Sequential urinary N tau-methylhistidine to creatinine ratios in premature infants

The present study was undertaken to establish normal values of the N tau-methylhistidine to creatinine excretion ratio in very premature infants, to observe changes with postnatal age, and to determine whether or not reliable data on this index of myofibrillar protein breakdown could be obtained from untimed urine samples without recourse to the 24-hour collections used previously. The normal range (95% confidence limits) of the molar excretion ratio for unstressed infants was established to be between 0.0248 and 0.0440. Narrower limits of variability occurred when nutrient intake was controlled at a satisfactory level or when comparisons were between sequential urine samples from single infants. No diurnal changes could be detected. We conclude that analyses of N tau-methylhistidine and creatinine on spot urine samples permit the calculation of an excretion ratio that is reproducible both within and between individual infants and that should be useful in assessing changes in myofibrillar protein breakdown caused by differences in clinical, pharmacologic, or nutritional status.