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Comparison Between Dodecanedioic Acid and Long-Chain Triglycerides as an Energy Source in Liquid Formula Diets

Cattedra di Medicina Interna II, Universitá Cattolica del Sacro Cuore, Roma, Italy

Andrea De Gaetano, MD, PhD

CNR Centro di Fisiopatologia dello Shock, Universitá Cattolica del Sacro Cuore, Roma, Italy

Aldo V. Greco, MD

Cattedra di Medicina Interna II, Universitá Cattolica del Sacro Cuore, Roma, Italy

Esmeralda Capristo, MD

Cattedra di Medicina Interna II, Universitá Cattolica del Sacro Cuore, Roma, Italy

Giuseppe Benedetti, MD

Cattedra di Medicina Interna II, Universitá Cattolica del Sacro Cuore, Roma, Italy

Marco Castagneto, MD, FACS

CNR Centro di Fisiopatologia dello Shock, Universitá Cattolica del Sacro Cuore, Roma, Italy

Giovanni Gasbarrini, MD

Cattedra di Medicina Interna II, Universitá Cattolica del Sacro Cuore, Roma, Italy

Background: Dicarboxylic acids (DA) are watersoluble substances with high-energy density proposed as an alternative lipid substrate for nutrition purposes. The aim of the present study was to investigate the interaction between glucose and DA or long-chain triglyceride (LCT) metabolism after oral administration. Methods: Two test meals containing either dodecanedioic acid (C12, the 12-atom DA) or LCT, together with glucose and amino acids, were each administered to five healthy volunteers. Tracer amounts of ¹⁴C-dodecanedioic acid were added to the C12 meal to recover expired traced CO₂ and estimate the minimum rate of C12 oxidation. Glucose, insulin, and C12 plasma levels were measured for 360 minutes after the test meal. Indirect calorimetry was performed for the duration of the study. Results: LCTs proved ineffective in promoting their own oxidation after oral administration. On the contrary, C12 was promptly oxidized, a minimum of 21.9% ± 8.3% of the administered amount giving rise to the recovered expired CO₂. This difference in metabolic fate was reflected in a sparing effect on glucose: suprabasal respiratory quotient and suprabasal carbohydrate oxidation were significantly (p < .05) lower under C12 administration than under LCT administration, with a difference of 0.024 ± 0.015 in respiratory quotient (RQ) and a difference of 0.791 ± 0.197 kJ/min in carbohydrate oxidation. In particular, carbohydrate oxidation increased by 54% over basal with LCT but only by 28% with C12 administration. RQ increased over basal by 5.8% with LCT but only by 3.0% with C12 administration. Conclusions: These results show a fundamental metabolic difference between conventional lipids and DAs, which is the basis for a possible role of DAs in clinical nutrition. The fate of spared glucose is likely to be storage in glycogen form when dodecanedioic acid is made available as an energy source. (Journal of Parenteral and Enteral Nutrition 23:80-84, 1999)

Journal of Parenteral and Enteral Nutrition, Vol. 23, No. 2, 80-84 (1999)
DOI: 10.1177/014860719902300280


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