Response of leucine metabolism to hyperinsulinemia in hypothyroid patients before and after thyroxine replacement.

We have investigated the effect of hypothyroidism and insulin on protein metabolism in humans. Six hypothyroid patients were studied in a postabsorptive state before and after 5 months of regular treatment for hypothyroidism (153 +/- 17 microg/day of L-T4). The effect of insulin was assessed under hyperinsulinemic euglycemic and eukalemic conditions. Insulin was infused for 140 min at 0.0063 +/- 0.0002 nmol/kg x min. An amino acid infusion was used to blunt insulin-induced hypoaminoacidemia. Whole body protein turnover was measured using L-[1-13C] leucine. When compared to L-T4-induced subclinical thyrotoxic state, hypothyroidism induced a significant decrease (P < 0.05) in leucine endogenous appearance rate (a reflection of proteolysis; 0.89 +/- 0.09 vs. 1.33 +/- 0.05 micromol/kg x min), oxidation (0.19 +/- 0.02 vs. 0.25 +/- 0.03 micromol/kg x min), and nonoxidative disposal (a reflection of protein synthesis; 0.87 +/- 0.11 vs. 1.30 +/- 0.05 micromol/ kg x min). Insulin lowered proteolysis during both the subclinical thyrotoxic and hypothyroid states. Hypothyroidism impaired the antiproteolytic effects of insulin. Thyroid hormones are, therefore, essential for the normal antiproteolytic action of insulin.

Detection of Pneumocystis carinii DNA by PCR amplification in various rat organs in experimental pneumocystosis.

Pneumocystosis is usually a disease of the lungs, but the number of cases of extrapulmonary pneumocystosis has greatly increased during the AIDS epidemic. Much remains unknown about the frequency and mechanisms of dissemination. In the present study, a systematic search for Pneumocystis carinii by PCR with primers specific for mitochondrial rRNA was performed in the lung, liver, spleen and kidney of 12 immunosuppressed rats and two immunocompetent rats. The amplified products were analysed by Southern hybridisation with a digoxigenin-11-dUTP labeled probe. P. carinii DNA was found in lungs in all 14 rats and in at least one organ other than lung in 11 immunosuppressed rats and the two control rats. We suggest that extrapulmonary dissemination may not be an exceptional phenomenon in the course of pneumocystosis, but rather part of the natural evolution of the disease.

[Uterine retroversion. A simple surgical cure]. / Rétroversion utérine. Cure chirurgicale simple.

In 20% of the cases, painful symptoms which cannot be dismissed in general practice are experienced by women with uterine retrodeviation. The technique described here is based on anatomical reduction of Douglas' pouch with restoration of tension in the uterosacral ligaments. It is simple and rapid as expected for a minor anatomical defect. The creation of two perpendicular peritoneo-ligamentous planes ensures its solidity. The effectiveness and safety of this technique has been confirmed by a series of more than 70 patients 50% of whom were examined at regular intervals for more than 5 years after surgery.

[Effect of diet and microflora on amino sugars in the digestive contents and faeces of rats, lambs and preruminant calves]. / Influence de l'aliment et de la microflore sur la teneur en sucres aminés des contenus digestifs et des fèces chez le rat, l'agneau et le veau prèruminant.

Glucosamine (Glc NH2) and galactosamine (Gal NH2) were determined by an automatized chromatographic method in samples from digestive contents and faeces. Germfree lambs and rats as well as conventional preruminant calves, lambs and rats were used in the experiments. The rats were fed an irradiated casein diet, the lambs UHT milk and the preruminant calves various diets (table 1). Concentrations of Glc NH2 and of Gal NH2 reached 6 g/16 g of N in the caecal contents and the faeces of germfree rats (table 2). Concentrations of Gal NH2 were 7 to 12 times lower and those of Glc NH2 4 times lower in conventional rats. In lambs, the amino sugar concentrations (table 3) found in the stomach contents resembled those supplied by the milk. In contrast, in the large intestine and the faeces, the concentration of amino sugars was very high. In conventional lambs, those concentrations were 8 to 4 times lower. For ruminant calves, the concentrations of amino sugars (table 4) were greater in the ileal contents than in the faeces. They reached that of meconium when the calves were fed milk. The lowest values were observed in the faeces of calves fed soya, colostrum or fish diets which are less digestible than milk. In germfree animals, the hexosamines were endogenous. In conventional animals, bacterial metabolism led to an increase in faecal Glc NH2/Gal NH2. In the calves fed soya or fish diets, the hexosamine content in the faeces was low owing to the dilution of bacterial and endogenous mucoproteins by the undigested dietary proteins.

