Isomaltose excretion in health, severe injury, and disease

The excretion of urinary aldoses was studied in nine severely injured or ill surgical patients and seven healthy subjects. The disaccharide isomaltose, at first found in large amounts in the urine of two injured men, was found to be regularly present in the urine of healthy, fasting individuals in the range of 2.35–3.23 mg/24 hr(2.80 mg/24 hr). Its level decreased by the fourth day of complete caloric starvation (less than 1.5 mg/24 hr). In a group of five patients, isomaltose ranged from 9.26 to 102.12 mg/24 hr (46.7 mg/24 hr). The highest value was found in a comatose patient with a brain stem injury, and the lowest one was found in a patient treated for cardiopulmonary insufficiency. In addition to isomaltose and a few only partially identified other oligosaccharides, the most frequently and profoundly elevated urinary aldoses were mannose, lactose, and glucuronolactone. No interrelations could be established in the rise of isomaltose, glucose, and other elevated saccharides. It is suggested that their elevated excretion is a consequence of independent metabolic and functional processes. High isomaltose excretion appears to be part of the systemic glycogenolytic response of the human body to severe injury and disease.