Absorption and metabolic effects of enterally administered glutamine in humans

Abstract

To assess absorption and metabolic effects of enterally delivered glutamine, a total of 10 healthy subjects received perfusions of natural L-glutamine at graded infusion rates (ranging from 0 to 126 mmol/h; n = 2-8 subjects at each rate) along with a nonabsorbable marker (polyethylene glycol) through a double-lumen nasojejunal tube. Perfusions were administered after an overnight fast during three consecutive 1- or 2.5-h periods and in a randomized order. In eight subjects, continuous intravenous infusion of D-[6,6-2H2]glucose, L-[1-13C]leucine, and L-[15N]alanine was simultaneously performed. Glutamine was nearly quantitatively absorbed over the 30-cm study segment; estimated Km and Vmax of glutamine absorption were 2.48 and 2.32 mmol/min over the 30-cm study segment. Enteral glutamine administration induced 1) a dose-dependent increase in plasma glutamine level; 2) a rise in the plasma level and appearance rate (Ra) of alanine (from 191 +/- 42 to 213 +/- 51 mumols.kg-1.h-1, P less than 0.05, for 0 and 46.8-mmol/h glutamine infusion rates, respectively) and in plasma levels of glutamate, citrulline, aspartate, and urea; 3) a decline in plasma free fatty acid and glycerol levels; and 4) no change in leucine or glucose Ra. We conclude that glutamine is efficiently absorbed by human jejunum in vivo and may directly inhibit lipolysis, whereas it neither affects proteolysis nor glucose production in healthy postabsorptive humans.