F73 NUTRIENT UTILIZATION DURING CONTINUOUS TOTAL PARENTERAL NUTRITION (T.P.N.) AND CYCLIC TOTAL PARENTERAL NUTRITION (C.T.P.N.) IN CHILDREN: PdELIMINARY RESULTS G. Put&, J.L. &es&, C’.- Ricour; INSERM U 34 Lvon. Service de Gastroenterolooie oediatriaue et de nutrition. -, I

a ’ Hopital des Enfants Malades, Paris, France C.T.P.N. has obvious psychological and social advantages in children

requiring long term exclusive parenteral nutrition. However such a cyclic energy and nitrogen intake may induce differences in nutrient utilization (oxydation and storage) and then in body composition as opposed to continous T.P.N. We studied two groups of. children who required long term parenteral nutrition providing glucose (C.H.O.) and aminoacids (A.A.); the first group of patients (group A, 9 children) was on C.T.P.N. (12h infusion at night); in the second group (group B, 3 children) patients were on continuous T.P.N. Oxygen consumption and carbon dioxide production were continuously monitored, through an open circuit system, over 24 hours periods. Nutrient utilization was calculated from the respiratory quotient, the energy balance and the fecal and urinary nitrogen output. The table shows mean values over 24h periods:

Gr A n=9 c.t.p.n.

C.H.O.* intake oxyd. int. 14.4+4.6 + 8.6 2.7 -

A.A.* Fat* oxyd. oxyd. stored 2.05+0.4 1.6+0.6 0.3+0.7 0 - - -

Gr 0 n=3 t.p.n.

16.3+2.7 11+1.7 2.34+4.7 1.2+0.8 0 0.7+0.7 - - -

* g/Kg/24H mean + S.D.

These results show that C.T.P.N. induces important difference particularly in fat metabolism opposed to continuous infusion; this might lead to a quite different body composition whether cycIic or continuous T.P.N. is used.

F74EFFECT OF A PROTEIN SPARING DIET ON LIPOPROTEINS AND SERUM PROTEINS IN iROSiLY OBESE ADOLESCENT PATIENTS. K.Widhalm, D.Zwiauer, W.Strobl. Dept.of Pediatrics. Univ.Vienna. Austria.

Excessiie obesity, wt&ch is resistant to most therapeutic regimens, re- presents a major clinical and social problem even in adolescents. As a part of an integrated therapeutic regimen, liquid protein sparing diets (LPSD) are commonly used in those patients. In order to evaluate metabolic changes after 3 weeks treatment with LPSD (339 prot., 259 CHO, 240 kcal/d), lipoproteins and serum protein were determined in 12 adolescents (8 m., 4 f., mean overweight 72 + 132, 1'2.6 + 1.9 years). Lipoproteins were de- termined by means of LRC-methods, serum protein and albumin by conventio- nal methods, short half time proteins by radial immunodiffusions. Results: Weight loss: 9.4 _r 2.4 kg

Prot.(g/l) Alb.(g/l) Prealb. (mg/l) Trans.(mg/l) RBG(mg/l) before diet 7.7t0.4 4 8 0 1 19839 31632 4113 5112 after diet 7.liO.2* 4:5:0:1 15:9:3:** 307f30 4:5:1:2 4:5:1:2

mg/dl Cholesterol TG VLDL-C LDL-C HDL-C HDL-C/LDL-C before diet 18Ot34 10/+41 96

9:5 13Ot33 38 10 0 296

after diet 125;16" 107+24 79+21** 33: 5 D:417* *o c 0.05. **cl/ 0.001 The significant fall in total cholesterol found after 3 week treatment is mainly due to the fall of LDL-C. Although HDL-C slightly decreased, the atherogenic index improved considerable. All serum proteins, including the short half time proteins remained, inspite of slight decreases within the normal range, indicating sufficient proteins supply. LPSD therefore seem to be suitable for weight reduction in grossly obese adolescents without adverse metabolic effects.

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