Synthesis rate of plasma albumin is a good indicator of liver albumin synthesis in sepsis.

Plasma albumin is well known to decrease in response to inflammation. The rate of albumin synthesis from both liver and plasma was measured in vivo by use of a large dose of L-[(2)H(3)-(14)C]valine in rats injected intravenously with live Escherichia coli and in pair-fed control rats during the acute-phase period (2 days postinfection). The plasma albumin concentration was reduced by 50% in infected rats compared with pair-fed animals. Infection induced a fall in both liver albumin mRNA levels and albumin synthesis relative to total liver protein synthesis. However, absolute liver albumin synthesis rate (ASR) was not affected by infection. In plasma, albumin fractional synthesis rate was increased by 50% in infected animals compared with pair-fed animals. The albumin ASR estimated in the plasma was similar in the two groups. These results suggest that hypoalbuminemia is not due to reduced albumin synthesis during sepsis. Moreover, liver and plasma albumin ASR were similar. Therefore, albumin synthesis measured in the plasma is a good indicator of liver albumin synthesis.

Leucine metabolism in lactating and dry goats: effect of insulin and substrate availability.

Early lactating goats show insulin resistance with respect to extramammary glucose utilization. However, much less is known about the two major factors, insulin and plasma amino acid concentration, that regulate protein metabolism in lactating goats. To examine this question, the in vivo effect of acute insulin was studied in goats during early lactation (12-31 days postpartum), midlactation (98-143 days postpartum), and the dry period (approximately 1 yr postpartum). Insulin was infused (at 0.36 or 1.79 nmol/min) under euglycemic and eukaliemic clamps. In addition, appropriate amino acid infusion was used to blunt insulin-induced hypoaminoacidemia or to create hyperaminoacidemia and maintain this condition under insulin treatment. Leucine kinetics were assessed using a primed continuous infusion of L-[1-14C]-leucine, which started 2.5 h before insulin. In all animals the insulin treatments failed to stimulate the nonoxidative leucine disposal (an estimate of whole body protein synthesis) under both euaminoacidemic and hyperaminoacidemic conditions. Thus, in goat as well as humans, infusion of insulin fails to stimulate protein synthesis even when combined with a substantially increased provision of amino acids. In contrast, insulin treatments caused a dose-dependent inhibition of the endogenous leucine appearance (an estimate of whole body protein degradation). Under euaminoacidemia the initial slope from the plot of the endogenous leucine appearance as a function of plasma insulin (an insulin sensitivity index) was steeper during early lactation than when compared with the dry period. A similar trend occurred during midlactation but not to any significant degree. These differences were abolished under hyperaminoacidemia. It was concluded that the ability of physiological insulin to inhibit protein degradation was improved during lactation, demonstrating a clear-cut dissociation between the effects of insulin on protein and glucose metabolism. This adaptation no doubt may provide a mechanism to save body protein.

Respective influences of age and weaning on skeletal and visceral muscle protein synthesis in the lamb.

1. The influences of age and weaning on muscle protein synthesis were studied in vivo, by injecting a large dose of [3H]valine into 1-, 5- and 8-week-old suckling or 8-week-old weaned lambs. 2. The fractional rates of protein synthesis, in red- and white-fibre-type skeletal muscles or striated and smooth visceral muscles, were in 8-week-old suckling animals 24-37% of their values at 1 week of age. This developmental decline was related to decreased capacities for protein synthesis, i.e. RNA/protein ratios. 3. At 8 weeks of age, suckling and weaned lambs had similar fractional synthesis rates, capacities for protein synthesis and efficiencies of protein synthesis (i.e. rates of protein synthesis relative to RNA) in skeletal muscles. 4. In contrast, visceral-muscle fractional synthesis rates were lower in 8-week-old suckling lambs than in weaned animals, owing to decreased efficiencies of protein synthesis. It was concluded that developmental factors and the change to a solid diet, or weaning in itself, or both, affect differently skeletal and visceral muscle protein synthesis in the immature lamb.

In vivo longitudinal variations in protein synthesis in developing ovine intestines.

