Predictors of muscle protein synthesis after severe pediatric burns

Eva C. Diaz, David Herndon, Jinhyung Lee, Craig Porter, Matthew Cotter, Oscar Suman, Labros S. Sidossis, Elisabet Børsheim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND: Following a major burn, skeletal muscle protein synthesis rate increases but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months after injury and to identify predictors that influence this response. METHODS: A total of 87 children with 40% or greater total body surface area (TBSA) burned were included. Patients participated in stable isotope infusion studies at 1, 2, and approximately 4 weeks after burn and at 6, 12, and 24 months after injury to determine skeletal muscle protein fractional synthesis rate. Generalized estimating equations with log link normal distribution were applied to account for clustering of patients and control for patient characteristics. RESULTS: Patients (8 ± 6 years) had large (62, 51-72% TBSA) and deep (47%±21%TBSA third degree) burns. Muscle protein fractional synthesis rate was elevated throughout the first 12 months after burn compared with established values from healthy young adults.Muscle protein fractional synthesis rate was lower in boys, in children older than 3 years, and when burnswere greater than 80% TBSA. CONCLUSION: Muscle protein synthesis is elevated for at least 1 year after injury, suggesting that greater muscle protein turnover is a component of the long-term pathophysiologic response to burn trauma. Muscle protein synthesis is highly affected by sex, age, and burn size in severely burned children. These findings may explain the divergence in net protein balance and lean body mass in different populations of burn patients.

Original languageEnglish (US)
Pages (from-to)816-822
Number of pages7
JournalJournal of Trauma and Acute Care Surgery
Volume78
Issue number4
DOIs
StatePublished - Apr 4 2015

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Muscle Proteins
Burns
Pediatrics
Body Surface Area
Wounds and Injuries
Skeletal Muscle
Normal Distribution
Isotopes
Cluster Analysis
Young Adult

Keywords

  • burn injury
  • fractional synthesis rate
  • muscle protein synthesis
  • Skeletal muscle

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Predictors of muscle protein synthesis after severe pediatric burns. / Diaz, Eva C.; Herndon, David; Lee, Jinhyung; Porter, Craig; Cotter, Matthew; Suman, Oscar; Sidossis, Labros S.; Børsheim, Elisabet.

In: Journal of Trauma and Acute Care Surgery, Vol. 78, No. 4, 04.04.2015, p. 816-822.

Research output: Contribution to journalArticle

Diaz, EC, Herndon, D, Lee, J, Porter, C, Cotter, M, Suman, O, Sidossis, LS & Børsheim, E 2015, 'Predictors of muscle protein synthesis after severe pediatric burns', Journal of Trauma and Acute Care Surgery, vol. 78, no. 4, pp. 816-822. https://doi.org/10.1097/TA.0000000000000594
Diaz, Eva C. ; Herndon, David ; Lee, Jinhyung ; Porter, Craig ; Cotter, Matthew ; Suman, Oscar ; Sidossis, Labros S. ; Børsheim, Elisabet. / Predictors of muscle protein synthesis after severe pediatric burns. In: Journal of Trauma and Acute Care Surgery. 2015 ; Vol. 78, No. 4. pp. 816-822.
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AU - Herndon, David

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AU - Børsheim, Elisabet

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N2 - BACKGROUND: Following a major burn, skeletal muscle protein synthesis rate increases but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months after injury and to identify predictors that influence this response. METHODS: A total of 87 children with 40% or greater total body surface area (TBSA) burned were included. Patients participated in stable isotope infusion studies at 1, 2, and approximately 4 weeks after burn and at 6, 12, and 24 months after injury to determine skeletal muscle protein fractional synthesis rate. Generalized estimating equations with log link normal distribution were applied to account for clustering of patients and control for patient characteristics. RESULTS: Patients (8 ± 6 years) had large (62, 51-72% TBSA) and deep (47%±21%TBSA third degree) burns. Muscle protein fractional synthesis rate was elevated throughout the first 12 months after burn compared with established values from healthy young adults.Muscle protein fractional synthesis rate was lower in boys, in children older than 3 years, and when burnswere greater than 80% TBSA. CONCLUSION: Muscle protein synthesis is elevated for at least 1 year after injury, suggesting that greater muscle protein turnover is a component of the long-term pathophysiologic response to burn trauma. Muscle protein synthesis is highly affected by sex, age, and burn size in severely burned children. These findings may explain the divergence in net protein balance and lean body mass in different populations of burn patients.

AB - BACKGROUND: Following a major burn, skeletal muscle protein synthesis rate increases but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months after injury and to identify predictors that influence this response. METHODS: A total of 87 children with 40% or greater total body surface area (TBSA) burned were included. Patients participated in stable isotope infusion studies at 1, 2, and approximately 4 weeks after burn and at 6, 12, and 24 months after injury to determine skeletal muscle protein fractional synthesis rate. Generalized estimating equations with log link normal distribution were applied to account for clustering of patients and control for patient characteristics. RESULTS: Patients (8 ± 6 years) had large (62, 51-72% TBSA) and deep (47%±21%TBSA third degree) burns. Muscle protein fractional synthesis rate was elevated throughout the first 12 months after burn compared with established values from healthy young adults.Muscle protein fractional synthesis rate was lower in boys, in children older than 3 years, and when burnswere greater than 80% TBSA. CONCLUSION: Muscle protein synthesis is elevated for at least 1 year after injury, suggesting that greater muscle protein turnover is a component of the long-term pathophysiologic response to burn trauma. Muscle protein synthesis is highly affected by sex, age, and burn size in severely burned children. These findings may explain the divergence in net protein balance and lean body mass in different populations of burn patients.

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