Protein kinetic differences between children with edematous and nonedematous severe childhood undernutrition in the fed and postabsorptive states.
BACKGROUND
Pathogenic factors that cause a child to develop the edematous instead of the nonedematous form of severe childhood undernutrition (SCU) during food deprivation are not clear. It was hypothesized that, in edematous but not nonedematous SCU, impaired protein breakdown leading to inadequate amino acids for maintenance of important organ systems was a factor.


OBJECTIVE
We measured protein kinetics in children with edematous and nonedematous SCU.


METHODS
Endogenous leucine flux, an index of whole-body protein breakdown rate, was determined in 4 groups of children with edematous or nonedematous SCU in the malnourished and recovered states. Two groups were studied in the postabsorptive state, and 2 groups were studied in the fed state.


RESULTS
In the postabsorptive state, leucine flux was slower (P < 0.01) in the edematous group than in the nonedematous group in the malnourished state, but in the recovered state, it was faster (P < 0.05) in the children who previously had edematous SCU. When compared with the malnourished state value, leucine flux at recovery doubled in the group that previously had edematous SCU, but it did not change in the other group. In the fed state, leucine flux was slower (P < 0.01) in the edematous group than in the nonedematous group in the malnourished state but not in the recovered state. In the recovered state, enteral leucine extraction by splanchnic tissues trended higher in the group that previously had edematous SCU than in the nonedematous group.


CONCLUSIONS
These findings indicate different protein breakdown responses to food deprivation between children with edematous and nonedematous SCU and inherent differences in protein metabolism when they have recovered.
Jahoor
Farook
F
US Department of Agriculture Agricultural Research Service, Children's Nutrition Research Center, Houston, TX 77030-2600, USA. fjahoor@bcm.tmc.edu
Badaloo
Asha
A
Reid
Marvin
M
Forrester
Terrence
T
D000293:Adolescent; D000596:Amino Acids / Q000378:metabolism; D002247:Carbon Isotopes; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications / Q000378:metabolism*; D004487:Edema / Q000150:complications / Q000378:metabolism*; D005260:Female; D005508:Food Deprivation / Q000502:physiology; D006801:Humans; D007732:Kwashiorkor / Q000150:complications / Q000378:metabolism; D007930:Leucine / Q000378:metabolism*; D008297:Male; D019518:Postprandial Period / Q000502:physiology; D014176:Protein Biosynthesis; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000378:metabolism*; D011506:Proteins / Q000378:metabolism*; D015430:Weight Gain
D000596:Amino Acids; D002247:Carbon Isotopes; D011506:Proteins; D007930:Leucine