Alterations in basal nutrient metabolism increase resting energy
expenditure in sickle cell disease.
Borel, Myfanwy J., Maciej S. Buchowski, Ernest A. Turner, Benjamin B.
Peeler, Richard E. Goldstein, and Paul J. Flakoll.
Departments of Surgery and Biochemistry, Vanderbilt University
School of Medicine, Nashville, TN 37232; and Center for Nutrition and
Comprehensive Sickle Cell Center, Meharry Medical College, Nashville,
TN 37208
APStracts 4:0252E, 1997.
We measured basal rates of whole-body protein, glucose, and lipid
metabolism and resting energy expenditure (REE) in 8 African-American
sickle cell disease (SCD) patients and in 6 African-American
controls. Catheters were placed (1) in an antecubital vein for stable
isotope infusion, and (2) in a heated hand vein for arterialized
venous blood. Breath and blood were collected during the last 30 min
of the 2.5 h study, and REE was measured by indirect calorimetry.
REE (128+/-5* vs 111+/-1 kJ x kg fat-free mass [FFM]-1 x day-1;
*p<0.05 vs controls) was 15% greater in the SCD patients. Whole
-body protein breakdown (5.0+/-0.3* vs 3.8+/-0.2 mg x kg FFM-1 x min
-1) and protein synthesis (4.4+/-0.3* vs 3.2+/-0.2 mg x kg FFM-1 x
min-1) were 32% and 38% greater, respectively, in the SCD patients,
but whole-body amino acid oxidation was similar (0.58+/-0.03 vs
0.66+/-0.03 mg x kg FFM-1 x min-1). Measures of whole-body glucose
and lipid metabolism were not significantly different between the
groups. The additional energy required for the greater rates of
whole-body protein breakdown and synthesis caused by SCD contributes
significantly to the observed increase in REE, suggesting that
dietary energy and protein requirements are enhanced in SCD patients.
Received 18 August 1997; accepted in final form 16 November 1997.
APS Manuscript Number E387-7.
Article publication pending Am. J. Physiol. (Endocrinol. Metab.).
ISSN 1080-4757 Copyright 1997 The American Physiological Society.
Published in APStracts on 14 November 1997