Changes in fractional rates of protein synthesis (Ks) were investigated at different small and large intestinal sites in 1-, 5-, and 8-wk-old milk-fed and 8-wk-old weaned lambs, a species with early intestinal maturation similar to most domestic animals and humans, with the use of a flooding dose of L-[3H]valine. Between 1 and 8 wk of age, Ks did not change significantly in the duodenum, the cecum, or the colon of milk-fed lambs, but was depressed by 30% in the jejunum and by 39% in the ileum. This was because of reduced ribosomal capacity, i.e., total RNA-to-protein ratio (Cs) in the jejunum, and also alterations in both Cs and protein synthetic efficiency, i.e., rate of synthesis relative to RNA (KRNA) in the ileum. Ks values throughout the small intestine were significantly higher (45-55%) in weaned lambs than in 8-wk-old milk-fed animals. This enhancement of protein synthesis was mainly related to an increase in KRNA (27-40%). Ks decreased by 43% from the duodenum to the ileum in both milk-fed and weaned 8-wk-old animals, but not in 1- and 5-wk-old milk-fed lambs, because of a marked reduction in KRNA. It was concluded that changes in nutrients at weaning, weaning itself, or both, enhanced protein synthesis without any specific effect on small intestinal site. By contrast, intrinsic developmental factors were responsible only for the regional differences in small intestinal Ks that occurred at 8 wk of age. Longitudinal variations in protein synthesis may contribute to the establishment of the well-recognized jejunoileal gradients of brush-border enzymes and villus height that characterize the mature mammalian small intestine.

Effect of amino acids alone or with insulin on muscle and liver protein synthesis in adult and old rats.

This study was carried out to analyze age-related changes on amino acid and insulin effects on muscle and liver protein synthesis. Conscious male rats, aged 12 (adult) and 24 (old) mo, were infused for 90 min with either saline, amino acids, or amino acids with insulin and glucose. Protein synthesis was measured during the last 15 min of infusion (flooding dose of valine with L-[2,3,4-3H]valine). Gastrocnemius protein mass was 29% lower in old rats than in adults. However, basal muscle absolute synthesis rates were unchanged with age, and fractional synthesis rates (FSR) were increased. Amino acids significantly stimulated muscle FSR to a similar extent (18-20%) in adult (P < 0.01) and old rats (P = 0.03 when variability introduced by muscle atrophy was taken into account by a variance-covariance analysis). Insulin did not elicit any additional effect. Liver protein synthesis did not change with age or in response to infusions. We conclude that, despite an age-related loss of muscle proteins, capacity of muscle protein synthesis to be stimulated is preserved with age.

Effect of insulin in conjunction with glucose, amino acids and potassium on net metabolism of glucose and amino acids in the goat mammary gland.

The hyperinsulinaemic euglycaemic insulin clamp technique was used to study the effect of insulin on the arterio-venous concentration differences of glucose and amino acids across the mammary gland in dairy goats. Insulin was given in conjunction with K to prevent insulin hypokalaemia. Appropriate amino acid infusion was used to blunt insulin-induced hypoaminoacidaemia or to create hyperaminoacidaemia and maintain this state under insulin treatment. Hyperaminoacidaemia alone only stimulated mammary leucine uptake but did not significantly modify the net metabolism of other amino acids and glucose. Insulin infusion at physiological level in conjunction with glucose, KCl-NaCl and amino acids failed to alter mammary uptake of glucose and essential amino acids; occasional increase in arginine extraction and decrease in tyrosine extraction were exceptions. Thus these new experimental conditions did not reveal any galactopoietic effect of insulin.

Sustained modifications of protein metabolism in various tissues in a rat model of long-lasting sepsis.

