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Department of Surgery, University of Texas Medical Branch and Metabolism Unit, Shriners Burns Hospital, Galveston, Texas 77550
Debilitating injury is
accompanied by hypercortisolemia, muscle wasting, and disruption of the
normal anabolic response to food. We sought to determine whether acute
hypercortisolemia alters muscle protein metabolism following ingestion
of a potent anabolic stimulus: essential amino acids (EAA). A
27-h infusion (80 µg · kg
1 · h
1)
of hydrocortisone sodium succinate mimicked cortisol (C) levels accompanying severe injury (>30 µg/dl), (C + AA;
n = 6). The control group (AA) received intravenous
saline (n = 6). Femoral arteriovenous blood samples and
muscle biopsies were obtained during a primed (2.0 µmol/kg) constant
infusion (0.05 µmol · kg
1 · min
1)
of
L-[ring-2H5]phenylalanine
before and after ingestion of 15 g of EAA. Hypercortisolemia [36.5 ± 2.1 (C + AA) vs. 9.0 ± 1.0 µg/dl (AA)]
increased postabsorptive arterial, venous, and muscle intracellular
phenylalanine concentrations. Hypercortisolemia also increased
postabsorptive and post-EAA insulin concentrations. Net protein balance
was blunted (40% lower) following EAA ingestion but remained positive
for a greater period of time (60 vs. 180 min) in the C + AA group.
Thus, although differences in protein metabolism were evident, EAA
ingestion improved muscle protein anabolism during acute
hypercortisolemia and may help minimize muscle loss following
debilitating injury.
cortisol; stress; metabolism; injury; stable isotopes
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