Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis
Background & aims: Some patients with cystic fibrosis continue to have excessive losses of stool lipid, despite the use of pancreatic enzyme replacement therapy to improve digestion. The aim of this study was to explore the residual capacity of the gastrointestinal tract to digest and absorb die...
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2004-06, Vol.23 (3), p.347-353 |
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| creator | Laiho, Kirsi M Gavin, Joan Murphy, Jane L Connett, Gary J Wootton, Stephen A |
| description | Background & aims: Some patients with cystic fibrosis continue to have excessive losses of stool lipid, despite the use of pancreatic enzyme replacement therapy to improve digestion. The aim of this study was to explore the residual capacity of the gastrointestinal tract to digest and absorb dietary lipid using stable isotopic methodology in ten patients with cystic fibrosis who were gastrostomy fed in comparison to eight healthy children. We sought to test the hypothesis that a reduction in the availability of dietary lipid may arise from malabsorption of the products of digestion, rather than maldigestion alone.
Methods: All subjects consumed [1,1,1-
13C] tripalmitin (10
mg/kg body weight) with a standardised meal but the patients with cystic fibrosis did not take their habitual pancreatic enzymes. Total enrichment of
13C was measured by isotope ratio mass spectrometry in stools collected over 3 days. Maldigestion and malabsorption was differentiated by measuring
13C-label excretion in stool triglyceride and fatty acid fractions, respectively.
Results: The patients with cystic fibrosis had elevated
13C-label losses in total stools (56.7%, 6.8–77.9%)(median and range; % administered dose), triglyceride (6.6%, 0–31.2%) and fatty acid (16.7%, 3.4–50.3%) fractions compared to healthy children (1.9%, 0–10.9%,
P |
| doi_str_mv | 10.1016/j.clnu.2003.08.002 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71951398</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0261561403001651</els_id><sourcerecordid>71951398</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2298-c3f2fa231f1421217d9ea6202ac58ddc92c8076e749f9bc642e4012fb71078b43</originalsourceid><addsrcrecordid>eNp9kEtrGzEURkVpaFy3f6CLok27m8m90jw0kE0wTVNI6KZdC40eqdx5RZIT_O8rx4ZkVRAIrs79-HQI-YRQImBzsS31MO1KBsBLECUAe0NWWHNWYCf4W7IC1mBRN1idk_cxbgGg5q14R86xxlqwTqzI3zs1GH9vY_LzRNVk6KgG1cc5LM-T2VHkG5pHdhisoSn4RQ2jT36i-dyrmMIc0zzuC5efF5W8nVKkTz79oXqfYzV1vs-Mjx_ImVNDtB9P95r8vv72a3NT3P78_mNzdVtoljsVmjvmFOPosGLIsDWdVQ0DpnQtjNEd0wLaxrZV57peNxWzFSBzfYvQir7ia_L1mLuE-WGXvyZHH3XuryY776JssauRZ0Vrwo6gzv1isE4uwY8q7CWCPCiWW3lQLA-KJQiZFeelz6f0XT9a87JycpqBLydARa0GF9SkfXzFCd7UrM3c5ZGz2cWjt0FGneVpa3ywOkkz-__1-AfVBpsT</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71951398</pqid></control><display><type>article</type><title>Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Laiho, Kirsi M ; Gavin, Joan ; Murphy, Jane L ; Connett, Gary J ; Wootton, Stephen A</creator><creatorcontrib>Laiho, Kirsi M ; Gavin, Joan ; Murphy, Jane L ; Connett, Gary J ; Wootton, Stephen A</creatorcontrib><description>Background & aims: Some patients with cystic fibrosis continue to have excessive losses of stool lipid, despite the use of pancreatic enzyme replacement therapy to improve digestion. The aim of this study was to explore the residual capacity of the gastrointestinal tract to digest and absorb dietary lipid using stable isotopic methodology in ten patients with cystic fibrosis who were gastrostomy fed in comparison to eight healthy children. We sought to test the hypothesis that a reduction in the availability of dietary lipid may arise from malabsorption of the products of digestion, rather than maldigestion alone.
Methods: All subjects consumed [1,1,1-
13C] tripalmitin (10
mg/kg body weight) with a standardised meal but the patients with cystic fibrosis did not take their habitual pancreatic enzymes. Total enrichment of
13C was measured by isotope ratio mass spectrometry in stools collected over 3 days. Maldigestion and malabsorption was differentiated by measuring
13C-label excretion in stool triglyceride and fatty acid fractions, respectively.
Results: The patients with cystic fibrosis had elevated
13C-label losses in total stools (56.7%, 6.8–77.9%)(median and range; % administered dose), triglyceride (6.6%, 0–31.2%) and fatty acid (16.7%, 3.4–50.3%) fractions compared to healthy children (1.9%, 0–10.9%,
P<0.001; triglyceride: 0.2%, 0–0.6%,
P<0.01; fatty acid 0.9%, 0–6.5%,
P<0.001).
