This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Peripheral arterial occlusive disease (PAOD) is a common, disabling medical condition which affects 1% of the United States population 55 years old, resulting in impaired walking ability, limb loss, and reduced functional independence. Older Americans are also subject to 'sarcopenia,' a condition in which lower extremity muscle mass and function declines with age. The combination of sarcopenia and reduced blood flow make older subjects with PAOD particularly vulnerable to walking impairments, reduced independence, and a poorer quality of life. The hypothesis of this study is that improved blood flow together with oral amino acid supplementation to treat sarcopenia will result in improved protein metabolism in older PAOD subjects. Subjects with PAOD will undergo prebypass quantification of leg protein metabolism before and after amino acid supplementation using stable isotope methodology. They will then undergo lower extremity bypass, and after the immediate recovery period, leg protein metabolism before and after amino acid supplementation will be restudied to determine if improved blood flow augments the response. The significance of this research study is that it assesses the benefit of the two interventions of leg revascularization and amino acid supplementation in improving leg muscle protein synthesis in older subjects witih PAOD. Ultimately, we hope this will lead to methods for improving walking ability and quality of life in these subjects.
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