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Abnormalities of whole body protein turnover, muscle metabolism and levels of metabolic hormones in patients with chronic heart failure.
J Intern Med. 2006 Jul; 260(1):11-21.JI

Abstract

OBJECTIVE

It is well known that chronic heart failure (CHF) is associated with insulin resistance and cachexia, but little is known about the underlying substrate metabolism. The present study was undertaken to identify disturbances of basal glucose, lipid and protein metabolism.

DESIGN

We studied eight nondiabetic patients with CHF (ejection fraction 30 +/- 4%) and eight healthy controls. Protein metabolism (whole body and regional muscle fluxes) and total glucose turnover were isotopically assayed. Substrate oxidation were obtained by indirect calorimetry. The metabolic response to exercise was studied by bicycle ergometry exercise.

RESULTS

Our data confirm that CHF patients have a decreased lean body mass. CHF patients are characterised by (i) decreased glucose oxidation [glucose oxidation (mg kg(-1) min(-1)): 1.25 +/- 0.09 (patients) vs. 1.55 +/- 0.09 (controls), P < 0.01] and muscle glucose uptake [a - v diff(glucose) (micromol L(-1)): -10 +/- 25 (patients) vs. 70 +/- 22 (controls), P < 0.01], (ii) elevated levels of free fatty acids (FFA) [FFA (mmol L(-1)): 0.72 +/- 0.05 (patients) vs. 0.48 +/- 0.03 (controls), P < 0.01] and 3-hydroxybutyrate and signs of elevated fat oxidation and muscle fat utilization [a - v diff(FFA) (mmol L(-1)): 0.12 +/- 0.02 (patients) vs. 0.05 +/- 0.01 (controls), P < 0.05] and (iii) elevated protein turnover and protein breakdown [phenylalanine flux (micromol kg(-1) h(-1)): 36.4 +/- 1.5 (patients) vs. 29.6 +/- 1.3 (controls), P < 0.01]. Patients had high circulating levels of noradrenaline, glucagon, and adiponectin, and low levels of ghrelin. We failed to observe any differences in metabolic responses between controls and patients during short-term exercise.

CONCLUSIONS

In the basal fasting state patients with CHF are characterized by several metabolic abnormalities which may contribute to CHF pathophysiology and may provide a basis for targeted intervention.

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Authors+Show Affiliations

Nørrelund H
Medical Department M (Endocrinology and Diabetes), Aarhus Universitets-Hospital, Aarhus, Denmark. helenenorrelund@dadlnet.dk
Wiggers H
No affiliation info available
Halbirk M
No affiliation info available
Frystyk J
No affiliation info available
Flyvbjerg A
No affiliation info available
Bøtker HE
No affiliation info available
Schmitz O
No affiliation info available
Jørgensen JO
No affiliation info available
Christiansen JS
No affiliation info available
Møller N
No affiliation info available

MeSH

AgedAmino AcidsBlood GlucoseBody Mass IndexCalorimetry, IndirectExerciseExercise TestFatty Acids, NonesterifiedForearmHeart FailureHormonesHumansLipid MetabolismMaleMiddle AgedMusclesOxidation-ReductionProteinsRegional Blood Flow

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16789974

Citation

Nørrelund, H, et al. "Abnormalities of Whole Body Protein Turnover, Muscle Metabolism and Levels of Metabolic Hormones in Patients With Chronic Heart Failure." Journal of Internal Medicine, vol. 260, no. 1, 2006, pp. 11-21.
Nørrelund H, Wiggers H, Halbirk M, et al. Abnormalities of whole body protein turnover, muscle metabolism and levels of metabolic hormones in patients with chronic heart failure. J Intern Med. 2006;260(1):11-21.
Nørrelund, H., Wiggers, H., Halbirk, M., Frystyk, J., Flyvbjerg, A., Bøtker, H. E., Schmitz, O., Jørgensen, J. O., Christiansen, J. S., & Møller, N. (2006). Abnormalities of whole body protein turnover, muscle metabolism and levels of metabolic hormones in patients with chronic heart failure. Journal of Internal Medicine, 260(1), 11-21.
Nørrelund H, et al. Abnormalities of Whole Body Protein Turnover, Muscle Metabolism and Levels of Metabolic Hormones in Patients With Chronic Heart Failure. J Intern Med. 2006;260(1):11-21. PubMed PMID: 16789974.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abnormalities of whole body protein turnover, muscle metabolism and levels of metabolic hormones in patients with chronic heart failure. AU - Nørrelund,H, AU - Wiggers,H, AU - Halbirk,M, AU - Frystyk,J, AU - Flyvbjerg,A, AU - Bøtker,H E, AU - Schmitz,O, AU - Jørgensen,J O L, AU - Christiansen,J S, AU - Møller,N, PY - 2006/6/23/pubmed PY - 2006/8/1/medline PY - 2006/6/23/entrez SP - 11 EP - 21 JF - Journal of internal medicine JO - J Intern Med VL - 260 IS - 1 N2 - OBJECTIVE: It is well known that chronic heart failure (CHF) is associated with insulin resistance and cachexia, but little is known about the underlying substrate metabolism. The present study was undertaken to identify disturbances of basal glucose, lipid and protein metabolism. DESIGN: We studied eight nondiabetic patients with CHF (ejection fraction 30 +/- 4%) and eight healthy controls. Protein metabolism (whole body and regional muscle fluxes) and total glucose turnover were isotopically assayed. Substrate oxidation were obtained by indirect calorimetry. The metabolic response to exercise was studied by bicycle ergometry exercise. RESULTS: Our data confirm that CHF patients have a decreased lean body mass. CHF patients are characterised by (i) decreased glucose oxidation [glucose oxidation (mg kg(-1) min(-1)): 1.25 +/- 0.09 (patients) vs. 1.55 +/- 0.09 (controls), P < 0.01] and muscle glucose uptake [a - v diff(glucose) (micromol L(-1)): -10 +/- 25 (patients) vs. 70 +/- 22 (controls), P < 0.01], (ii) elevated levels of free fatty acids (FFA) [FFA (mmol L(-1)): 0.72 +/- 0.05 (patients) vs. 0.48 +/- 0.03 (controls), P < 0.01] and 3-hydroxybutyrate and signs of elevated fat oxidation and muscle fat utilization [a - v diff(FFA) (mmol L(-1)): 0.12 +/- 0.02 (patients) vs. 0.05 +/- 0.01 (controls), P < 0.05] and (iii) elevated protein turnover and protein breakdown [phenylalanine flux (micromol kg(-1) h(-1)): 36.4 +/- 1.5 (patients) vs. 29.6 +/- 1.3 (controls), P < 0.01]. Patients had high circulating levels of noradrenaline, glucagon, and adiponectin, and low levels of ghrelin. We failed to observe any differences in metabolic responses between controls and patients during short-term exercise. CONCLUSIONS: In the basal fasting state patients with CHF are characterized by several metabolic abnormalities which may contribute to CHF pathophysiology and may provide a basis for targeted intervention. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/16789974/Abnormalities_of_whole_body_protein_turnover_muscle_metabolism_and_levels_of_metabolic_hormones_in_patients_with_chronic_heart_failure_ L2 - https://doi.org/10.1111/j.1365-2796.2006.01663.x DB - PRIME DP - Unbound Medicine ER -