期刊论文详细信息
Nutrition Journal
Diurnal variation of phenylalanine and tyrosine concentrations in adult patients with phenylketonuria: subcutaneous microdialysis is no adequate tool for the determination of amino acid concentrations
K Otfried Schwab3  Jörn Oliver Sass1  Klaus Hennighausen2  Christian Fleischhaker2  Reinhold Rauh2  Hans-Willi Clement2  Andreas Krebs3  Corinna M Brichta2  Sarah C Grünert3 
[1] Clinical Chemistry and Biochemistry, University Children’s Hospital Zürich, Zürich, Switzerland;Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany;Center for Pediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany
关键词: Ergometry;    Dried blood spot;    Microdialysis;    Physical exercise;    Diet;    Diurnal variation;    Tyrosine;    Phenylalanine;    Phenylketonuria;   
Others  :  806810
DOI  :  10.1186/1475-2891-12-60
 received in 2013-02-12, accepted in 2013-05-07,  发布年份 2013
PDF
【 摘 要 】

Background

Metabolic control and dietary management of patients with phenylketonuria (PKU) are based on single blood samples obtained at variable intervals. Sampling conditions are often not well-specified and intermittent variation of phenylalanine concentrations between two measurements remains unknown. We determined phenylalanine and tyrosine concentrations in blood over 24 hours. Additionally, the impact of food intake and physical exercise on phenylalanine and tyrosine concentrations was examined. Subcutaneous microdialysis was evaluated as a tool for monitoring phenylalanine and tyrosine concentrations in PKU patients.

Methods

Phenylalanine and tyrosine concentrations of eight adult patients with PKU were determined at 60 minute intervals in serum, dried blood and subcutaneous microdialysate and additionally every 30 minutes postprandially in subcutaneous microdialysate. During the study period of 24 hours individually tailored meals with defined phenylalanine and tyrosine contents were served at fixed times and 20 min bicycle-ergometry was performed.

Results

Serum phenylalanine concentrations showed only minor variations while tyrosine concentrations varied significantly more over the 24-hour period. Food intake within the patients’ individual diet had no consistent effect on the mean phenylalanine concentration but the tyrosine concentration increased up to 300% individually. Mean phenylalanine concentration remained stable after short-term bicycle-exercise whereas mean tyrosine concentration declined significantly. Phenylalanine and tyrosine concentrations in dried blood were significantly lower than serum concentrations. No close correlation has been found between serum and microdialysis fluid for phenylalanine and tyrosine concentrations.

Conclusions

Slight diurnal variation of phenylalanine concentrations in serum implicates that a single blood sample does reliably reflect the metabolic control in this group of adult patients. Phenylalanine concentrations determined by subcutaneous microdialysis do not correlate with the patients’ phenylalanine concentrations in serum/blood.

