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Effects on Amino Acid and Fuel Substrate Profiles

Sukumar P. Desai, MD; Bruce R. Bistrian, MD, PhD; John D. Palombo; Lyle L. Moldawer; George L. Blackburn, MD, PhD

Arch Surg. 1987;122(7):760-764.

Abstract
• During the first five days following gastric bypass surgery, 15 patients received near isotonic amino acid solutions that varied in their branched-chain amino acid (BCAA) content and amino acid profiles (15.6%, 50%, or 100% BCAA solutions). Plasma valine concentrations were elevated in patients receiving 50% and 100% BCAA solutions. Plasma alanine concentrations were highest in patients receiving 50% BCAA. Plasma free fatty acids and blood lactate concentrations were unchanged by either the operation or BCAA administration. Serum glucose concentration was unaffected by the different amino acid administrations and followed the pattern induced by stress initially and later by starvation. β-Hydroxybutyrate concentrations increased as starvation proceeded and were highest in patients receiving the 15.6% BCAA solution. Branched-chain amino acid—enriched solutions without additional energy may be administered safely to patients recovering from operative trauma. Plasma amino acid concentrations and fuel substrate profiles appear to follow metabolic patterns determined by the physiologic response to stress and starvation and can be affected by large quantities of BCAAs.

(Arch Surg 1987;122:760-764)

Author Affiliations
From the Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital/Harvard Medical School, Boston. Dr Desai is now with Brigham and Women's Hospital, Boston.

Footnotes
Accepted for publication June 16, 1986.

Reprint requests to Department of Anesthesia, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Dr Desai).

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