Abstract
The effects on oxygen consumption and carbon dioxide production of a constant intravenous infusion of 0.15 g of disodium sebacate (Sb), the sodic salt of a medium-chain dicarboxylic acid with 10 carbon atoms, per kilogram of body weight per hour over 5 hours and of a 50% mixture of medium-and long-chain triglycerides (MCT/LCT) were compared in 10 healthy men. Oxygen consumption and carbon dioxide production were measured by indirect calorimetry. Mean oxygen consumption was about 19% higher than the basal oxygen consumption at the end of MCT/LCT infusion but was only 5% higher than the basal oxygen consumption when Sb was infused. There was an eightfold increase in plasma β-hydroxybutyrate and acetoacetate concentrations and a threefold increase in serum insulin levels during MCT/LCT infusion, but no significant change in ketone bodies and insulin from basal values was observed during and after Sb infusion. Pharmacokinetic parameters were also computed, showing an average apparent volume of distribution of 167 mL/kg of body weight for MCTs and 112 mL/kg of body weight for Sb. The t½ of MCTs was 50 minutes and that of Sb was 78 minutes. Urinary excretion of Sb and its β-oxidative by-product, suberic acid, globally accounted for 48% of the given amount of Sb. In spite of its urinary loss and slower tissue uptake compared with MCTs, Sb avoided ketone body formation or elevation in insulin levels and did not induce a significant increase in oxygen consumption. The Sb caloric equivalent was 6.643 kcal/g, and the remaining amount of Sb administered (approximately 5.2 g/h in a 70-kg subject) seemed to be energetically useful by furnishing 34.54 kcal/h, ie, 829 kcal over 24 hours. This caloric support is equivalent to or even higher than that usually given as MCTs; however, formation of ketone bodies and interference with glucose metabolism are avoided. ( Journal of Parenteral and Enteral Nutrition
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