Ornithine-alpha-ketoglutarate improves skeletal muscle protein synthesis as assessed by ribosome analysis and nitrogen use after surgery.

Total parenteral nutrition (TPN) was given for 3 days after elective abdominal surgery. The control group (N = 9) received TPN only and one group of patients (N = 6) received TPN supplemented with ornithine-alpha-ketoglutarate (0.35 g/kg bw/day). Protein synthesis in skeletal muscle was assessed from the total ribosome concentration and the percentage of polyribosomes. In the control group the total concentration of ribosomes decreased after surgery by 23% (p less than 0.05) and the percentage of polyribosomes decreased by 21% (p less than 0.01), whereas in the ornithine-alpha-ketoglutarate group both variables remained unaffected. The cumulative urinary urea excretion was significantly larger in the control group than in the ornithine-alpha-ketoglutarate group (p less than 0.05). The calculated nitrogen balance was negative in the control group on each day of the study (p less than 0.05), but that of the ornithine-alpha-ketoglutarate group was not statistically different from zero. The results show that postoperative maintenance of muscle protein synthesis and a more effective nitrogen use was achieved by supplementing TPN with ornithine-alpha-ketoglutarate, 0.35 g/kg bw/day.