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Biomedical subjects

P Darling

Publications and source records attributed to P Darling.

27 records · Page 2Linked to original sources

Protein quality and quantity in preterm infants receiving the same energy intake.

Fifteen low-birth-weight appropriate for gestational age infants, weighing 1.3 to 1.6 kg, were assigned to three isocaloric formulas differing in the quantity and form of nitrogen delivered. A balance study was done between 21 and 30 days after birth. Nitrogen retention expressed as milligram per kilogram per 100 kcal of metabolizable energy was greater with the 60:40 whey/casein and with the casein hydrolysate preparations than with the 20:80 whey/casein formula, which provided the same amount of energy (150 kcal/kg/day) but smaller quantities of protein (3.5 g/kg/day) than the two others (4.3 g/kg/day and 4.4 g/kg/day). Weight gain until discharge from the hospital and increment of height and head circumference over a three-month period showed an advantage of the two formulas providing higher intakes of protein. This study suggests that with high-energy intakes, protein quality does not affect nitrogen retention and growth unless the quantity of protein ingested falls below a critical level.

Caseins↗

Continuous infusion of glucose with model assessment: measurement of insulin resistance and beta-cell function in man.

Continuous infusion of glucose with model assessment (CIGMA) is a new method of assessing glucose tolerance, insulin resistance and beta-cell function. It consists of a continuous glucose infusion 5 mg glucose/kg ideal body weight per min for 60 min, with measurement of plasma glucose and insulin concentrations. These are similar to postprandial levels, change slowly, and depend on the dynamic interaction between the insulin produced and its effect on glucose turnover. The concentrations can be interpreted using a mathematical model of glucose and insulin homeostasis to assess insulin resistance and beta-cell function. In 23 subjects (12 normal and 11 with Type 2 (non-insulin-dependent diabetes) the insulin resistance measured by CIGMA correlated with that measured independently by euglycaemic clamp (Rs = 0.87, p less than 0.0001). With normal insulin resistance defined as 1, the median resistance in normal subjects was 1.35 by CIGMA and 1.39 by clamp, and in diabetic patients 4.0 by CIGMA and 3.96 by clamp. In 21 subjects (10 normal and 11 Type 2 diabetic) the beta-cell function measured by CIGMA correlated with steady-state plasma insulin levels during hyperglycaemic clamp at 10 mmol/l (Rs = 0.64, p less than 0.002). The CIGMA coefficient of variability was 21% for resistance and 19% for beta-cell function. CIGMA is a simple, non-labour-intensive method for assessing insulin resistance and beta-cell function in normal and Type 2 diabetic subjects who do not have glycosuria during the test.

Body Weight↗

The half-life of endogenous insulin and C-peptide in man assessed by somatostatin suppression.

The in-vivo half-lives of insulin and C-peptide have been assessed in normal man by a method which examines the decline of endogenously produced insulin and C-peptide after somatostatin suppression of secretion. Venous blood samples were taken each minute from seven normal subjects: i.v. glucose (0.1 g/kg ideal body weight) was given over 1 min to stimulate secretion, followed by a bolus of 250 micrograms of somatostatin-14 and an infusion of a further 250 micrograms somatostatin-14 over the subsequent 30 min. Plasma samples were analysed for C-peptide, glucose and insulin. The initial mono-exponential half-lives over 8 min were 3.9 +/- 0.3 and 10.2 +/- 0.7 min respectively (mean +/- SEM), with subsequent slower declines. Log transformed insulin and C-peptide yielded biphasic declinations which were assessed by a two-pool model. The rate constant of clearance of insulin implied avid uptake, while the kinetics of C-peptide clearance were slower, and irreversible loss might be explained by glomerular filtration alone. The somatostatin suppression method of measuring hormone kinetics could be used for newly described hormones which are not available for in-vivo studies.

Adult↗

Human ultralente insulin.

