title: Dietary cysteine is used more efficiently by children with severe acute malnutrition with edema compared with those without edema.
abstract: BACKGROUND
  Children with edematous severe acute malnutrition (SAM) produce less cysteine than do their nonedematous counterparts. They also have marked glutathione (GSH) depletion, hair loss, skin erosion, gut mucosal atrophy, and depletion of mucins. Because GSH, skin, hair, mucosal, and mucin proteins are rich in cysteine, we hypothesized that splanchnic extraction and the efficiency of cysteine utilization would be greater in edematous than in nonedematous SAM.
  
  
  OBJECTIVE
  We aimed to measure cysteine kinetics in childhood edematous and nonedematous SAM.
  
  
  METHODS
  Cysteine flux, oxidation, balance, and splanchnic uptake (SPU) were measured in 2 groups of children with edematous (n = 9) and nonedematous (n = 10) SAM at 4.4 ± 1.1 d after admission (stage 1) and at 20.5 ± 1.6 d after admission (stage 2) when they had replenished 50% of their weight deficit.
  
  
  RESULTS
  In comparison with the nonedematous group, the edematous group had slower cysteine flux at stage 1 but not at stage 2; furthermore, they oxidized less cysteine at both stages, resulting in better cysteine balance and therefore better efficiency of utilization of dietary cysteine. Cysteine SPU was not different between groups but was ∼45% in both groups at the 2 stages.
  
  
  CONCLUSIONS
  These findings suggest that children with edematous SAM may have a greater requirement for cysteine during early and mid-nutritional rehabilitation because they used dietary cysteine more efficiently than did their nonedematous counterparts and because the splanchnic tissues of all children with SAM have a relatively high requirement for cysteine. This trial was registered at clinicaltrials.gov as NCT00069134.
authors.affiliation: Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica.
authors.forename: Asha
authors.initials: A
authors.lastname: Badaloo
authors.forename: Jean W
authors.initials: JW
authors.lastname: Hsu
authors.forename: Carolyn
authors.initials: C
authors.lastname: Taylor-Bryan
authors.forename: Curtis
authors.initials: C
authors.lastname: Green
authors.forename: Marvin
authors.initials: M
authors.lastname: Reid
authors.forename: Terrence
authors.initials: T
authors.lastname: Forrester
authors.forename: Farook
authors.initials: F
authors.lastname: Jahoor
mesh_terms: D003545:Cysteine / Q000378:metabolism* / Q000627:therapeutic use; D004032:Diet; D004487:Edema / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006130:Growth Disorders / Q000178:diet therapy / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000150:complications / Q000178:diet therapy / Q000378:metabolism*; D008297:Male; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000178:diet therapy / Q000378:metabolism*; D015430:Weight Gain / Q000502:physiology*
chemical_list: D003545:Cysteine