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Taurine status and response to intravenous taurine supplementation in adults with short-bowel syndrome undergoing long-term parenteral nutrition: a pilot study

Published online by Cambridge University Press:  08 March 2007

Stéphane M. Schneider ,
Françoise Joly ,
Marie-France Gehrardt ,
Abdul M. Badran ,
Anne Myara ,
François Thuillier ,
Colette Coudray-Lucas ,
Luc Cynober ,
François Trivin  and
Bernard Messing
Stéphane M. Schneider*
Affiliation:
AP-HP Saint-Lazare Hospital, Gastroenterology and Nutrition Support Unit. Paris, France
Françoise Joly
Affiliation:
AP-HP Saint-Lazare Hospital, Gastroenterology and Nutrition Support Unit. Paris, France
Marie-France Gehrardt
Affiliation:
Saint-Joseph Hospital, Biochemistry Laboratory. Paris, France
Abdul M. Badran
Affiliation:
AP-HP Saint-Lazare Hospital, Gastroenterology and Nutrition Support Unit. Paris, France
Anne Myara
Affiliation:
Saint-Joseph Hospital, Biochemistry Laboratory. Paris, France
François Thuillier
Affiliation:
AP-HP Saint-Lazare Hospital, Gastroenterology and Nutrition Support Unit. Paris, France Meaux Hospital, Biochemistry Laboratory. Meaux, France
Colette Coudray-Lucas
Affiliation:
AP-HP Saint-Antoine Hospital, Biochemistry Laboratory. Paris, France
Luc Cynober
Affiliation:
AP-HP Saint-Antoine Hospital, Biochemistry Laboratory. Paris, France
François Trivin
Affiliation:
Saint-Joseph Hospital, Biochemistry Laboratory. Paris, France
Bernard Messing
Affiliation:
AP-HP Saint-Lazare Hospital, Gastroenterology and Nutrition Support Unit. Paris, France
*
*Corresponding author: Dr Stéphane M. Schneider, fax +33 4 92 03 65 75, email stephane.schneider@unice.fr
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Abstract

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Taurine deficiency in patients on long-term parenteral nutrition may be involved in cholestasis. We aimed to assess plasma taurine and tauro-conjugated bile acids in adults with short-bowel syndrome and their response to intravenous taurine. Thirty-two adult patients, who had been on taurine-free parenteral nutrition for a mean of 59(SE14) months for short-bowel syndrome, were studied retrospectively. In a second study, a subgroup of ten patients with chronic cholestasis received taurine-enriched (6·0(SE0·6)mg/kg per d) parenteral nutrition for 55(SE13) months. Post-absorptive plasma taurine and bile acid concentrations were measured and liver function tests routinely sampled. At baseline, plasma taurine was lower in patients with a jejunal length of less than 35cm (group A, n 16) than in those with a jejunal length of 35cm or more (group B, n 16): 43(SE3) v. 58(SE4)μmol/l (P=0·01). The groups were no different in terms of chronic cholestasis (1/6v.1/6 patients), total bile acids (26(SE13)v.14(SE5)μmol/l) or the ratio of tauro-conjugated:glyco-conjugated bile acids (5(SE2)v.8(SE 4)%, usual range 30–60%). After supplementation, there was an increase in plasma taurine level (63(SE8)v. 43(SE4), P=0·007) but was no change in either total bile acids or the ratio of tauro-conjugated: glyco-conjugated bile acids. There was a significant decrease in aspartate aminotransferase level. Long-term parenteral nutrition for short-bowel syndrome is associated with an impaired tauro-conjugation of bile acids (enterohepatic pool), irrespective of plasma taurine level (systemic pool) and despite long-term taurine intravenous supplementation.

Keywords

TaurineBiliary acidsTPNShort-bowel syndrome
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 2 , August 2006 , pp. 365 - 370
Copyright
Copyright © The Nutrition Society 2006

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