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Urea kinetics in healthy women during normal pregnancy

Published online by Cambridge University Press:  09 March 2007

Irene S. M. McClelland
Affiliation:
Department of Human Nutrition, University of Southampton, Southampton SO16 7PX
Chandarika Persaud
Affiliation:
Department of Human Nutrition, University of Southampton, Southampton SO16 7PX
Alan A. Jackson
Affiliation:
Department of Human Nutrition, University of Southampton, Southampton SO16 7PX
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Abstract

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Urea kinetics were measured in normal women aged 22-34 years at weeks 16, 24 and 32 on either their habitual protein intake (HABIT.) or a controlled intake of 60 g protein/d (CONTROL), using primed-intermittent oral doses of [15N15N]urea and measurement of plateau enrichment in urinary urea over 18 h (ID) or a single oral dose of [15N15N]urea and measurement of enrichment of urea in urine over the following 48 h (SD). The intake of protein during HABIT-ID (80 g/d) was greater than that on HABIT-SD (71 g/d); urea production as a percentage of intake was significantly greater at week 16 for HABIT-ID than HABIT-SD, whereas urea hydrolysis at week 16 was greater for HABIT-SD than HABIT-ID and urea excretion at week 32 was greater for HABIT-ID than HABIT SD. The combined results for HABIT-ID and HABIT-SD showed a significant reduction in urea production at week 32 compared with week 24. Urea excretion decreased significantly from week 16 to week 24 with no further decrease to week 32 and urea hydrolysis was significantly greater at week 24 than either week 16 or week 32. Compared with HABIT, on CONTROL there was a decrease in urea production at week 16, and urea excretion was significantly reduced at week 16. For all time periods urea production was closely related to the sum of intake plus hydrolysis. Hydrolysis was greatest at week 24 and closely related to urea production. There was a significant inverse linear relationship overall for hydrolysis as a proportion of production and excretion as a proportion of intake. The results show that on HABIT N is more effectively conserved in mid-pregnancy through an increase in urea hydrolysis and salvage, and during late pregnancy through a reduction in urea formation. Lowering protein intake at any stage of pregnancy increased the hydrolysis and salvage of urea. The staging of these changes was later than that in pregnancy in Jamaica.

Type
Human and Clinical Nutrition
Copyright
Copyright © The Nutrition Society 1997

