Improved growth and nutrition status in children with methylmalonic or propionic acidemia fed an elemental medical food.
BACKGROUND
Failure-to-thrive (FTT) has been described in patients with organic acidemias treated with low protein diets.


OBJECTIVE
To determine if patients with methylmalonic (MMA) or propionic acidemia (PA) can achieve normal growth and nutrition status.


METHODS
A 6-month multicenter outpatient study was conducted with infants and toddlers treated with Propimex-1 Amino Acid-Modified Medical Food With Iron (Ross Products Division, Abbott Laboratories, Columbus, OH). Main outcome measures were anthropometrics, protein status indices, plasma retinol, and alpha-tocopherol.


RESULTS
Sixteen patients completed the study. Mean baseline age was 0.54 +/- 0.02 years (range 0.03-3.00 years). By study end, mean National Center for Health Statistics (NCHS) weight centile increased from 26 to 49%; mean crown-heel length centile from 25 to 33%; and mean head circumference centile from 43 to 54%. Mean (+/- SE) protein and energy intakes by <6-month-old, 6<12-month-old, and 1<4-year-old patients were 15.3 +/- 0.9 g and 645 +/- 10 kcal; 18.3 +/- 1.1 g and 741 +/- 92 kcal; and 25.1 +/- 2.46 g and 1062 +/- 100 kcal, respectively. Plasma glycine concentrations were significantly and negatively correlated with energy intake (r=-0.77, p<0.0005). No correlation was found between dietary protein intakes and plasma ammonia concentrations. Protein status indices, retinol and alpha-tocopherol concentrations were within reference ranges at study end.


CONCLUSIONS
Propimex-1 improved growth and nutrition status in patients with MMA or PA in just 6 months when fed in sufficient amounts. Providing energy and protein for patients with FTT at intakes recommended for catch-up growth may have resulted in even better growth.
Yannicelli
Steven
S
Ross Products Division, Abbott Laboratories, 625 Cleveland Avenue, Columbus, OH 43215-1724, USA.
Acosta
Phyllis B
PB
Velazquez
Antonio
A
Bock
Hans-Georg
HG
Marriage
Barbara
B
Kurczynski
Thaddeus W
TW
Miller
Marvin
M
Korson
Mark
M
Steiner
Robert D
RD
Rutledge
Lane
L
Bernstein
Laurie
L
Chinsky
Jeffrey
J
Galvin-Parton
Patricia
P
Arnold
Georgianne L
GL
D000596:Amino Acids / Q000008:administration & dosage; D000641:Ammonia / Q000097:blood; D001835:Body Weight / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007501:Iron / Q000008:administration & dosage; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood*; D009752:Nutritional Status / Q000235:genetics / Q000502:physiology*; D018529:Nutritional Support; D018901:Peroxisomal Disorders / Q000178:diet therapy* / Q000235:genetics; D011422:Propionates / Q000097:blood*; D014801:Vitamin A / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood
D000596:Amino Acids; D011422:Propionates; D014801:Vitamin A; D000641:Ammonia; D008764:Methylmalonic Acid; D007501:Iron; D024502:alpha-Tocopherol; C029658:propionic acid