Metabolic handling of 13C labelled tripalmitin in healthy controls and patients with cystic fibrosis
Institute of Human
Nutrition, University of Southampton, Southampton SO16 6YD, UK
Correspondence to: Dr J L Murphy, Clinical Nutrition and Metabolism Unit, Mailpoint 113, Level C West Wing, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
Accepted 5 February
1998
AIM
To examine the
gastrointestinal handling and metabolic disposal of emulsified
[1-13C]palmitic acid esterified into a triglyceride in
nine healthy children and seven patients with cystic fibrosis on enzyme
replacement treatment.
METHODSAfter an
overnight fast, each child was given 10 mg/kg body weight
[1,1,1-13C]tripalmitin with a standardised test
meal of low natural 13C abundance. The total enrichment of
13C was measured using isotope ratio mass spectrometry in
stool collected for a period of up to five days and in breath samples collected over a 24 hour period.
RESULTSThe mean
proportion of administered 13C label excreted in stool was
6% (range, 1-12.7%) in healthy children and 24.6% (range, 0-64%)
in patients with cystic fibrosis. Healthy children excreted 31.3% of
the administered label on their breath (range, 14.2-42.9%). Correcting the excretion of administered 13C label on the
breath for differences in digestion and absorption in patients with
cystic fibrosis increased the difference between individuals from
0-31.3% of administered dose (mean, 17.9%) to 0-49.1% of absorbed
dose (mean, 23.2%) and was poorly related to the amount of
13C label in stool.
CONCLUSIONMeasurements
of breath 13CO2 do not consistently reflect the
gastrointestinal handling of emulsified 13C labelled
tripalmitin because of differences in digestion and absorption in
cystic fibrosis. Further studies need to examine whether "breath
tests" alone can predict with confidence the gastrointestinal handling of other 13C labelled triglycerides and fatty acids.
© 1998 by Archives of Disease in Childhood
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