References

REFERENCES

Barker, D. J. P. (1992). The Fetal and Infant Origins of Adult Disease. London: BMJ Publishing Group.Google Scholar
Calloway, D. H. (1974). Nitrogen balance during pregnancy. In Nutrition and Fetal Development, pp. 7994 [Winnick, M. editor]. New York: Wiley and Sons.Google Scholar
Christensen, H. M. (1992). Amino acid nutrition across the placenta. Nutrition Reviews 50, 1324.Google Scholar
Committee on Medical Aspects of Food Policy (1991). Dierary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41. London: H. M. Stationery Office.Google Scholar
Danielsen, M. & Jackson, A. A. (1992). Limits of adaptation to a diet low in protein in normal man: urea kinetics. Clinical Science 83, 103108.CrossRefGoogle ScholarPubMed
de Benoist, B., Jackson, A. A., Hall, J. S. E. & Persaud, C. (1985). Whole-body protein turnover in Jamaican women during normal pregnancy. Human Nutrition: Clinical Nutrition 39C, 167179.Google Scholar
Department of Health and Social Security (1979). Recommended Daily Amounts of Food Energy and Nutrients for Groups of People in the UK. London: H. M. Stationery Office.Google Scholar
Food and Agriculture Organization/World Health Organization/United Nations University (1985). Energy and Protein Requirements. WHO Technical Report Series no. 552. Geneva: WHO.Google Scholar
Forrester, T., Badaloo, A. V., Persaud, C. & Jackson, A. A. (1994). Urea production and salvage during pregnancy in normal Jamaican women. American Journal of Clinical Nutrition 60, 341346.CrossRefGoogle ScholarPubMed
Godfrey, K., Robinson, S., Barker, D. J. P., Osmond, C. & Cox, V. (1996). Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. British Medical Journal 312, 410414.CrossRefGoogle ScholarPubMed
Graham, D. Y., Klein, P. D., Evans, D. J., Evans, D. G., Alpert, L. C., Opekun, A. R. & Boutton, T. W. (1987). Campylobacter pylori detected non-invasively by the 13C-urea breath test. Lancet i, 11741177.CrossRefGoogle Scholar
Harper, A. E., Benevenga, N. J. & Wohlhueter, R. M. (1970). Effects of ingestion of disproportionate amounts of amino acids. Physiological Reviews 50, 428458.Google Scholar
Hibbert, J. M., Forrester, T. & Jackson, A. A. (1992). Urea kinetics: comparison of oral and intravenous dose regimens. European Journal of Clinical Nutrition 45, 405409.Google Scholar
Hytten, H. E. & Leitch, I. (1971). The Physiology of Human Pregnancy. Oxford: Blackwell Scientific Publications.Google Scholar
Jackson, A. A. (1989). Optimizing amino acid and protein supply and utilization in the newborn. Proceedings of the Nutrition Society 48, 293301.CrossRefGoogle ScholarPubMed
Jackson, A. A. (1993). Chronic malnutrition: protein metabolism. Proceedings of the Nutrition Society 52, 110.CrossRefGoogle ScholarPubMed
Jackson, A. A. (1994). Urea as a nutrient: bioavailability and role in nitrogen economy. Archives of Disease in Childhood 70, 34.Google Scholar
Jackson, A. A. (1995). Salvage of urea-nitrogen and protein requirements. Proceedings of the Nutrition Society 54, 535547.Google Scholar
Jackson, A. A., Danielsen, M. S. & Boyes, S. (1993). A non-invasive method for measuring urea kinetics with a single dose of [15N15N]urea in free-living humans. Journal of Nutrition 123, 21292136.Google Scholar
Jackson, A. A., Golden, M. H. N., Jahoor, P. F. & Landman, J. P. (1980). The isolation of urea-N and ammonia-N from biological samples for mass spectrometry. Analytical Biochemistry 105, 1417.Google Scholar
Jackson, A. A., Persaud, C., Werkmeister, G., McClelland, I. S. M., Badaloo, A. & Forrester, T. (1997). Comparison of urinary 5-L-oxoproline (L-pyroglutamate) during normal pregnancy in women in England and Jamaica. British Journal of Nutrition 77, 183196.Google Scholar
Jackson, A. A., Picou, D. & Landman, J. (1984). The non-invasive measurement of urea kinetics in normal man by a constant infusion of 15N15N-urea. Human Nutrition: Clinical Nutrition 38C, 339354.Google Scholar
Jackson, A. A. & Wootton, S. A. (1990). The energy requirements of growth and catch-up growth. In Activity, Energy Expenditure and Energy Requirements of Infants and Children, pp. 185214. [Schurch, B. and Scrimshaw, N. S. editors]. Lausanne, Switzerland: IDECG.Google Scholar
Johnstone, F. D., Campbell, D. M. & MacGillvray, I. (1981). Nitrogen balance studies in human pregnancy. Journal of Nutrition 111, 18841893.Google Scholar
