Effect of the route of nutrition and l -alanyl- l -glutamine supplementation in amino acids’ concentration in trauma patients

Abstract

Purpose

Our purpose was to assess the amino acids’ (AAs) profile in trauma patients and to assess the effect of the route of nutrition and the exogenous ALA-GLN dipeptide supplementation on plasma AAs’ concentration.

Methods

This is a secondary analysis of a previous randomized controlled trial. On day 1 and day 6 after trauma, plasma concentration of 25 AAs was measured using reverse phase high-performance liquid chromatography. Results were analyzed in relation to the route of nutrition and supplementation of ALA-GLN dipeptide. Differences between plasma AAs’ concentrations at day 1 and day 6 were evaluated using the Student’s t test or Mann–Whitney–Wilcoxon test. One-way ANOVA and the Kruskal–Wallis test were used to compare groups. A two-sided p value less than 0.05 was considered statistically significant.

Results

Ninety-eight patients were analyzed. Mean plasma concentrations at day 1 were close to the lower normal level for most AAs. At day 6 we found an increase in the eight essential AAs’ concentrations and in 9 out of 17 measured non-essential AAs. At day 6 we found no differences in plasma concentrations for the sum of all AAs (p = .72), glutamine (p = .31) and arginine (p = .23) distributed by the route of nutrition. Administration of ALA-GLN dipeptide increased the plasma concentration of alanine (p = .004), glutamine (p < .001) and citrulline (p = .006).

Conclusions

We found an early depletion of plasma AAs’ concentration which partially recovered at day 6, which was unaffected by the route of nutrition. ALA-GLN dipeptide supplementation produced a small increase in plasma levels of glutamine and citrulline.

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