Table 6 -.
Whole Body Metabolism of moderate and several ill critically ill populations
| SOFA 1–7 (n=31) | SOFA 8–16 (n=22) | p (t-test) | p (ANCOVA) | |
|---|---|---|---|---|
| Age (years) | 59.1 [52.1, 66.9] |
61.4 [52.8, 71.4] |
0.687 | |
| Sex (male/female) | 20/11 | 18/4 | 0.222 | |
| Body Weight (kg) | 80.5 [74.5, 87.0] |
87.4 [80.3, 95.2] |
0.155 | |
| BMI | 28.2 [26.1, 30.6] |
30.1 [28.1, 32.2]] |
0.252 | |
| Fat-free Mass (kg) | 59.8 [55.3, 64.6] |
66.5 [59.5, 74.4] |
0.097 | |
| Fat Mass (kg) | 14.5 [10.2, 20.7] |
13.9 [10.0, 19.1] |
0.832 | |
| Intracellular H2O (L) |
26.1 [23.7, 28.7] |
29.1 [26.4, 32.1] |
0.100 | 0.151 |
| Extracellular H2O (L) | 17.7 [16.1, 19.5] |
21.0 [18.7, 23.5] |
0.021 | 0.021 |
| Phase Angle | 4.10 [3.69, 4.55] |
3.29 [3.00, 3.62] |
0.004 | 0.0005 |
| CRP (mg/L) | 144.7 [109.9, 190.5] |
153.0 [114.1, 205.2] |
0.770 | 0.802 |
| Glucose (mM) | 7.36 [6.78, 8.00] |
7.53 [6.80, 8.35] |
0.712 | 0.725 |
| REE (kcal/day) | 1822 [1678, 1979] |
1663 [1480, 1869] |
0.184 | 0.025 |
| Blood Pressure Systole (mm Hg) | 121 [115, 127] |
111 [101, 121] |
0.050 | 0.078 |
| Blood Pressure Diastole (mm Hg) | 56.7 [53.6, 60.0] |
59.2 [54.4, 64.4] [54.2, 64.5] |
0.359 | 0.162 |
| Heart Rate (beats/min) | 82.4 [75.7, 89.6] |
93.7 [85.5, 102] |
0.042 | 0.004 |
| Plasma Amino Acids | ||||
| Aspartate | 1.9 [1.6, 2.3] |
1.3 [1.0, 1.7] |
00.023 | 0.0562 |
| Glutamate | 45.4 [37.6, 54.7] |
28.1 [21.7, 36.5] |
0.003 | 0.0067 |
| Hydroxyproline | 5.18 [4.43, 6.06] |
8.41 [6.06, 11.7] |
0.004 | 0.0028 |
| Asparagine | 58.0 [50.1, 67.1] |
65.6 [53.6, 80.3] |
0.304 | 0.6710 |
| Glutamine | 414 [375, 457] |
366 [321, 418] |
0.124 | 0.0679 |
| Citrulline | 19.4 [16.6, 22.7] |
16.6 [12.5, 22.2] |
0.298 | 0.0869 |
| Serine | 62.2 [55.0, 70.4] |
54.9 [45.8, 65.7] |
0.223 | 0.0655 |
| Glycine | 132 [115, 151] |
136 [112, 166] |
0.783 | 0.9020 |
| Arginine | 51.1 [43.2, 60.6] |
42.9 [34.5, 53.2] |
0.188 | 0.0647 |
| Threonine | 102 [87.2, 120] |
90.7 [73.4, 112] |
0.348 | 0.1498 |
| Alanine | 132.6 [110, 159] |
184 [158, 215] |
0.012 | 0.0220 |
| Taurine | 34.8 [27.7, 43.8] |
26.5 [19.1, 36.7]] |
0.149 | 0.1470 |
| Proline | 117.8 [101, 137] |
130 [100, 169] |
0.460 | 0.7419 |
| tau-methyl histidine | 5.18 [3.98, 6.73] |
10.2 [7.37, 14.0] |
0.002 | 0.0215 |
| Valine | 177 [157, 198] |
128 [106, 156] |
0.003 | 0.0011 |
| Methionine | 19.7 [15.8, 24.6] |
23.7 [17.5, 32.3] |
0.303 | 0.578 |
| Isoleucine | 65.8 [58.2, 74.3] |
49.8 [37.6, 66.0] |
0.041 | 0.0152 |
| Leucine | 112 [97.2, 129] |
88.0 [69.2, 112]] |
0.063 | 0.0201 |
| Tryptophan | 24.0 [21.1, 27.3] |
19.8 [15.3, 25.6] |
0.129 | 0.084 |
| Phenylalanine | 61.0 [53.1, 70.0] |
70.0 [56.3, 87.1] |
0.247 | 0.545 |
| Ornithine | 52.0 [43.5, 62.2] |
49.1 [37.0, 65.1] |
0.706 | 0.544 |
| Histidine | 42.3 [38.7, 46.1] |
49.5 [43.2, 56.8] |
0.040 | 0.0877 |
| Lysine | 126 [110, 145] |
131 [109, 157] |
0.756 | 0.955 |
| Tyrosine | 48.0 [40.8, 56.3] |
49.6 [37.4, 65.8] |
0.819 | 0.667 |
| BCAA | 356 [315, 401] |
270 [218, 334] |
0.015 | 0.0043 |
| EAA | 736 [663, 816] |
679 [574, 802] |
0.379 | 0.160 |
| NEAA | 1228 [1110, 1358] |
1241 [1079, 1428] |
0.894 | 0.752 |
| LNAA | 494 [440, 554] |
420 [343, 513] |
0.126 | 0.0337 |
| SumAA | 1816 [1656, 1991] |
1793 [1572, 2045] |
0.869 | 0.441 |
| ICU (n=51) estimated difference with healthy group | P value | % change | ||
| TRP, corrected for LNAA | −1.197 [−4.623 to 2.229] |
0.4854 | - | |
| TYR, corrected for LNAA | 12.69 [2.233 to 23.14] |
0.0185 | 24.1% | |
| Whole body production and conversions | ||||
