Relation between liver fat content and the rate of VLDL apolipoprotein B-100 synthesis in children with protein-energy malnutrition.
BACKGROUND
Fatty infiltration of the liver is associated with an increased morbidity and mortality in children with severe protein-energy malnutrition (PEM), but its pathogenesis remains unclear. Although impaired synthesis of VLDL apolipoprotein B-100 (VLDL-apo B-100) is generally accepted as the pathogenetic mechanism, the rate of it synthesis has not been measured in children with PEM.


OBJECTIVE
The objective of the study was to ascertain the relation between the degree of hepatic steatosis and the rate of VLDL-apo B-100 synthesis in children with PEM.


METHODS
The fractional and absolute rates of VLDL-apo B-100 synthesis were measured with a prime-constant intravenous infusion of [2H3]leucine in 13 severely malnourished children (8 boys and 5 girls) aged 7-18 mo. Hepatic fat content was estimated by computerized tomography scanning by using the ratio of liver to spleen (L:S) attenuation. The ratio is inversely related to hepatic fat content such that the lower the L:S, the greater the amount of fat in the liver.


RESULTS
There were significant inverse relations between L:S attenuation and VLDL-apo B-100 concentration (P < 0.02), the absolute rate of VLDL-apo B-100 synthesis (P < 0.02), and plasma triacylglycerol (P < 0.02) and serum cholesterol (P < 0.05) concentrations.


CONCLUSIONS
These results suggest that children with PEM synthesize VLDL-apo B-100 at a faster rate as the degree of hepatic fat infiltration increases. Thus, fatty infiltration of the liver in PEM is not due to a reduction in the synthesis of VLDL-apo B-100.
Badaloo
Asha
A
Tropical Metabolism Research Unit, University Hospital of the West Indies, University of the West Indies, Mona, Kingston, Jamaica.
Reid
Marvin
M
Soares
Deanne
D
Forrester
Terrence
T
Jahoor
Farook
F
D053299:Apolipoprotein B-100; D001055:Apolipoproteins B / Q000096:biosynthesis*; D005234:Fatty Liver / Q000378:metabolism*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D011502:Protein-Energy Malnutrition / Q000378:metabolism* / Q000628:therapy; D014057:Tomography, X-Ray Computed
D053299:Apolipoprotein B-100; D001055:Apolipoproteins B