1. Sepsis was induced in rats by an intravenous injection of live bacteria. Infected and pair-fed animals were studied before the infection, in an acute septic phase (day 2 post-infection), in a chronic septic phase (day 6) and in a late septic phase (day 10). Protein synthesis rates were measured in vivo after administration of a flooding dose of L[1-13C]valine. 2. During the acute phase, muscle protein loss associated with infection resulted from both a decrease in protein synthesis and an increase in proteolysis. During the chronic phase and the late phase, the increase of proteolysis in infected rats as compared with pair-fed animals persisted, worsening muscle atrophy. Skin protein synthesis rates were not significantly modified by infection. However, skin protein content decreased 6 and 10 days after infection, suggesting an increased proteolysis in response to sepsis. 3. Protein synthesis in liver of infected rats was twice that of pair-fed animals. Liver protein synthesis remained elevated in infected rats compared with pair-fed animals until day 10. Hypoalbuminaemia and high plasma concentrations of fibrinogen were evident at all periods studied. alpha 2-Macroglobulin and alpha 1-acid glycoprotein reached peak concentrations during the acute phase (concentrations increased 50 times in infected rats). On day 10, the levels of these proteins were still about 12-fold higher. 4. Protein synthesis rates were significantly increased in the digestive tract and lung of infected rats compared with pair-fed groups on days 2 and 6, but were similar in the two groups on day 10 post-infection. The fractional protein synthesis rate was increased 3-fold over the entire experimental period in the spleen. 5. The results show that sepsis stimulates protein synthesis in various tissues over a long time, and that skin, like muscle, can provide amino acids to the rest of the body.

Effect of colostrum feeding on protein metabolism in the small intestine of newborn lambs.

In a first experiment with 24 newborn lambs, the promoting effect of colostrum feeding on the fresh weight of the small intestine and its protein content was demonstrated by comparison with that of other dietary treatments (fasting, lactose, protein hydrolysate feeding). In a second experiment, the amounts of colostral IgG1 entrapped within the intestine wall and the valine incorporation rates into the intestinal protein were determined in 3-, 8- and 18-hour-old lambs fed either cow milk, cow colostrum or ewe colostrum. The amounts of IgG1 in the small intestine wall and the valine incorporation rates were higher in the lambs fed colostrum (ewe or cow) than in the milk-fed animals. The intestinal protein increase resulted primarily from the retention of colostral proteins in the colostrum-fed newborn lambs. However, colostrum feeding stimulated intestinal protein synthesis more actively than milk feeding.

[Transport of amino acids in the splanchnic bed by blood plasma and blood in the preruminant calf]. / Transport des acides aminés dans l'aire splanchnique par le plasma sanguin et le sang chez le veau préruminant.

Three preruminant calves were fitted with catheters in portal and hepatic veins and in a mesenteric artery. Two electromagnetic flowmeter probes were clipped around the portal vein and the hepatic artery. The calves were fed either a diet with a low (L) or a high (R) abomasal emptying rate for dietary proteins. Blood flow and free amino acid levels in plasma (P) and blood (S) were determined before the morning meal and during the following 7 h. In the portal vein, for most amino acids P/S ratios were correlated to the net amino acid balance of the digestive tract measured in plasma. By contrast in the hepatic vein, these ratios were mainly correlated to hepatic balance measured in whole blood. Correlations between digestive tract and hepatic balance calculated using either plasma or whole blood pool were different for some amino acids. This suggests that amino acid exchange between plasma and blood cells is low and absorbed amino acids are mainly transported to the liver by plasma, whereas whole blood rather than plasma is concerned in amino acid exchanges in the liver.

Influences of age and weaning on in vivo pancreatic protein synthesis in the lamb.

In vivo pancreatic protein synthesis rates were obtained from the uptake of L-[3,4(n)-3H]valine co-injected with a flooding dose of unlabeled valine into 1-, 5-, and 8-wk-old suckling lambs, and 8-wk-old weaned animals. Protein fractional synthesis rate was 184%/d at 1 wk of age and 153%/d in 5-wk-old animals (P greater than 0.05). This lack of developmental change resulted from constant (P greater than 0.05) ribosomal capacities (total RNA/protein ratios) and efficiencies of protein synthesis (synthetic rates relative to RNA). No further alteration for protein fractional synthesis rate (144%/d) occurred in 8-wk-old suckling animals (P greater than 0.05). In contrast, 8-wk-old ruminants exhibited higher protein fractional synthesis rate (244%/d) than 8-wk-old suckling animals, although ribosomal capacity was markedly higher in both 8-wk-old groups than in youngest animals (P less than 0.05). The present findings clearly indicate that in vivo protein synthesis in the developing ovine pancreas depends primarily on age. Potentialities for increased rates of pancreatic protein synthesis, i.e., increases in total RNA content and ribosomal capacity appear between 5 and 8 wk of age in this species. At 8 wk of age, however, when lambs are generally weaned, solid food ingestion resulted in a rise for both fractional and absolute rates of protein synthesis, essentially because ruminants maintained a higher efficiency of protein synthesis than milk-fed animals (P less than 0.005). Finally, there was a relationship between pancreatic protein synthesis and protein intake in only ruminant lambs.