Kalhan, S. C., Tserng, K. Y., Gilfillan, C. & Dierker, L. J. (1982). Metabolism of urea and glucose in normal and diabetic pregnancy. Metabolism 31, 824833.CrossRefGoogle ScholarPubMed
Kaplan, A. (1965). Urea nitrogen and ammonia nitrogen. In Standard Methods in Clinical Chemistry. pp. 245256 [Meites, S. editor]. New York: Academic Press.Google Scholar
King, J. C. (1975). Protein metabolism during pregnancy. Clinics in Perinatology 2, 243254.Google Scholar
Kramer, M. S. (1987). Determinants of low birthweight: methodological assessment and meta-analysis. Bulletin of the World Health Organization 65, 663737.Google ScholarPubMed
Langley, S. C. & Jackson, A. A. (1994). Increased systolic blood presure in adult rats caused by fetal exposure to maternal low protein diets. Clinical Science 86, 217222.CrossRefGoogle Scholar
Langran, M., Moran, B. J., Murphy, J. L. & Jackson, A. A. (1992). Adaptation to a diet low in protein: effect of complex carbohydrate upon urea kinetics in normal man. Clinical Science 82, 191198.Google Scholar
Lemons, J. A. & Schreiner, R. L. (1984). Metabolic balance of the ovine fetus during the fed and fasted states. Annals of Nutrition and Metabolism 28, 268280.CrossRefGoogle ScholarPubMed
McClelland, I. S. M. & Jackson, A. A. (1996). Urea kinetics in healthy young women: minimal effect of stage of menstrual cycle, contraceptive pill and protein intake. British Journal of Nutrition 76, 199209.CrossRefGoogle ScholarPubMed
Mayel-Afshar, S. & Grimble, F. R. (1983). Changes in protein turnover during gestation in the foetuses, placentas, liver, muscle and whole body of rats given low protein diet. Biochimica et Biophysica Acra 756, 182190.Google Scholar
Meakins, T. S. & Jackson, A. A. (1996). Salvage of exogenous urea-nitrogen enhances nitrogen balance in normal men consuming marginally inadequate protein diets. Clinical Science 90, 215225.Google Scholar
Millward, D. J. (1992). The metabolic basis of amino acid requirements. In Protein-energy Interactions, pp. 3136 [Scrimshaw, N. S. and Schurch, B. editors]. Vevey, Switzerland: IDECG.Google Scholar
Naismith, D. J. & Morgan, B. L. G. (1976). The biphasic nature of protein metabolism during pregnancy in the rat. British Journal of Nutrition 36, 563566.Google Scholar
National Academy of Sciences (1990). Nutrition During Pregnancy Part 1, Weight Gain. Washington, DC: National Academy Press.Google Scholar
Olufemi, O. S., Whittaker, P. G. & Lind, T. (1991). Glycine and urea metabolism during normal and diabetic pregnancies. Proceedings of the Nutrition Society 50, 200A.Google Scholar
Picou, D. & Phillips, M. (1972). Urea metabolism in malnourished and recovered children receiving a high or a low protein diet. American Journal of Clinical Nutrition 25, 12611266.CrossRefGoogle ScholarPubMed
Rand, W. M., Uauy, R. & Scrimshaw, N. S. (1984). Protein-energy-requirement studies in developing countries: results of international research. Food and Nutrition Bulletin Suppl. 10.Google Scholar
Rush, D. (1989). Effects of changes in maternal energy and protein intake during pregnancy, with special reference to fetal growth. In Fetal Growth, pp. 203229 [Sharpe, F., Fraser, R. B. and Milner, R. D. G. editors]. London: Springer-Verlag.Google Scholar
Steinbrecher, H. A.Griffiths, D. M. & Jackson, A. A. (1996). Urea kinetics in normal breast-fed infants measured with 15N15N-urea. Acra Paediatrica 85, 656662.Google Scholar
Thompson, G. N. & Halliday, D. (1992). Protein turnover in pregnancy. European Journal of Clinical Nutrition 46, 411417.Google ScholarPubMed
Walser, M., George, J. & Bodenios, L. J. (1954). Altered proportions of isotopes of molecular nitrogen from biological samples for mass spectrometry. Journal of Chemistry and Physics 22, 1146.Google Scholar
Widdowson, E. M., Southgate, D. A. T. & Hey, E. M. (1979). Body composition of the fetus and infant. In Nutrition and Metabolism of the Ferus and Infant, pp. 169177 [Visser, H. A. K. editor]. The Hague: Martinus Nijhoff.Google Scholar
Yeboah, N., Ah-Sing, E., Badaloo, A., Forrester, T., Jackson, A. & Millward, D. J. (1996). Transfer of 15N from urea to the circulating lysine pool in the human infant. Proceedings of the Nutrition Society 55, 37A.Google Scholar
Young, V. R., Bier, D. M. & Pellet, P. L. (1989). A theoretical basis for increasing current estimates of the amino acid requirements in adult men, with experimental support. American Journal of Clinical Nutrition 50, 8092.Google Scholar