| Arginine | 11596 [10242, 13128] |
11422 [9852, 13243] |
0.873 | 0.4582 |
| Glycine | 21893 [19437, 24660] |
18422 [16211, 20933]] |
0.053 | 0.0266 |
| Hydroxyproline | 314 [266, 370] |
450 [335, 606] |
0.021 | 0.0155 |
| Citrulline | 880 [780, 993] |
712 [531, 955] |
0.125 | 0.0275 |
| Phenylalanine | 5965 [5425, 6560] |
6228 [5447, 7121] |
0.580 | 0.9582 |
| tau-methyl histidine | 98.8 [78.3, 125] |
195 [134, 286] |
0.002 | 0.0244 |
| Methionine | 2650 [2243, 3131] |
2646 [2114, 3312] |
0.990 | 0.7562 |
| Tyrosine | 5084 [4582, 5641] |
5309 [4546, 6199] |
0.621 | 0.9950 |
| Tryptophan | 2058 [1861, 2277] |
1800 [1604, 2020] |
0.082 | 0.0800 |
| Glutamate | 175317 [146233, 210185] |
131683 [101450, 170926] |
0.061 | 0.0501 |
| Isoleucine | 5746 [4943, 6678] |
4972 [4109, 6017] |
0.223 | 0.2268 |
| Histidine | 4425 [3923, 4992] |
4435 [3784, 5197] |
0.982 | 0.9050 |
| Glutamine | 59549 [54404, 65180] |
49636 [42979, 57323] |
0.024 | 0.0320 |
| Taurine | 3361 [2809, 4022] |
3296 [2748, 3952] |
0.871 | 0.8506 |
| Valine | 17361 [15904, 18952] |
16510 [14698, 18546] |
0.473 | 0.1692 |
| Leucine | 17341 [15824, 19003] |
17022 [15267, 18978] |
0.790 | 0.5994 |
| Ornithine | 3167 [2791, 3594] |
2938 [2334, 3698] |
0.526 | 0.2871 |
| Essential Amino Acids | 56420 [51785, 61470] |
55571 [49714, 62119] |
0.822 | 0.4464 |
| Branched-Chain Amino Acids | 40881 [37598, 44450] |
38864 [34843, 43350] |
0.447 | 0.2235 |
| Glutamate ➨ Glutamine | 60670 [49503, 74356] |
43849 [32001, 60082] |
0.067 | 0.0860 |
| Citrulline ➨ Arginine | 785 [678, 909] |
423 [298, 602] |
0.0004 | 0.0001 |
| Arginine ➨ Citrulline | 92.5 [70.5, 121] |
83.3 [60.3, 115] |
0.611 | 0.8116 |
| Arginine ➨ Ornithine | 3926 [3321, 4641] |
3558 [2833, 4468] |
0.486 | 0.3184 |
| Ornithine ➨ Citrulline | 86.9 [59.7, 126] |
78.8 [57.7, 108]] |
0.675 | 0.6795 |
| Citrulline ➨ Ornithine | 266 [213, 331] |
133 [94.8, 188] |
0.0006 | 0.0004 |
| Phenylalanine ➨ Tyrosine | 263 [214, 324] |
138 [93.6, 204] |
0.0020 | 0.008 |
| Whole Body Clearance | ||||
| SOFA 8–16 estimated difference with SOFA 1–7 group | P value | % change | ||
| Arginine | −529 [−2732, 1674] |
0.6312 | - | |
| Glycine | −4183 [−7677, −689] |
0.0201 | −18.1% | |
| Hydroxyproline | −64.3 [−145, 15.9] |
0.1135 | - | |
| Citrulline | −22.8 [−161, 115] |
0.7408 | - | |
| Phenylalanine | 81.7 [−582, 745] |
0.8054 | - | |
| tau-methyl histidine | −12.8 [−20.8, −4.91] |
0.0021 | −10.4% | |
| Methionine | −191 [−1057, 675] |
0.6581 | ||
| Tyrosine | −41.0 [−806, 724] |
0.9145 | ||
| Tryptophan | −113 [−324, 98.6] |
0.2883 | - | |
| Glutamate | −36258 [−87057, 14542] |
0.1574 | - | |
| Isoleucine | −591 [−2075, 894] |
0.4269 | - | |
| Histidine | −217 [−945, 512] |
0.5527 | - | |
| Glutamine | −8490 [−15315, −1665] |
0.0160 | −14.0% | |
| Taurine | −89.2 [−1033, 854] |
0.8482 | - | |
| Valine | 193 [−1506, 1892] |
0.8201 | - | |
| Leucine | 155 [−1722, 2031] |
0.8689 | - | |
| Ornithine | −251 [−908, 407] |
0.4465 | - | |
Values are geometric mean [95% CI] or mean (estimated differences), plasma concentration in μM, whole body production and conversions in μmol/h. Statistics are on logtransformed data by unpaired t-test (p ttest) (except sex: Mann-Whitney test) or ANCOVA (p ANCOVA) when data are corrected for confounders sex, age and BMI. For clearance calculation, ANCOVA with WBP as dependent and plasma concentration as independent. Values (μmol/hour) are estimated differences with SOFA 1–7 group. % change is estimated difference mean divided by WBP mean of the SOFA 1–7 group. Bold is p<0.05.