea-N excretion by ~80%. Over the first 24 h of protein
restriction, urinary sulfate excretion decreased more than urea-N
excretion for both the normal and IDDM subjects. Under conditions of a
high prior protein intake, fed-state sulfate production was normal for
the IDDM subjects; protein restriction reduced fed-state sulfate
production by 51% (normal subjects) and 59% (IDDM subjects; not
significant). We conclude that whole body SAA metabolism is normal in
conventionally treated IDDM before and after dietary protein
restriction. SAA catabolism, as measured by fed-state sulfate
production, may be a convenient and useful method to determine the
extent of whole body protein dysregulation in IDDM.
adaptation; fed state; humans; sulfate; urea