Muscle metabolic changes in severe malnutrition — Effect of total parenteral nutrition

Abstract

Severe malnutrition with extreme loss of muscle mass and body fat can be seen in anorexia nervosa. Seven otherwise healthy girls with anorexia nervosa with a weight loss of 25–40% of their premorbid weight were studied. Because of their critical condition and unsuccessful refeeding, total parenteral nutrition (TPN for 3–5 weeks) was indicated. The TPN was administered via a tunnelated silicon catheter. Their weight gain was about 2.5 kg/week. Muscle biopsies were taken from the quadriceps femoris muscle at admission and after TPN for analysis of energy substrates and electrolytes. Initially ATP, phosphocreatine, glycogen, magnesium and potassium were decreased compared to controls. The values returned to normal with 3–5 weeks of TPN. Total muscle water was increased at admission and was not significantly affected by the TPN. No serious complications were observed during the nutritional treatement. These findings emphasized the importance of nutritional supply to patients with severe anorexia nervosa who do not have any known disturbances in the metabolic pathways of the cell.