Acidosis and Creatine Elimination. 



113 



has remained free from sugar for a period of seventeen days during 

 which the food ingested has been augmented little by little to the 

 point where about 10 grams of carbohydrate in addition to that 

 present in the previous strict diet are being ingested daily. 

 Throughout the entire course of his treatment the patient has 

 continued at his duties as an instructor in the university. 



63 (1127) 



Possible inter-relations between acidosis and creatine elimination. 

 By Frank P. Underhill. 



[From the Sheffield Laboratory of Physiological Chemistry, Yale 

 University, New Haven.] 



Current views associate the elimination of creatine with some 

 perversion of carbohydrate metabolism. The probability of a 

 close relationship of this sort is indicated by the well known fact 

 that a deficiency of carbohydrate in the body leads to creatine 

 elimination which may be checked promptly by ingestion of car- 

 bohydrate. There are experimental facts which the familiar 

 hypothesis fails to explain. McCollum and Steenbock 1 found 

 that in the pig a diet of corn products led to the appearance of 

 relatively large quantities of creatine in the urine. Similar 

 experiments of Folin (reported at the December meeting of the 

 American Society of Biological Chemists) with oat feeding yielded 

 comparable results. The dietaries employed can scarcely be 

 regarded as lacking in carbohydrate. 



Deficiency of carbohydrate usually means an accompanying 

 acidosis, not necessarily caused by ketogenic substances, which 

 presumably involve the tissues associated with creatine-creatinine 

 metabolism. At any rate nearly every instance in which there is 

 creatine in the urine is accompanied by an acidosis — generally a 

 ketonuria also. These facts suggest the hypothesis that a con- 

 dition of acidosis in the tissues is responsible for the appearance of 

 creatine in the urine. To test it the following questions demand an 

 answer. 



1 J. Biol. Chem., 1912-13, 13, p. 209. 



