Impaired dietary lipid oxidation in kwashiorkor

Abstract

Energy substrate oxidation studies were performed on 12 kwashiorkor children and five well-nourished children fed on a standard recovery diet for kwashiorkor. 13C labeled leucine, Glucose, and hiolein were administered orally on three consecutive days. The recovery of 13C from the breath air was monitored after administration of each feed. The mean cumulative percent dose (CUMPD) recovery of 13C seven hours after the ingestion of labeled leucine was 22.0 ± 1.7% (mean ± SEM) for the kwashiorkor children as compared to 32.7 ± 3.7% for the well-nourished children (p<0.05). The CUMPD recovery of 13C 12 hours after ingestion of labeled glucose was 58.3 ± 4.7% as compared to 70.2 ± 6.0% in the well-nourished children (p<0.05). The CUMPD recovery of 13C 16 hours after the ingestion of labeled hiolein was 4.8 ± 1.1% for the kwashiorkor children as compared to 19.0 ± 2.1% for the well-nourished children (p<0.0001). 13C recovery following hiolein ingestion was inversely correlated to the weight/expected weight for age and sex ratio (r = −0.93; p< 0.001). It is concluded that the well-nourished children oxidize more exogenous energy substrate than do the kwashiorkor children, and that the kwashiorkor children have a grossly impaired capacity to oxidize exogenous lipids.