Increased urinary polyamine excretion after starting a very low calorie diet

Abstract

Uusitupa M, Pöyhönen M, Sarlund H, Laakso M, Kari A, Helenius T, Alakui-jala L, Eloranta T. Increased urinary polyamine excretion after starting a very low calorie diet. Scand J Clin Lab Invest 1993; 53: 811-819.

Urinary polyamine excretion has been suggested to reflect hypermetabolism or catabolism in different illnesses. In the present study, the excretion of urinary polyamines was examined in 12 obese subjects (3 men, 9 women aged 32-55 y, body mass index 33.3-64.7 kgm⁻²) before and during a very low calorie diet (the total calorie intake 2100-3350 kJ). In addition, nitrogen balance, basal energy expenditure (BEE) and serum thyroid hormone levels were examined. During the first week on a very low calorie diet (VLCD) the mean body weight declined from 121.8 ± 27.3 to 117.4 ± 26.2kg (mean ± SD, p < 0.001), and after 12 weeks of treatment body weight was 106.6 ± 24.6 kg. Immediate reduction of BEE from 1.44 ± 0.24 to 1.34 ± 0.24 kcalmin¹ (p < 0.001) was found within the first week of therapy and BEE measured on weight-maintaining diet remained lower at 12 weeks (1.25 ± 0.27kcalmin⁻¹, p < 0.01). Serum free T3 decreased and reverse T3 increased significantly after starting VLCD. Nitrogen balance remained negative during the first 2 weeks on VLCD. A significant increase in total (38%), and in N1-acetyl- and N8-acetylspermidine excretions in the urine (40% and 27%, respectively, p < 0.05) was found during the first week, but later on the levels were not significantly different from the baseline levels. The changes in free T3 and reverse T3 showed moderate correlations with the changes in Nl-acetylspermidine (r = −0.59 and r = 0.55, respectively, p < 0.05), and N8-acetylspermidine excretion rates (r = −0.63, p < 0.05 and r = 0.47, N.S.). The present results suggest that during a very low calorie diet increased urinary acetylpolyamine excretion is a marker of catabolism.

Key Words:

• basal energy expenditure
• thyroid hormones
• urinary polyamines
• very low calorie diet