Influence of an ω3-fatty acid–enriched enteral diet with and without added glutamine on the metabolic response to injury in a rat model of prolonged acute catabolism

摘要

Abstract Objective In critically ill patients, acute injury alters gut function, causing greater risk for sepsis and malnutrition. Peptide-enriched diets may promote nitrogen absorption, whereas ω3-enriched diets reduce alterations in gut barrier function. The aim of this study was to assess the effectiveness of a peptide- and ω3-enriched diet on the metabolic response to injury and the gut barrier function in a model of prolonged catabolism in the rat. Given the intestinal trophic effect of glutamine, we tested for a synergistic effect of glutamine. Methods We randomized 40 male Sprague-Dawley rats (250?g) into four groups to enterally receive a standard high-protein diet (S), or a peptide- and ω3-enriched diet either alone (IMN) or supplemented with glutamine and alanine supplied as dipeptide (DIP) or as free amino acids (AAs) for 4?d. Metabolic response to injury was induced by turpentine injections on days 1 and 3. At sacrifice, nutritional and inflammatory biomarkers and intestinal and liver function were assessed. Results Weight gain (+45–62%) and nitrogen balance (+33–56%) were significantly higher in all groups than in the S group. In jejunal mucosa, total glutathione was significantly higher (+20–30%) and myeloperoxidase activity significantly lower in all groups compared with the S group. Hepatic?triacylglycerol content was significantly lower in the AA (0.30?±?0.04?μM/g) and DIP (0.43?±?0.08?μM/g) groups than in the S group (0.71?±?0.08?μM/g). Conclusions In this model of prolonged catabolism, compared with a standard diet, a peptide- and ω3-enriched diet improved metabolic response to injury, with better nitrogen balance and weight recovery, and decreased intestinal myeloperoxidase activity. Only marginal additional effects of glutamine supplementation were observed with decreased hepatic fat content. Highlights ? Peptides have better absorption than proteins and ω3 fatty acids exert protective effects on the gut. ? Peptide- and ω3-enriched enteral nutrition may be beneficial in situations of aggression. ? In a model of prolonged catabolism, this enteral diet improved the metabolic response to injury. ? Addition of glutamine had little or no additive effects.