Factors affecting the integrity of the intestinal mucosa of Gambian children.
The interrelationship between diarrhea, malnutrition, and small bowel integrity was investigated prospectively in 68 Gambian infants aged 0-18 mo. Profiles of growth and morbidity were recorded for 8 mo. Each month intestinal permeability was measured by the differential uptake of orally administered lactulose (L) and mannitol (M). In well infants the mean L:M ratio was 0.42 (range 0.11-1.42). This ratio was increased slightly for underweight (60-80% wt for age) infants (mean 0.52) but considerably for those with marasmus (less than 60% wt for age) (mean 1.3, p less than 0.001), for those with acute or chronic diarrhea (mean 1.0 and 2.85, respectively; p less than 0.001), or with measles (mean 1.4, p less than 0.001). Sequential studies of ward patients with malnutrition and diarrhea showed a rapid fall in L:M ratios with resolution of diarrhea. These studies suggest that damage to the small intestine may play an important part in the development of infant malnutrition in The Gambia.
D050260:Carbohydrate Metabolism; D002675:Child, Preschool; D003968:Diarrhea, Infantile / Q000378:metabolism; D005260:Female; D005714:Gambia; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000378:metabolism*; D007231:Infant, Newborn; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism*; D007421:Intestine, Small / Q000378:metabolism*; D007785:Lactose / Q000378:metabolism; D007792:Lactulose / Q000378:metabolism; D008297:Male; D008353:Mannitol / Q000378:metabolism; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000378:metabolism
D008353:Mannitol; D007792:Lactulose; D007785:Lactose