Volume 31, Issue 2 p. 312-330

High-precision mass spectrometric analysis using stable isotopes in studies of children

Henk Schierbeek

Corresponding Author

Henk Schierbeek

Division of Neonatology, Department of Pediatrics, Erasmus MC—Sophia Children's Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands

Department of Pediatrics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

Department of Pediatrics, Emma Children's Hospital—AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands

Division of Neonatology, Department of Pediatrics, Erasmus MC—Sophia Children's Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands.Search for more papers by this author
Chris H.P. van den Akker

Chris H.P. van den Akker

Division of Neonatology, Department of Pediatrics, Erasmus MC—Sophia Children's Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands

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Laurent B. Fay

Laurent B. Fay

Department of Nutrition and Health, Nestlé Research Center, Nestec Ltd, P.O. Box 44, CH-1000 Lausanne 26, Switzerland

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Johannes B. van Goudoever

Johannes B. van Goudoever

Department of Pediatrics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

Department of Pediatrics, Emma Children's Hospital—AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands

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First published: 18 July 2011
Citations: 26

Abstract

The use of stable isotopes combined with mass spectrometry (MS) provides insight into metabolic processes within the body. Herein, an overview on the relevance of stable isotope methodology in pediatric research is presented. Applications for the use of stable isotopes with MS cover carbohydrate, fat, and amino acid metabolism as well as body composition, energy expenditure, and the synthesis of specific peptides and proteins, such as glutathione and albumin. The main focus of these studies is on the interactions between nutrients and the endogenous metabolism within the body and how these factors affect the health of a growing infant. Considering that the early imprinting of metabolic processes hugely impacts metabolism (and thus functional outcome) later in life, research in this area is important and is advancing rapidly. The major fluxes on a metabolic level are the synthesis and breakdown rates. They can be quantified using kinetic tracer analysis and mathematical modeling. Organic MS and isotope ratio mass spectrometry (IRMS) are the two most mature techniques for the isotopic analysis of compounds. Introduction of the samples is usually done by coupling gas chromatography (GC) to either IRMS or MS because it is the most robust technique for specific isotopic analysis of volatile compounds. In addition, liquid chromatography (LC) is now being used more often as a tool for sample introduction of both volatile and non-volatile compounds into IRMS or MS for 13C isotopic analyses at natural abundances and for 13C-labeled enriched compounds. The availability of samples is often limited in pediatric patients. Therefore, sample size restriction is important when developing new methods. Also, the availability of stable isotope-labeled substrates is necessary for measurements of the kinetics and concentrations in metabolic studies, which can be a limiting factor. During the last decade, the availability of these substrates has increased. Furthermore, improvements in the accuracy, precision, and sensitivity of existing techniques (such as GC/IRMS) and the development of new techniques (such as LC/IRMS) have opened up new avenues for tackling these limitations. © 2011 Wiley Periodicals, Inc. Mass Spec Rev 31:312–330, 2012