Enhanced levels of whole-body protein turnover in patients with chronic obstructive pulmonary disease

M.P.K.J. Engelen, N.E.P. Deutz, E.F.M. Wouters, A.M.W.J. Schols

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Abstract

A substantial number of patients with chronic obstructive pulmonary disease (COPD) are characterized by fat-free mass wasting and altered muscle and plasma amino acid levels, suggesting changes in protein metabolism. In the present study, we examined whether whole-body protein breakdown (PB) and synthesis (PS) differ between 14 stable patients with COPD and 8 healthy controls. Whole-body PB, PS, and net PB (= PB-PS) were measured by the combined Infusion of the stable isotopes L-[ring-H-2(5)]phenylalanine (Phe) and L-[ring-H-2(2)]tyrosine. Because there is evidence for specific disturbances in leucine (Leu) metabolism, the PB values were compared with those obtained when infusing L-[1-C-13]Leu tracer. In arterialized-venous plasma and in vastus lateralis muscle, the isotope enrichment values and amino acid concentrations were measured. Whole-body PS and PB, assessed by Phe and Tyr tracer, were higher in the COPD group than in the control group (p <0.05), indicating an elevated protein turnover. Net PB was increased in both groups, indicating a comparable degree of protein catabolism in the postabsorptive state. In contrast, whole-body PB determined by Leu tracer was not different between the groups. As a consequence, the ratio of Leu to Phe breakdown was reduced in the COPD group (p <0.001). Moreover, in the COPD group a higher muscle-to-plasma gradient was found for Leu (p <0.001) but not for Phe. The present study reveals elevated levels for protein turnover in patients with COPD, and indicates that infusion of the Leu tracer gives a reflection of Leu metabolism but not of whole-body protein metabolism in these patients.
Original languageEnglish
Pages (from-to)1488-1492
Number of pages5
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume162
DOIs
Publication statusPublished - 1 Jan 2000

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