title: Impaired glucose absorption in children with severe malnutrition.
abstract: OBJECTIVE
  To quantify intestinal glucose absorption in children with two types of severe malnutrition, kwashiorkor and marasmus, compared with healthy children.
  
  
  METHODS
  Children with kwashiorkor (n = 6) and marasmus (n = 9) and control subjects (n = 3) received a primed (13 mg/kg), constant infusion (0.15 mg/kg/min) of [6,6H2]glucose for 4.5 hours. Two hours after start of the infusion an oral bolus of glucose 1.75 g/kg labeled with [U-13C]glucose 10 mg/g was given and was followed by periodic blood sampling. Mathematical modeling was applied to determine oral glucose absorption.
  
  
  RESULTS
  Median total glucose absorption was 5.9 mmol/kg, interquartile range (IQR) 4.5-6.7 mmol/kg and 4.4 (IQR 2.9-5.9) mmol/kg in children with kwashiorkor and marasmus compared with 7.7 (IQR 5.8-9.0) mmol/kg in control subjects; P = .03 compared with marasmus). Children with the lowest glucose absorption were found specifically in the kwashiorkor group and marasmic children with hypoalbuminemia. Severe impairment in absorption correlated with urinary 8-hydroxydeoxyguanosine secretion (r = -0.62, P = .01).
  
  
  CONCLUSIONS
  Severe malnutrition is associated with an impaired glucose absorption and decreased glucose absorption correlates with oxidative stress in these children.
authors.affiliation: Department of Biochemistry, College of Medicine, University of Malawi, Blantyre, Malawi. robert.bandsma@sickkids.ca
authors.forename: Robert H J
authors.initials: RH
authors.lastname: Bandsma
authors.forename: Martijn N
authors.initials: MN
authors.lastname: Spoelstra
authors.forename: Andrea
authors.initials: A
authors.lastname: Mari
authors.forename: Marijke
authors.initials: M
authors.lastname: Mendel
authors.forename: Patrick F
authors.initials: PF
authors.lastname: van Rheenen
authors.forename: Edward
authors.initials: E
authors.lastname: Senga
authors.forename: Theo
authors.initials: T
authors.lastname: van Dijk
authors.forename: Geert Tom
authors.initials: GT
authors.lastname: Heikens
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D005943:Gluconeogenesis / Q000502:physiology; D005947:Glucose / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007408:Intestinal Absorption; D007732:Kwashiorkor / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D008295:Malawi; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D018384:Oxidative Stress / Q000502:physiology; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate
chemical_list: D001786:Blood Glucose; D005947:Glucose