Effect of a Branched Chain Amino Acid Enriched Solution as a Component of Parenteral Nutrition in Patients who Underwent Total Gastrectomy

Yasuo Yamaguchi, Naoya Hisama, Yuji Kurusu, Michio Ogawa

Department of Surgery II, Kumamoto University Medical School

The metabolic response to stress results in proteolysis, increased gluconeogenesis, and negative nigrogen balance. The branched chain amino acid (BCAA) has been shown to decrease protein degradation and to stimulate protein synthesis in liver and muscle in the stressed state. However, controversy still remains as whether BCAA has any beneficial effects on nutritional support after surgical stress. Cytokines play an important role in the regulation of hepatic and muscle protein metabolism during stress. Therefore, the present study was undertaken to investigate the effect of BCAA solution as a component of parenteral nutrition in patients undergoing total gastrectomy. Urinary excretion of norepinephrine and serum levels of IL-1 and IL-6 were measured as markers of surgical stress. There were no significant differences in the severity of surgical stress among these subjects. Infusion of BCAA decreased the urinary excretion of 3-methylhistidine as a marker of muscular protein degradation. Such infusion may modify the response of patients to surgical stress.

Key words
branched chain amino acid, surgical stress, cytokine

Reprint requests
Yasuo Yamaguchi Department of Surgery II, Kumamoto University Medical School
1-1-1 Honjo, Kumamoto, 860 JAPAN

Accepted
December 9, 1992

To read the PDF file you will need Abobe Reader installed on your computer.