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Urinary Excretion of 3-Methylhistidine as an Index of Protein Nutrition in Total Parenteral Nutrition

First Department of Surgery and Department of Pediatric Surgery, Osaka University Medical School, Osaka, Japan

Akira Okada, M.D.

First Department of Surgery and Department of Pediatric Surgery, Osaka University Medical School, Osaka, Japan

Takeo Itakura, M.D.

First Department of Surgery and Department of Pediatric Surgery, Osaka University Medical School, Osaka, Japan

Yoji Takagi, M.D.

First Department of Surgery and Department of Pediatric Surgery, Osaka University Medical School, Osaka, Japan

Kazuyasu Nakao, M.D.

First Department of Surgery and Department of Pediatric Surgery, Osaka University Medical School, Osaka, Japan

Yasunaru Kawashima, M.D.

First Department of Surgery and Department of Pediatric Surgery, Osaka University Medical School, Osaka, Japan

In 39 healthy adult volunteers and nine patients receiving total parenteral nutrition (TPN), determinations were made of the urinary excretion of 3-methylhistidine (3-Mehis) to estimate the degree to which the urinary output of 3-Mehis reflects the status of protein nutrition.

In 19 males and 10 females of the former group, measurements were made of the amount of 3-Mehis and of creatinine (Cr) in 24-hr urine samples. The urinary output of 3-Mehis was also measured in two subgroups of five healthy adult male subjects who were fed one of the two different diets prescribed: meat (M) and meat-free (F) diet. Furthermore, in one of these subgroups which was fed on F diet, the urinary output of 3-Mehis was measured both while the subject was kept at bed rest and while the subject was allowed to live a normal life.

From these measurements the standard value was determined for the urine 3-Mehis level and the 3-Mehis/Cr ratio in 24-hr urine in healthy adult human subjects of both sexes.

In nine patients maintained on TPN these indices of nutritional status were measured before and at 4 weeks of TPN. The time course of the indices was also investigated.

The results obtained suggest that both the urinary output of 3-Mehis and the 3-Mehis/Cr ratio can provide a sensitive index of the status of protein nutrition. (Journal of Parenteral and Enteral Nutrition 12:198-204, 1988)

Journal of Parenteral and Enteral Nutrition, Vol. 12, No. 2, 198-204 (1988)
DOI: 10.1177/0148607188012002198


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