You Are What You Eat: Mass spectrometry in paediatric kinetic studies using stable isotopes

An overview will be presented about applications of stable isotopes in paediatric research. Mass spectrometry has proven to be an essential tool for unravelling kinetic studies in a large range of different research disciplines related to intestinal diseases, obesities, severe cerebral palsy, oxidative stress and foetal metabolism. Due to the diversity and complexity of the different metabolites involved in these studies, there is a high demand on sophisticated mass spectrometric instruments. Several new methods have been developed for measurement of isotopic labelled compounds in body fluids. 13C isotopic glucose enrichment in human plasma is analysed, using liquid chromatography isotope ratio mass spectrometry (LC/IRMS). Also new methods were developed for measuring the glutathione (GSH) fractional synthesis rate (FSR) in neonates after infusion of [1-13C]glycine as a tracer. For measuring energy expenditure and total body water composition in humans the doubly labelled water method is valuable technique. It usually involves blood or urine sampling, which might be difficult in neonates and children with cerebral palsy or other disabilities. We therefore aimed to validate a method making use of saliva samples analyzed by automated thermal conversion elemental analyzer in combination with isotope ratio mass spectrometry (TC/EA/IRMS). The different types of mass spectrometric instruments will be discussed here as well as several applications in paediatric research utilizing these techniques. The applications cover amino acid metabolism and body composition, energy expenditure, and the synthesis of specific proteins such as glutathione and albumin in different groups of children and even in foetuses. Finally, the aims and outline of this dissertation are covered.

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