New Synthetic Substrates for Parenteral Feeding

Abstract

The glycerol esters of short and medium chain fatty acids are predicted to become important in future nutritional therapy. These compounds provide a mixture of carbohydrate and “carnitine-independent” fat which, together, can serve more tissues than either substrate alone. Medium chain triglycerides are available for enteral feeding, and water-soluble monoglycerides are suggested for parenteral feeding. Two mon-oglycerides have been tested by continuous infusion into the rat and dog. Experimental evidence indicates rapid ester hydrolysis by endogenous mechanisms which release the basic components of the glycerides. Nutritional tests with these glycerides have produced results at least comparable to glucose as an energy source, and no toxicity has yet been noted. The data suggest that further investigations should be conducted on the benefits of these compounds.

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References

Scheig R : Hepatic metabolism of medium chain fatty acids. IN Senior JR (ed): Medium chain triglycerides, Philadelphia, Univ Penn. Press, 1968., p 39.

Romberg A , Pricer Jr WE : Enzymatic esterification of a-glycerol phosphate by long chain fatty acids. J Biol Chem 204:345–357, 1953.

Border JR , Chenier R , McMemary , RH et al: Multiple systems organ failure–Muscle fuel deficit with viscerol protein malnutrition. Surg Clin N Am 56:1147–1167, 1976.

Winkler B , Rathgeb J , Steele R et al: Conversion of glycerol to glucose in the normal dog. Am J Physiol 219:497–502, 1970.

Munro HN : General aspects of the regulation of protein metabolism by diet and hormones. IN Munro HN and Allison JB (ed): Mammalian Protein Metabolism, Vol I, New York, Academic Press, 1964., pp 381–481.

Froesch ER : The metabolism of glucose, its endocrine control and comparative aspects with fructose, sorbitol and xylitol metabolism. IN Lee HA (ed): Parenteral Nutrition in Acute Metabolic Illness. New York, Academic Press, 1974., pp 13–36.

Frohman LA : Hypothalamus and metabolic control. Pathobiol Ann 1:353–372, 1971.

Berger M , Hagg SA , Goodman MN et al: Glucose metabolism in perfused skeletal muscle. Effects of starvation, diabetes, fatty acids, acetoacetate, insulin and exercise on glucose uptake. Biochem J 158:192–202, 1976.

Owen OE , Morgan AP , Kemp HG et al: Brain metabolism during fasting. J Clin Invest 46:1589–1595, 1967.

10.

Fajans SS , Floyd JC Jr , Knopf RF et al: A comparison of leucine-and acetoacetate-induced hypoglycemia in man. J Clin Invest 43:2003–2008, 1964.

11.

Madison LL , Mebane D , Unger L et al: The hypoglycemic action of ketones. II Evidence for a stimulatory feedback of ketones on the pancreatic beta cells. J Clin Invest 43:408–419, 1964.

12.

Flatt JP , Blackburn GL , Raders G et al: Effects of ketone body infusions on hypoglycemic reaction in post-absorptive dogs. Metabolism 23:151–158, 1974.

13.

Johnson WA , Weiner MW : Protective effects of ketogenic diets on signs of hypoglycemia. Diabetes 27:1087–1091, 1978.

14.

Geyer RP : Parenteral nutrition, Physiol Rev 40:150–186, 1960.

15.

Pi-Sunyer FX : Resistance to ketosis during prolonged fasting by rats fed on a diet containing undecanoie acid, an odd-carbon-number fatty acid. Br J Nutr 35:41–46, 1976.

16.

Coats DA : The place of ethanol in parenteral nutrition. IN Wilkinson AW (ed): Parenteral Nutrition, London, Churchill Livingstone, 1972.

17.

Birkhahn RH , McMemary RH , Border JR : Intravenous feeding of the rat with short chain fatty acid esters. I. Glycerol monobutyrate. J Am Clin Nutr 30:2078–2082, 1977.

18.

Birkhahn RH , Border JR : Intravenous feeding of the rat with short chain fatty acid esters. II. Monoacetoacetin. J Am Clin Nutr 31: 436–441, 1978.

19.

Hanriot M : Sur un nouveau ferment du sang. CR Soc Biol 48:925–926, 1896.

20.

Birkhahn RH , McMemany RH , Border JR : Monoglyceryl acetoacetate: A ketone body-carbohydrate substrate for parenteral feeding of the rat. J. Nutr. July, 1979.

21.

Birkhahn RH , Bellinger LL , Bernardis L et al: The stress response in the rat from harnessing for chronic intravenous infusion. J Surg Res 21:185–190, 1976.