Calculation of turnover rates in stable-isotope studies

Tserng and Kalhan have raised the question of the appropriate equation to use for the measurement of turnover rate in a stable-isotope study. In a comparison of glucose turnover measured with 2H-glucose and with 13C-glucose they used five apparently different equations and obtained conflicting answers. There is, however, no difference in principle between the use of a stable isotope as a tracer and the use of a radioactive isotope, and the rate of appearance of tracee in a steady-state system (the turnover) can therefore be shown to be proportional to the equilibrium dilution of the infused tracer. Because the sensitivity of measurement of this dilution made using a gas chromatograph-mass spectrometer is lower than that made by radioactivity measurement, the contribution to the measured turnover rate due to the infusate cannot be neglected, as it usually is in radioisotope work. A convenient calibration curve to establish this dilution is the mole ratio of the pure infusate against the area ratio for the relevant ions. Tserng and Kalhan's apparently conflicting results for glucose turnover using 13C-glucose as the tracer can all be shown to amount to approximately 11.6 mumol min-1 kg-1. This value is only slightly lower (0.05 less than P less than 0.1) than that obtained using 2H-glucose as the tracer and supports the use of 13C-glucose as an alternative.