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Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis

Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis
Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis
Background & aims: some patients with cystic fibrosis continue to have excessive losses of stool lipid, despite the use of pancreatic enzyme replacement therapy to improve digestion. The aim of this study was to explore the residual capacity of the gastrointestinal tract to digest and absorb dietary lipid using stable isotopic methodology in ten patients with cystic fibrosis who were gastrostomy fed in comparison to eight healthy children. We sought to test the hypothesis that a reduction in the availability of dietary lipid may arise from malabsorption of the products of digestion, rather than maldigestion alone.
Methods: all subjects consumed [1,1,1-13C] tripalmitin (10 mg/kg body weight) with a standardised meal but the patients with cystic fibrosis did not take their habitual pancreatic enzymes. Total enrichment of 13C was measured by isotope ratio mass spectrometry in stools collected over 3 days. Maldigestion and malabsorption was differentiated by measuring 13C-label excretion in stool triglyceride and fatty acid fractions, respectively.
Results: the patients with cystic fibrosis had elevated 13C-label losses in total stools (56.7%, 6.8–77.9%)(median and range; % administered dose), triglyceride (6.6%, 0–31.2%) and fatty acid (16.7%, 3.4–50.3%) fractions compared to healthy children (1.9%, 0–10.9%, P<0.001; triglyceride: 0.2%, 0–0.6%, P<0.01; fatty acid 0.9%, 0–6.5%, P<0.001).
Conclusions: these results highlight differences between gastrostomy fed patients with cystic fibrosis to both digest and absorb dietary lipid. There is a need to extend these observations and apply this approach to patients both with and without pancreatic enzyme replacement therapy.
stable isotopes, long chain fatty acids, digestion, absorption, cystic fibrosis
0261-5614
347-353
Laiho, Kirsi M.
aa0d2e34-a2ed-45ff-b1e4-0b7d4100ec82
Gavin, Joan
09064cc2-7f5e-4c0d-a891-8d4a53165d7c
Murphy, Jane L.
843d5062-b3b3-46a1-9a43-993f04af419a
Connett, Gary J.
55d5676c-90d8-46bf-a508-62eded276516
Wootton, S.A.Stephen A.
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Laiho, Kirsi M.
aa0d2e34-a2ed-45ff-b1e4-0b7d4100ec82
Gavin, Joan
09064cc2-7f5e-4c0d-a891-8d4a53165d7c
Murphy, Jane L.
843d5062-b3b3-46a1-9a43-993f04af419a
Connett, Gary J.
55d5676c-90d8-46bf-a508-62eded276516
Wootton, S.A.Stephen A.
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c

Laiho, Kirsi M., Gavin, Joan, Murphy, Jane L., Connett, Gary J. and Wootton, S.A.Stephen A. (2004) Maldigestion and malabsorption of 13C labelled tripalmitin in gastrostomy-fed patients with cystic fibrosis. Clinical Nutrition, 23 (3), 347-353. (doi:10.1016/j.clnu.2003.08.002).

Record type: Article

Abstract

Background & aims: some patients with cystic fibrosis continue to have excessive losses of stool lipid, despite the use of pancreatic enzyme replacement therapy to improve digestion. The aim of this study was to explore the residual capacity of the gastrointestinal tract to digest and absorb dietary lipid using stable isotopic methodology in ten patients with cystic fibrosis who were gastrostomy fed in comparison to eight healthy children. We sought to test the hypothesis that a reduction in the availability of dietary lipid may arise from malabsorption of the products of digestion, rather than maldigestion alone.
Methods: all subjects consumed [1,1,1-13C] tripalmitin (10 mg/kg body weight) with a standardised meal but the patients with cystic fibrosis did not take their habitual pancreatic enzymes. Total enrichment of 13C was measured by isotope ratio mass spectrometry in stools collected over 3 days. Maldigestion and malabsorption was differentiated by measuring 13C-label excretion in stool triglyceride and fatty acid fractions, respectively.
Results: the patients with cystic fibrosis had elevated 13C-label losses in total stools (56.7%, 6.8–77.9%)(median and range; % administered dose), triglyceride (6.6%, 0–31.2%) and fatty acid (16.7%, 3.4–50.3%) fractions compared to healthy children (1.9%, 0–10.9%, P<0.001; triglyceride: 0.2%, 0–0.6%, P<0.01; fatty acid 0.9%, 0–6.5%, P<0.001).
Conclusions: these results highlight differences between gastrostomy fed patients with cystic fibrosis to both digest and absorb dietary lipid. There is a need to extend these observations and apply this approach to patients both with and without pancreatic enzyme replacement therapy.

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More information

Published date: June 2004
Keywords: stable isotopes, long chain fatty acids, digestion, absorption, cystic fibrosis

Identifiers

Local EPrints ID: 25742
URI: https://eprints.soton.ac.uk/id/eprint/25742
ISSN: 0261-5614
PURE UUID: 7c98ad9e-8185-4b28-a0b7-c2eff39c55d1
ORCID for Gary J. Connett: ORCID iD orcid.org/0000-0003-1310-3239

Catalogue record

Date deposited: 10 Apr 2006
Last modified: 06 Jun 2018 12:10

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