【 授权许可】

   
2013 Grünert et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140708100517853.pdf 361KB PDF download
Figure 3. 30KB Image download
Figure 2. 100KB Image download
Figure 1. 37KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]Donlon J, Levy H, Scriver CR: Hyperphenylalaninemia: Phenylalanine Hydroxylase Deficiency. In Scriver's Online Metabolic and Molecular Bases of Inherited Disease Edited by Valle D, Beaudet AL, Vogelstein B, Kinzler KW. http://dx.doi.org/10.1036/ommbid.97 webcite. Accessed 07-10-12
  • [2]Paine RS: The variability in manifestations of untreated patients with phenylketonuria (phenylpyruvic aciduria). Pediatrics 1957, 20:290-302.
  • [3]National Institutes of Health Consensus Development P: National institutes of health consensus development conference statement: phenylketonuria: screening and management, October 16–18, 2000. Pediatrics 2001, 108:972-982.
  • [4]Enns GM, Koch R, Brumm V, Blakely E, Suter R, Jurecki E: Suboptimal outcomes in patients with PKU treated early with diet alone: revisiting the evidence. Mol Genet Metab 2010, 101:99-109.
  • [5]Report of Medical Research Council Working Party on Phenylketonuria: Recommendations on the dietary management of phenylketonuria. Arch Dis Child 1993, 68:426-427.
  • [6]Abadie V, Berthelot J, Feillet F, Maurin N, Mercier A, Ogier de Baulny H, de Parscau L, Association francaise pour le depistage et la prevention des handicaps de le: Management of phenylketonuria and hyperphenylalaninemia: the French guidelines. Arch Pediatr 2005, 12:594-601.
  • [7]Burgard P, Bremer HJ, Buhrdel P, Clemens PC, Monch E, Przyrembel H, Trefz FK, Ullrich K: Rationale for the German recommendations for phenylalanine level control in phenylketonuria 1997. Eur J Pediatr 1999, 158:46-54.
  • [8]Farquhar DL, Steven F, Westwood A: Preliminary report on inverse diurnal variation of phenylalanine: implications in maternal phenylketonuria. Hum Nutr Appl Nutr 1985, 39:224-226.
  • [9]Ferguson C: Monitoring the effect of varying the distribution of phenylalanine exchanges and protein substitute on serum phenylalanine—a preliminary study. J Hum Nutr Diet 1996, 9:293-302.
  • [10]MacDonald A, Rylance G, Hall SK, Asplin D, Booth IW: Factors affecting the variation in plasma phenylalanine in patients with phenylketonuria on diet. Arch Dis Child 1996, 74:412-417.
  • [11]MacDonald A, Rylance GW, Asplin D, Hall SK, Booth IW: Does a single plasma phenylalanine predict quality of control in phenylketonuria? Arch Dis Child 1998, 78:122-126.
  • [12]van Spronsen FJ, van Dijk T, Smit GP, van Rijn M, Reijngoud DJ, Berger R, Heymans HS: Phenylketonuria: plasma phenylalanine responses to different distributions of the daily phenylalanine allowance over the day. Pediatrics 1996, 97:839-844.
  • [13]van Spronsen FJ, van Rijn M, van Dijk T, Smit GP, Reijngoud DJ, Berger R, Heymans HS: Plasma phenylalanine and tyrosine responses to different nutritional conditions (fasting/postprandial) in patients with phenylketonuria: effect of sample timing. Pediatrics 1993, 92:570-573.
  • [14]Baumeister FA, Rolinski B, Busch R, Emmrich P: Glucose monitoring with long-term subcutaneous microdialysis in neonates. Pediatrics 2001, 108:1187-1192.
  • [15]Dabrosin C, Hallstrom A, Ungerstedt U, Hammar M: Microdialysis of human breast tissue during the menstrual cycle. Clin Sci 1997, 92:493-496.
  • [16]Rolinski B, Baumeister FA, Roscher AA: Determination of amino acid tissue concentrations by microdialysis: method evaluation and relation to plasma values. Amino Acids 2001, 21:129-138.
  • [17]Ungerstedt U: Microdialysis–principles and applications for studies in animals and man. J Intern Med 1991, 230:365-373.
  • [18]Baldini F: Microdialysis-based sensing in clinical applications. Anal Bioanal Chem 2010, 397:909-916.
  • [19]Muller M: Science, medicine, and the future: Microdialysis. BMJ 2002, 324:588-591.
  • [20]Bolinder J, Ungerstedt U, Arner P: Microdialysis measurement of the absolute glucose concentration in subcutaneous adipose tissue allowing glucose monitoring in diabetic patients. Diabetologia 1992, 35:1177-1180.
  • [21]Ekberg NR, Wisniewski N, Brismar K, Ungerstedt U: Measurement of glucose and metabolites in subcutaneous adipose tissue during hyperglycemia with microdialysis at various perfusion flow rates. Clin Chim Acta 2005, 359:53-64.
  • [22]Ferguson C, Morris AM: Changes in serum phenylalanine after overnight fasts in youngsters with phenylketonuria. J Hum Nutr Diet 1999, 12:213-218.
  • [23]Fingerhut R, De Jesus Silva Arevalo G, Baumgartner M, Häberle J, Rohrbach M, Figueroa A, Fresse E, Polanco O, Torresani T: Postprandial changes of amino acid and acylcarnitine concentrations in dried blood samples. J Inherit Metab Dis 2010, 33:235-239.
  • [24]van Rijn M, Hoeksma M, Sauer PJJ, Modderman P, Reijngoud DJ, van Spronsen FJ: Adult Patients with Well-Controlled Phenylketonuria Tolerate Incidental Additional Intake of Phenylalanine. Ann Nutr Metab 2011, 58:94-100.
  • [25]Tipton KD, Wolfe RR: Exercise-induced changes in protein metabolism. Acta Physiol Scand 1998, 162:377-387.
  • [26]Henriksson J: Effect of exercise on amino acid concentrations in skeletal muscle and plasma. J Exp Biol 1991, 160:149-165.
  • [27]Carraro F, Naldini A, Weber JM, Wolfe RR: Alanine kinetics in humans during low-intensity exercise. Med Sci Sports Exerc 1994, 26:348-353.
  • [28]Phillips SM, Atkinson SA, Tarnopolsky MA, MacDougall JD: Gender differences in leucine kinetics and nitrogen balance in endurance athletes. J Appl Physiol 1993, 75:2134-2141.
  • [29]Wolfe RR, Goodenough RD, Wolfe MH, Royle GT, Nadel ER: Isotopic analysis of leucine and urea metabolism in exercising humans. J Appl Physiol 1982, 52:458-466.
  • [30]Devlin JT, Brodsky I, Scrimgeour A, Fuller S, Bier DM: Amino acid metabolism after intense exercise. Am J Physiol 1990, 258:E249-255.
  • [31]Bergstrom J, Furst P, Hultman E: Free amino acids in muscle tissue and plasma during exercise in man. Clin Physiol 1985, 5:155-160.
  • [32]Eriksson LS, Broberg S, Bjorkman O, Wahren J: Ammonia metabolism during exercise in man. Clin Physiol 1985, 5:325-336.
  • [33]Sahlin K, Katz A, Broberg S: Tricarboxylic acid cycle intermediates in human muscle during prolonged exercise. Am J Physiol 1990, 259:C834-841.
  • [34]Kronenberg F, Trenkwalder E, Kronenberg MF, Konig P, Utermann G, Dieplinger H: Influence of hematocrit on the measurement of lipoproteins demonstrated by the example of lipoprotein(a). Kidney Int 1998, 54:1385-1389.
  • [35]Yu Z, Kastenmuller G, He Y, Belcredi P, Moller G, Prehn C, Mendes J, Wahl S, Roemisch-Margl W, Ceglarek U: Differences between human plasma and serum metabolite profiles. PLoS One 2011, 6:e21230.
  文献评价指标  
  下载次数:30次 浏览次数:12次