Effect of hyperinsulinemia and hyperaminoacidemia on muscle and liver protein synthesis in lactating goats.

The experiment was carried out to clarify the roles of insulin and amino acids on protein synthesis in fed lactating goats (30 days postpartum). Protein synthesis in the liver and various skeletal muscles was assessed after an intravenous injection of a large dose of unlabeled valine containing a tracer dose of L-[2,3,4-3H]valine. The animals were divided into three groups. Group I was infused with insulin (1.7 mumol/min) for 2.5 h under glucose, potassium, and amino acid replacement. Group A was infused with an amino acid mixture to create stable hyperaminoacidemia for 2.5 h. Group C animals were controls. The fractional synthesis rates (FSR) were 31.5 +/- 2.2, 6.5 +/- 0.4, 4.3 +/- 0.8, 4.0 +/- 1.2, 3.9 +/- 1.2, and 3.6 +/- 0.4%/day (SD) in liver, masseter, diaphragm, anconeus, semitendinosus, and longissimus dorsi, respectively, for group C. Neither hyperinsulinemia in group I nor hyperaminoacidemia in group A had not affected by hyperinsulinemia but was stimulated by hyperaminoacidemia (+30%, P < 0.05). In contrast to previous experiments in which a labeled amino acid was constantly infused, this study revealed a stimulating effect of amino acids on protein synthesis in the liver but not in skeletal muscles. As previously observed in studies with the constant-infusion method, insulin had no effect on protein synthesis.

Altered partition of threonine metabolism in pigs by protein-free feeding or starvation.

Kinetic aspects of threonine (Thr) metabolism were examined in growing pigs fed a well-balanced diet (C), an isocaloric protein-free diet (PF), or starved (S) for 48 h. With the use of continuous simultaneous infusion of L-[1-13C]Thr, [1-14C]sarcosine, and 2-[1-14C]ketobutyrate (KB) for 10 h, estimates were made of rates of Thr incorporated into protein (S), released from body proteins (B), and oxidized through the catabolic pathways of L-Thr 3-dehydrogenase (TDG) and threonine dehydratase (TDH). In the C group S was 185, B was 138, Thr disposal to glycine (DRThr-Gly) was 47, and Thr disposal to KB (DRThr-KB) was 7 mumol.h-1.kg-1. Consequently, Thr balance was +48 mumol.h-1.kg-1. In the PF-fed pigs, S, B, DRThr-Gly, and DRThr-KB were significantly reduced by 38, 15, 74, and 75%, respectively. In the S group, S, B, and DRThr-Gly were significantly reduced by 47, 17, and 55%, respectively, but DRThr-KB was similar to the C group. DRThr-Gly in all groups was highly correlated with TDG enzyme activity measured in liver homogenates. By contrast with in vivo results, TDH enzyme activity was increased by 88% (P less than 0.05) in the S group and decreased by 27% (not significant) in the PF group compared with the C group. The TDH pathway accounted for 13, 12, and 27% of total Thr oxidation in the C, PF, and S groups, respectively. These results suggest that Thr conservation in protein-depleted states (PF and S groups) occurred mainly by a decrease of Thr oxidation and that the partition through these pathways was only altered when energy was completely withdrawn.

The effect of a high dose of 3-hydroxy-3-methylbutyrate on protein metabolism in growing lambs.

The effect of a high dose of 3-hydroxy-3-methylbutyrate (HMB, a leucine catabolite) on protein metabolism was investigated in growing male lambs fed on hay and concentrate. Concentrate was supplemented with either Ca(HMB)2 (4 g/kg) or Ca(CO3)2 in experimental (HMB) and control groups respectively. Both groups consisted of six 2-month old lambs. Three complementary methods to study protein metabolism were carried out consecutively 2.5 months after beginning the dietary treatment: whole body phenylalanine fluxes, postprandial plasma free amino acid time course and fractional rates of protein synthesis in skeletal muscles. Feeding a high dose of HMB led to a significant increase in some plasma free amino acids compared with controls. Total, oxidative and non-oxidative phenylalanine fluxes were not modified by dietary HMB supplementation. Similarly, an acute infusion of HMB, in the control group, did not change these fluxes. In skeletal muscles, fractional rates of protein synthesis were not affected by long-term dietary supplementation with HMB. Taken together our results showed that administration of a high dose of HMB to lambs was able to modify plasma free amino acid pattern without any effect on whole-body protein turnover and skeletal muscle protein synthesis.

