ZINC AND COPPER EXCRETION AND ABSORPTION IN INFANTS WITH OSTOMIES

造口婴儿的锌和铜排泄和吸收

• 批准号: 8166718
• 负责人: STEVEN A ABRAMS
• 金额: $ 1.55万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2010-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8166718
• 关键词: Calories; Ceruloplasmin; Computer Retrieval of Information on Scientific Projects Database; Copper; Data; Enteral Feeding; Enteral Nutrition; Equilibrium; Excretory function; Feces; Funding; Grant; Hour; Ileostomy; Infant; Institution; Intestines; Measures; Metabolism; Operative Surgical Procedures; Ostomy; Output; Patients; Pilot Projects; Population; Premature Infant; Research; Research Personnel; Resources; Serum; Serum zinc level result; Source; Time; Total Parenteral Nutrition; United States National Institutes of Health; Zinc; absorption; design; stable isotope

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We propose to examine the absorption and excretion of zinc and copper in infants with ostomies. This will be accomplished by measuring baseline excretion and serum levels of zinc, copper, and ceruloplasmin, and by utilizing stable isotopes of zinc and copper to measure absorption and excretion. When an infant with an ostomy is receiving primarily total parenteral nutrition (TPN) with minimal or no enteral feeds, we will collect ostomy output for 24 hours to measure zinc and copper excretion, and will measure serum zinc, copper, and ceruloplasmin levels. We will utilize stable isotopes of zinc and copper at two time points: when the infant still has the ostomy and is receiving primarily enteral nutrition without TPN, and lastly, when/if the patient s ostomy is removed with the bowels reanastamosed and the patient is stable on enteral feeds. For the first part of the study, excretion data for zinc will be obtained for ostomy patients. We hypothesize that infants with an ostomy will excrete more zinc in their stools than healthy term or preterm infants without ostomies. For the second part of the study, we will obtain data on zinc absorption, secretion, and excretion through use of stable isotopes. Jalla et al determined that healthy infants retain zinc of 0.4 mg/day. We hypothesize that due to increased zinc losses, the infants in the study will be less positive than the healthy infants in the study by Jalla et al. Our study is designed to be able to detect if the ostomy patients net retention is one-half that described by Jalla (i.e. 0.2 mg/d). We will also obtain data on copper absorption, secretion, and excretion through the use of stable isotopes in the second part of the study. As a pilot study, we do not fully know what to expect regarding copper levels in infants with ostomies, but we hypothesize that they may be less positive than healthy infants without ostomies. Also, we hypothesize that zinc and copper are competitively absorbed in the gut; therefore, infants who receive more zinc may absorb less copper. For the third part of the study, we will obtain data on zinc absorption through the use of stable isotopes after the infant has had surgery to reanastamose the bowel. We hypothesize that there may be continued zinc losses above those documented for healthy infants who have never had an ostomy, but decreased losses compared to when the infant had an ostomy. To determine how the presence of an ileostomy impacts zinc and copper metabolism in infants at three time points: 1) when the infant has an ostomy and is receiving the majority of calories from total parenteral nutrition (TPN); 2) when the infant has an ostomy and is receiving primarily enteral nutrition without TPN; and 3) when/if the infant has a surgery to reconnect the bowel and is receiving primarily enteral nutrition. The primary objective of this study revolves around part 2, the stable isotope portion of zinc and copper absorption, secretion, and excretion in infants with an ostomy. There is currently no data available in this population for zinc balance.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 我们建议检查造口婴儿体内锌和铜的吸收和排泄情况。这将通过测量锌、铜和铜蓝蛋白的基线排泄和血清水平，并利用锌和铜的稳定同位素来测量吸收和排泄来实现。当造口婴儿主要接受全肠外营养 (TPN) 且极少或无肠内喂养时，我们将收集 24 小时的造口输出以测量锌和铜的排泄，并测量血清锌、铜和铜蓝蛋白水平。我们将在两个时间点使用锌和铜的稳定同位素：当婴儿仍然有造口术并且主要接受肠内营养而没有 TPN 时，最后，当/如果患者造口术被移除且肠道重新吻合并且患者肠内饲料稳定。 对于该研究的第一部分，将获得造口术患者的锌排泄数据。 我们假设有造口的婴儿会比没有造口的健康足月或早产儿在粪便中排出更多的锌。 对于研究的第二部分，我们将通过使用稳定同位素获得锌吸收、分泌和排泄的数据。 Jalla 等人确定健康婴儿每天保留 0.4 毫克的锌。我们假设，由于锌流失增加，研究中的婴儿的阳性率将低于 Jalla 等人研究中的健康婴儿。我们的研究旨在能够检测造口患者的净保留量是否为 Jalla 描述的一半（即 0.2 毫克/天）。我们还将在研究的第二部分中通过使用稳定同位素获得铜吸收、分泌和排泄的数据。作为一项试点研究，我们并不完全知道造口婴儿的铜水平会如何，但我们假设他们的铜水平可能低于没有造口的健康婴儿。此外，我们假设锌和铜在肠道中竞争性吸收。因此，摄入较多锌的婴儿可能吸收较少的铜。 在研究的第三部分中，我们将在婴儿接受肠道重新吻合手术后通过使用稳定同位素获得锌吸收的数据。我们假设，锌的持续损失可能高于从未做过造口的健康婴儿记录的锌损失，但与婴儿进行造口术时相比，损失有所减少。 确定回肠造口的存在如何在三个时间点影响婴儿的锌和铜代谢：1）当婴儿进行造口并且从全肠外营养（TPN）接收大部分热量时； 2) 当婴儿进行造口术并且主要接受肠内营养但不进行 TPN 时； 3) 当/如果婴儿接受了重新连接肠道的手术并且主要接受肠内营养。 本研究的主要目标围绕第二部分，即造口婴儿中锌和铜吸收、分泌和排泄的稳定同位素部分。目前尚无该人群锌平衡的数据。