Conclusions: These results highlight differences between gastrostomy fed patients with cystic fibrosis to both digest and absorb dietary lipid. There is a need to extend these observations and apply this approach to patients both with and without pancreatic enzyme replacement therapy.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2003.08.002</identifier><identifier>PMID: 15158298</identifier><identifier>CODEN: CLNUDP</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Absorption ; Adolescent ; Biological and medical sciences ; Carbon Isotopes ; Case-Control Studies ; Child ; Cystic fibrosis ; Cystic Fibrosis - complications ; Cystic Fibrosis - metabolism ; Cystic Fibrosis - therapy ; Digestion ; Enzymes - therapeutic use ; Fatty Acids - analysis ; Feces - chemistry ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrostomy ; Humans ; Intestinal Absorption ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Long chain fatty acids ; Malabsorption Syndromes - etiology ; Malabsorption Syndromes - metabolism ; Male ; Medical sciences ; Other diseases. Semiology ; Pancreas - enzymology ; Stable isotopes ; Triglycerides - analysis ; Triglycerides - metabolism</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2004-06, Vol.23 (3), p.347-353</ispartof><rights>2003 Elsevier Ltd</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2298-c3f2fa231f1421217d9ea6202ac58ddc92c8076e749f9bc642e4012fb71078b43</citedby><cites>FETCH-LOGICAL-c2298-c3f2fa231f1421217d9ea6202ac58ddc92c8076e749f9bc642e4012fb71078b43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2003.08.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15836527$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15158298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Laiho, Kirsi M</creatorcontrib><creatorcontrib>Gavin, Joan</creatorcontrib><creatorcontrib>Murphy, Jane L</creatorcontrib><creatorcontrib>Connett, Gary J</creatorcontrib><creatorcontrib>Wootton, Stephen A</creatorcontrib><title>Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>Background & aims: Some patients with cystic fibrosis continue to have excessive losses of stool lipid, despite the use of pancreatic enzyme replacement therapy to improve digestion. The aim of this study was to explore the residual capacity of the gastrointestinal tract to digest and absorb dietary lipid using stable isotopic methodology in ten patients with cystic fibrosis who were gastrostomy fed in comparison to eight healthy children. We sought to test the hypothesis that a reduction in the availability of dietary lipid may arise from malabsorption of the products of digestion, rather than maldigestion alone.
Methods: All subjects consumed [1,1,1-
13C] tripalmitin (10
mg/kg body weight) with a standardised meal but the patients with cystic fibrosis did not take their habitual pancreatic enzymes. Total enrichment of
13C was measured by isotope ratio mass spectrometry in stools collected over 3 days. Maldigestion and malabsorption was differentiated by measuring
13C-label excretion in stool triglyceride and fatty acid fractions, respectively.
Results: The patients with cystic fibrosis had elevated
13C-label losses in total stools (56.7%, 6.8–77.9%)(median and range; % administered dose), triglyceride (6.6%, 0–31.2%) and fatty acid (16.7%, 3.4–50.3%) fractions compared to healthy children (1.9%, 0–10.9%,
P<0.001; triglyceride: 0.2%, 0–0.6%,
P<0.01; fatty acid 0.9%, 0–6.5%,
P<0.001).
Conclusions: These results highlight differences between gastrostomy fed patients with cystic fibrosis to both digest and absorb dietary lipid. There is a need to extend these observations and apply this approach to patients both with and without pancreatic enzyme replacement therapy.</description><subject>Absorption</subject><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Carbon Isotopes</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Cystic fibrosis</subject><subject>Cystic Fibrosis - complications</subject><subject>Cystic Fibrosis - metabolism</subject><subject>Cystic Fibrosis - therapy</subject><subject>Digestion</subject><subject>Enzymes - therapeutic use</subject><subject>Fatty Acids - analysis</subject><subject>Feces - chemistry</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrostomy</subject><subject>Humans</subject><subject>Intestinal Absorption</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Long chain fatty acids</subject><subject>Malabsorption Syndromes - etiology</subject><subject>Malabsorption Syndromes - metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Pancreas - enzymology</subject><subject>Stable isotopes</subject><subject>Triglycerides - analysis</subject><subject>Triglycerides - metabolism</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtrGzEURkVpaFy3f6CLok27m8m90jw0kE0wTVNI6KZdC40eqdx5RZIT_O8rx4ZkVRAIrs79-HQI-YRQImBzsS31MO1KBsBLECUAe0NWWHNWYCf4W7IC1mBRN1idk_cxbgGg5q14R86xxlqwTqzI3zs1GH9vY_LzRNVk6KgG1cc5LM-T2VHkG5pHdhisoSn4RQ2jT36i-dyrmMIc0zzuC5efF5W8nVKkTz79oXqfYzV1vs-Mjx_ImVNDtB9P95r8vv72a3NT3P78_mNzdVtoljsVmjvmFOPosGLIsDWdVQ0DpnQtjNEd0wLaxrZV57peNxWzFSBzfYvQir7ia_L1mLuE-WGXvyZHH3XuryY776JssauRZ0Vrwo6gzv1isE4uwY8q7CWCPCiWW3lQLA-KJQiZFeelz6f0XT9a87JycpqBLydARa0GF9SkfXzFCd7UrM3c5ZGz2cWjt0FGneVpa3ywOkkz-__1-AfVBpsT</recordid><startdate>200406</startdate><enddate>200406</enddate><creator>Laiho, Kirsi