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13 Alterations in Protein Metabolism Due to the Stress of Injury and Infection
Pages 279-284

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From page 279...
... Over a short period of time, the muscle has an adequate reserve of protein to maintain normal function despite accelerated catabolism. However, when the catabolic response is extended over several days or weeks, severe debilitation can occur.
From page 280...
... The increase in muscle protein breakdown is coupled with an increase in the outward transport of amino acids, which is consistent with the role of the muscle to provide amino acid precursors for synthesis elsewhere in the body. The negative amino acid balance persists across the muscle even for a person in the fed state.
From page 281...
... The effect of growth hormone on adult muscle protein metabolism is less clear. It has been recently shown that growth hormone replacement in growth hormone-deficient adults increased lean body mass after six months, but not after 1 month, of growth hormone supplementation (Solomon et al., 1989~.
From page 282...
... Local hyperinsulinemia to an extent comparable to that achieved during a normal meal caused a significant increase in muscle protein synthesis and inward transmembrane transport of phenylalanine (Sakurai et al., 1995~. To extend this observation to the clinical setting, severely burned adults were infused for 7 days at a rate high enough to maintain plasma insulin concentrations of approximately 500 ,uU/ml.
From page 283...
... Thus, it is possible that whereas a higher Can normal protein intake in injured patients normally doesn't provide art added benefit beyond that achieved with a normal intake, a higher protein Natalie becomes beneficial when the system is "primed" by testosterone and/or insulin therapy. Based on currently available data, a diet is recommended for severely injured patients of 1.5 g protein/kg day, with carbohydrate given at a rate Hat supplies approximately the caloric equivalent of the resting energy expenditure.
From page 284...
... 1993b. Short term growth hormone treatment does not increase muscle protein synthesis in experienced weight lifters.

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