Cost containment through L-alanyl-L-glutamine supplemented total parenteral nutrition after major abdominal surgery: a prospective randomized double-blind controlled study

Clin Nutr. 2000 Dec;19(6):395-401. doi: 10.1054/clnu.2000.0142.


Background & aims: Glutamine is recognized as a conditionally essential amino acid. Recent studies indicate that glutamine-containing total parenteral nutrition improves nitrogen economy, enhances gastrointestinal and immune functions and shortens hospital stay.

Methods: Thirty-seven patients (19 w and 18 m; age 61. 4+/-10.4 years; BMI 23.7+/-2.8 kg/m(2)) following major abdominal surgery receiving an isonitrogenous isoenergetic TPN with or without alanyl-glutamine supplementation (0.5 g/kg BW/day), were evaluated in a double-blind, randomized, controlled trial over a five-day period by measuring nitrogen balance, selected biochemical parameters and length of hospital stay.

Results: Supplemental alanyl-glutamine improved the overall mean (-3.5+/-1.6 vs. -5.5+/-1. 4 g N;P<0.05) and cumulative nitrogen balance (-14.1+/-9.1 vs. -21.7+/-11.4 g N;P<0.05) compared with the isonitrogenous, isoenergetic standard regimen. Alanyl-glutamine normalized plasma glutamine concentration and reduced the length of hospital stay (12.8+/-2.6 vs. 17.5+/-6.4 days;P<0.05).

Conclusions: The results of the study confirm that supplementation with synthetic alanyl-glutamine dipeptide is associated with cost containment due to shortened hospitalization and improved nitrogen economy.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amino Acids / blood
  • Cost Control
  • Dipeptides / administration & dosage*
  • Dipeptides / therapeutic use
  • Double-Blind Method
  • Female
  • Glutamine / blood
  • Humans
  • Length of Stay* / economics
  • Male
  • Middle Aged
  • Parenteral Nutrition, Total* / economics
  • Postoperative Care / economics*
  • Prospective Studies
  • Proteins / metabolism
  • Time Factors


  • Amino Acids
  • Dipeptides
  • Proteins
  • Glutamine
  • alanylglutamine