M</creator><creator>Gavin, Joan</creator><creator>Murphy, Jane L</creator><creator>Connett, Gary J</creator><creator>Wootton, Stephen A</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200406</creationdate><title>Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis</title><author>Laiho, Kirsi M ; Gavin, Joan ; Murphy, Jane L ; Connett, Gary J ; Wootton, Stephen A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2298-c3f2fa231f1421217d9ea6202ac58ddc92c8076e749f9bc642e4012fb71078b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Absorption</topic><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Carbon Isotopes</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Cystic fibrosis</topic><topic>Cystic Fibrosis - complications</topic><topic>Cystic Fibrosis - metabolism</topic><topic>Cystic Fibrosis - therapy</topic><topic>Digestion</topic><topic>Enzymes - therapeutic use</topic><topic>Fatty Acids - analysis</topic><topic>Feces - chemistry</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrostomy</topic><topic>Humans</topic><topic>Intestinal Absorption</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Long chain fatty acids</topic><topic>Malabsorption Syndromes - etiology</topic><topic>Malabsorption Syndromes - metabolism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Pancreas - enzymology</topic><topic>Stable isotopes</topic><topic>Triglycerides - analysis</topic><topic>Triglycerides - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Laiho, Kirsi M</creatorcontrib><creatorcontrib>Gavin, Joan</creatorcontrib><creatorcontrib>Murphy, Jane L</creatorcontrib><creatorcontrib>Connett, Gary J</creatorcontrib><creatorcontrib>Wootton, Stephen A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Laiho, Kirsi M</au><au>Gavin, Joan</au><au>Murphy, Jane L</au><au>Connett, Gary J</au><au>Wootton, Stephen A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2004-06</date><risdate>2004</risdate><volume>23</volume><issue>3</issue><spage>347</spage><epage>353</epage><pages>347-353</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><coden>CLNUDP</coden><abstract>Background & aims: Some patients with cystic fibrosis continue to have excessive losses of stool lipid, despite the use of pancreatic enzyme replacement therapy to improve digestion. The aim of this study was to explore the residual capacity of the gastrointestinal tract to digest and absorb dietary lipid using stable isotopic methodology in ten patients with cystic fibrosis who were gastrostomy fed in comparison to eight healthy children. We sought to test the hypothesis that a reduction in the availability of dietary lipid may arise from malabsorption of the products of digestion, rather than maldigestion alone.
Methods: All subjects consumed [1,1,1-
13C] tripalmitin (10
mg/kg body weight) with a standardised meal but the patients with cystic fibrosis did not take their habitual pancreatic enzymes. Total enrichment of
13C was measured by isotope ratio mass spectrometry in stools collected over 3 days. Maldigestion and malabsorption was differentiated by measuring
13C-label excretion in stool triglyceride and fatty acid fractions, respectively.
Results: The patients with cystic fibrosis had elevated
13C-label losses in total stools (56.7%, 6.8–77.9%)(median and range; % administered dose), triglyceride (6.6%, 0–31.2%) and fatty acid (16.7%, 3.4–50.3%) fractions compared to healthy children (1.9%, 0–10.9%,
P<0.001; triglyceride: 0.2%, 0–0.6%,
P<0.01; fatty acid 0.9%, 0–6.5%,
P<0.001).
Conclusions: These results highlight differences between gastrostomy fed patients with cystic fibrosis to both digest and absorb dietary lipid. There is a need to extend these observations and apply this approach to patients both with and without pancreatic enzyme replacement therapy.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>15158298</pmid><doi>10.1016/j.clnu.2003.08.002</doi><tpages>7</tpages></addata></record> |
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| ispartof | Clinical nutrition (Edinburgh, Scotland), 2004-06, Vol.23 (3), p.347-353 |
| issn | 0261-5614 1532-1983 |
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| subjects | Absorption Adolescent Biological and medical sciences Carbon Isotopes Case-Control Studies Child Cystic fibrosis Cystic Fibrosis - complications Cystic Fibrosis - metabolism Cystic Fibrosis - therapy Digestion Enzymes - therapeutic use Fatty Acids - analysis Feces - chemistry Female Gastroenterology. Liver. Pancreas. Abdomen Gastrostomy Humans Intestinal Absorption Liver. Biliary tract. Portal circulation. Exocrine pancreas Long chain fatty acids Malabsorption Syndromes - etiology Malabsorption Syndromes - metabolism Male Medical sciences Other diseases. Semiology Pancreas - enzymology Stable isotopes Triglycerides - analysis Triglycerides - metabolism |
| title | Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis |
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