Contribution of proteolysis and de novo synthesis to alanine production in diabetic rat skeletal muscle: a 15N/1H nuclear magnetic resonance study.

To assess the role of leucine as a precursor of alanine alpha-amino nitrogen in skeletal muscle during diabetes, extensor digitorum longus muscles from control (n = 7 experiments) and streptozotocin-diabetic rats (n = 8 experiments) were isolated and superfused with [15N]leucine (3 mmol/l) in the presence of glucose (10 mmol/l) for 2 h. Muscle perchloric acid extraction was performed at the end of superfusion in order to quantify newly synthesized alanine by 15N/1H nuclear magnetic resonance. Release of [15N]alanine in the superfusion medium was also measured. The pool of newly synthesized [15N]alanine was significantly increased (approximately 40%) in extensor digitorum longus muscles from streptozotocin-diabetic rats. Whereas a significant enhancement of total alanine release from muscle was induced by diabetes (20%), only a slight increase in [15N]alanine release was detectable under our experimental conditions. Consequently, we conclude that streptozotocin-diabetes in growing rats induces in skeletal muscle: 1) an increase in nitrogen exchange between leucine and alanine leading to newly synthesized [15N]alanine; and 2) an increase of total alanine release from muscle originating from both proteolysis and de novo synthesis.

Response of leucine metabolism to hyperinsulinemia under amino acid replacement in experimental hyperthyroidism.

We investigated the responsiveness of protein metabolism to insulin as a mediator of the protein catabolic response to hyperthyroidism in humans. Six healthy volunteers were studied in a postabsorptive state before and after oral intake of thyroid hormones (2 micrograms.kg-1.day-1 L-thyroxine for 6 wk along with 1 microgram.kg-1.day-1 triiodothyronine for the last 2 wk). Insulin was infused at 7.14 nmol.kg-1.min-1 for 140 min under euglycemic and eukalemic clamps. An appropriate amino acid infusion was used to blunt insulin-induced hypoaminoacidemia. Leucine kinetics were assessed using a primed continuous infusion of L-[1-13C]leucine. Hyperthyroidism induced a significant increase (P < 0.05) in leucine endogenous appearance rate (a reflection of proteolysis; 2.15 +/- 0.06 vs. 1.76 +/- 0.03 mumol.kg-1.min-1 in the control state), oxidation (0.54 +/- 0.04 vs. 0.47 +/- 0.07), and nonoxidative disposal (a reflection of protein synthesis; 1.80 +/- 0.06 vs. 1.45 +/- 0.06). Insulin lowered proteolysis. Further hyperthyroidism improved the ability of insulin to inhibit proteolysis, whether considered as an absolute decrease (-0.57 +/- 0.02 vs. -0.45 +/- 0.05 mumol.kg-1.min-1, P < 0.05) or related to insulinemia [1.59 +/- 0.11 vs. 1.01 +/- 0.08 mumol leucine.kg-1.min-1/(nmol insulin/l), P < 0.05]. Insulin also moderately (but significantly P < 0.05) lowered protein synthesis in both control and hyperthyroid states. These changes in insulin action may provide a mechanism to save body protein during hyperthyroidism.

Protein turnover modifications induced by the protein feeding pattern still persist after the end of the diets.

This study was undertaken to determine whether the protein feeding pattern could induce chronic adaptation of protein turnover. After a 15-day adaptive period, elderly (68 yr) and young (26 yr) women received, for 14 days, a diet providing 200 KJ x kg fat-free mass (FFM)(-1) x day(-1), where the daily protein intake (1.7 g protein x kg FFM(-1) x day(-1)) was either spread over 4 meals in the spread pattern or mainly (80%) consumed at noon in the pulse pattern. One day after the end of the dietary treatment, whole body leucine kinetics were measured by use of a continuous [(13)C]leucine infusion, both in the postabsorptive state and in the same fed state. The pulse pattern was able to induce, in young as in elderly women, a lower postabsorptive leucine oxidation and endogenous leucine flux than the spread pattern and improved the responsiveness of nonoxidative leucine disposal during 4-h oral feeding. Thus the pulse pattern was able to induce chronic regulation of protein metabolism in young as in elderly women.