Chronic infection is often accompanied by a wasting process, the metabolic basis of which is not fully understood. The aims of the present study were to measure protein and energy metabolism in patients with melioidosis (a serious and antibiotic-refractory Gram-negative bacterial infection which is endemic in South-East Asia) in order to define the metabolic abnormalities that might contribute to wasting. Whole-body protein turnover was measured using the [13C]leucine technique, both in the fasted state and while consuming a high-energy meal. Resting energy expenditure was measured by indirect calorimetry, and total energy expenditure by the bicarbonate/urea method. Results were normalized for fat-free mass, as estimated from skinfold thickness. Protein turnover was increased in melioidosis patients compared with healthy controls during fasting (170.9 compared with 124.1 µmol·kg-1·h-1; P = 0.04), but the net rate of catabolism (22.2 compared with 20.5 µmol·kg-1·h-1; P = 0.77) and the anabolic response to feeding were similar in the two groups. Resting energy expenditure was higher in melioidosis patients compared with controls (191.4 and 157.3 kJ·kg-1·day-1 respectively; P = 0.04), but total energy expenditure (measured in a separate group of eight patients with melioidosis) was low (192.1 kJ·kg-1·day-1). In conclusion, this study found no evidence of metabolic causative factors, such as accelerated net protein catabolism during fasting, a blunted anabolic response to feeding or increased daily energy expenditure, and therefore suggests that reduced energy intake is the prime cause of wasting. The observed normal response to feeding should encourage nutritional approaches to prevent wasting.
Skip Nav Destination
Article navigation
Research Article|
December 13 2000
Protein and energy metabolism in chronic bacterial infection: studies in melioidosis
Nicholas I. PATON;
*St. George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, U.K.
Correspondence: Dr N. I. Paton, Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, Moulmein Road, Singapore 308433 (e-mail [email protected]).
Search for other works by this author on:
Brian ANGUS;
Brian ANGUS
†Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
‡Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford, U.K.
Search for other works by this author on:
Wipada CHAOWAGUL;
Wipada CHAOWAGUL
§Department of Medicine, Sappasitprasong Hospital, Ubon Ratchatani, Thailand
Search for other works by this author on:
Andrew J. SIMPSON;
Andrew J. SIMPSON
†Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
‡Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford, U.K.
Search for other works by this author on:
Yupin SUPUTTAMONGKOL;
Yupin SUPUTTAMONGKOL
†Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Search for other works by this author on:
Marinos ELIA;
Marinos ELIA
║Dunn Clinical Nutrition Centre, Cambridge CB2 2DH, U.K.
Search for other works by this author on:
Graham CALDER;
Graham CALDER
¶Rowett Research Institute, Aberdeen AB2 9SB, U.K.
Search for other works by this author on:
Eric MILNE;
Eric MILNE
¶Rowett Research Institute, Aberdeen AB2 9SB, U.K.
Search for other works by this author on:
Nicholas J. WHITE;
Nicholas J. WHITE
†Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
‡Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford, U.K.
Search for other works by this author on:
George E. GRIFFIN
George E. GRIFFIN
*St. George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, U.K.
†Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Search for other works by this author on:
Publisher: Portland Press Ltd
Received:
February 04 2000
Revision Received:
August 17 2000
Accepted:
September 29 2000
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2001
2001
Clin Sci (Lond) (2001) 100 (1): 101–110.
Article history
Received:
February 04 2000
Revision Received:
August 17 2000
Accepted:
September 29 2000
Citation
Nicholas I. PATON, Brian ANGUS, Wipada CHAOWAGUL, Andrew J. SIMPSON, Yupin SUPUTTAMONGKOL, Marinos ELIA, Graham CALDER, Eric MILNE, Nicholas J. WHITE, George E. GRIFFIN; Protein and energy metabolism in chronic bacterial infection: studies in melioidosis. Clin Sci (Lond) 1 January 2001; 100 (1): 101–110. doi: https://doi.org/10.1042/cs1000101
Download citation file:
Sign in
Don't already have an account? Register
Sign in to your personal account
You could not be signed in. Please check your email address / username and password and try again.
Could not validate captcha. Please try again.
Biochemical Society Member Sign in
Sign InSign in via your Institution
Sign in via your InstitutionGet Access To This Article
Cited By
Open Access for all
We offer compliant routes for all authors from 2025. With library support, there will be no author nor reader charges in 5 journals. Check here |
![]() |