The greater solubility of human insulin and its possible faster action have led to doubts about whether a sufficiently long acting formulation could be produced to provide a basal supply for diabetics. In a double blind crossover study in 18 diabetics human ultralente insulin was as effective as beef ultralente insulin in controlling basal plasma glucose concentrations (median 5.7 mmol/l (103 mg/100 ml) with human and 6.3 mmol/l (114 mg/100 ml) with beef ultralente insulin respectively). There was no significant difference between human and bovine insulin in the rise in plasma glucose concentration from 0400 to 0700 after an injection the previous morning and no difference between patients receiving an adequate or insufficient dose of human ultralente insulin. Bovine insulin antibody binding was reduced with human insulin (p less than 0.002), which suggests that human insulin is less antigenic than beef insulin. Once daily human ultralente insulin provides a suitable formulation for the basal insulin requirement of diabetics.

Adult↗

The composition of preterm milk in relation to the degree of prematurity.

Fifty-one samples of 24-h milk collections obtained during the 1st month of lactation from mothers who delivered after gestations of 26 to 31 wk (VPT) contained higher concentrations of nitrogen (297 +/- 11 mg/dl), total fatty acids (4.46 +/- 0.17 g/dl), percentage medium chain fatty acids (10.8 +/- 0.7), and energy (78.3 +/- 2.0 kcal/dl) than either or both those from 32 to 36 wk (PT) and term (T) gestations. PT collections did not differ from T milk with regard to nitrogen (250 +/- 13 versus 259 +/- 13), total fatty acids (3.94 +/- 0.20 versus 3.20 +/- 0.30), percentage medium chain fatty acids (9.1 +/- 0.5 versus 8.1 +/- 0.7) and energy (69.0 +/- 2.7 versus 66.6 +/- 2.4). Although postpartum age (5 to 10 versus 11 to 30 days) did not change the nutrient and energy content of VPT, PT, and T collections, it is only in 11 to 30 day VPT milk that nitrogen and energy content became higher (p less than 0.05) than either or both PT and T milk. We conclude that the differences in macronutrient composition of PT milk are limited to VPT milk and the data from repeated milk collections in the same mother (28 wk) suggest that there is considerable variability in its composition.

Amino Acids↗

No glycemic benefit from guar administration in NIDDM.

A randomized crossover study of 5-g guar minitablets against placebo, given three times per day with main meals for 8 wk, was done in 29 non-insulin-dependent diabetes mellitus (NIDDM) patients who had near-normal fasting plasma glucose concentrations on treatment with diet alone, additional sulfonylurea, or ultralente insulin. Guar did not reduce the excessive postprandial glycemic excursion, glycosylated hemoglobin values, basal plasma glucose concentrations, basal or incremental plasma C-peptide values, or body weight. There were few side effects with either guar or placebo therapy. Mean low-density lipoprotein cholesterol levels were significantly reduced (P less than .001) by guar administration (116 +/- 23 vs. 104 +/- 19 mg/dl). Guar additives did not improve the excessive postprandial glycemia found in NIDDM patients in whom near-normal fasting plasma glucose levels had been obtained.

Adult↗

Use of amino acid profiles of preterm and term human milks in evaluating scoring patterns for routine protein quality assessment of infant formulas.

Reports on the amino acid composition of human milk vary considerably with respect to concentrations of sulfur amino acids. Often, analyses forego tryptophan determination. A complete analysis of protein and amino acid concentrations was performed on human milk samples (5-10 days postpartum) collected from mothers of preterm (gestations of 25-32 weeks) and term (gestations of > 36 weeks) infants. Careful attention was given to quantitate amino acids such as cysteine and tryptophan, which are vulnerable to acidic hydrolysis conditions. Differences in concentrations of total amino acids (expressed on protein basis) between preterm and term milks were small, despite the higher true protein content of preterm milk versus term milk (19.20 versus 12.60 g/L). The methionine + cyst(e)ine contents of term and preterm milks (3.72-3.84 g/100 g protein) were comparable with those reported in 1991 by the Food and Agricultural Organization/World Health Organization (FAO/WHO) for mature human milk (4.20 g/100 g protein) but higher than those reported in 1991 by the European Commission (2.9 g/100 g protein). The amino acid pattern of human milk obtained in this study confirms that the 1991 FAO/WHO amino acid scoring pattern for predicting protein quality of infant formulas is representative of the amino acid quality of both preterm and term human milks.

Amino Acids↗