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Effect of DL-3-Hydroxybutyrate Infusions on Leucine and Glucose Kinetics in Burned Rats Receiving TPN¹

The Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital/Harvard Medical School, Boston, MA 02215

Whole-body leucine and plasma glucose kinetics were simultaneously measured in burned rats after 2 d of total parenteral nutrition (TPN) containing sodium DL-3-hydroxybutyrate or sodium acetate to evaluate the ketone bodies as energy substrates during stress. TPN solutions consisted of dextrose and amino acids [200 kcal/(kg · d); 13 g amino acids/(kg · d)] and contained 34.3 mEq/(kg · d) either as sodium DL-3-hydroxybutyrate (n = 8) or sodium acetate (n = 7). Whole-body leucine appearance, incorporation into protein, release from protein breakdown and oxidation rates, as measured after a constant infusion of L-[1-¹⁴C]leucine did not significantly differ between the groups. In contrast, D-[6-³H]glucose appearance rates after constant infusion of this tracer were significantly higher in rats given sodium DL-3-hydroxybutyrate [209.3 ± 3.8 µmol/(kg body weight · min)] than in those given sodium acetate [162.4 ± 9.7 µmol/(kg body weight · min)] (P < 0.01). Since leucine kinetics did not differ, the results suggest that sodium DL-3-hydroxybutyrate infusions increase endogenous glucose production [61.0 ± 4.6 µmol/(100 kg body weight · min)] by enhancing glucose recycling. However, there was no unique protein-sparing effect of ketone bodies identified during injury.

KEY WORDS: • DL-3-hydroxybutyrate • leucine kinetics • glucose kinetics • burn injury

¹ Supported in part by grants GM-24206, awarded by the National Institute of General Medical Sciences, AM-31933 awarded by the National Institute of Arthritis and RR-05591, awarded by the Research Resources Division of NIH.

² A. Maiz was supported in part with a visiting fellowship from the Pontifícia Universidad Católica de Chile.

³ Reprint requests should be directed to: Bruce R. Bistrian, M.D., Ph.D., Cancer Research Institute, 194 Pilgrim Road, Boston, Massachusetts 02215.

Manuscript received 16 April 1985. Revision accepted 24 September 1985.