Response of splanchnic and whole-body leucine kinetics to treatment of children with edematous protein-energy malnutrition accompanied by infection.

Abstract

BACKGROUND:

Although the reduction in whole-body protein turnover and net protein loss induced by protein-energy malnutrition (PEM) has been well documented, it is unclear whether the protein-sparing mechanisms elicited by chronically inadequate intakes of dietary protein and energy are affected by the protein catabolic response to infection.

OBJECTIVE:

The objective of this study was to determine whether the presence of infection alters the PEM-induced reduction in whole-body protein metabolism.

DESIGN:

We determined whole-body leucine kinetics in 4 boys and 3 girls aged 6-15 mo with edematous PEM and infection approximately 3 d after admission (study 1), when they were both infected and malnourished; approximately 11 d after admission (study 2), when infection had resolved but they were still anthropometrically malnourished; and at recovery (study 3), when weight-for-length was at least 90% of that expected.

RESULTS:

The children had significantly less leucine flux in both study 1 and study 2 than they had in study 3. There were no significant differences in the amount of leucine released from protein breakdown or used for protein synthesis between study 1 and study 2. There were no significant differences in leucine balance or in either the amount or percentage of enteral leucine extracted by the splanchnic tissues among the 3 studies.

CONCLUSIONS:

When subjects are in the fed state, severe PEM induces a marked reduction in whole-body protein synthesis and breakdown rates, and the presence of infection does not alter this adaptation and hence the overall protein balance. A corollary is that children with severe PEM do not mount a protein catabolic response to infection.

• Authors: Marvin Reid, Asha Badaloo, Terrence Forrester, William C Heird, Farook Jahoor
• Journal: The American journal of clinical nutrition (Am J Clin Nutr) Vol. 76 Issue 3 Pg. 633-40 (Sep 2002) ISSN: 0002-9165 [Print] United States
• PMID: 12198011 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Keto Acids
• Proteins
• alpha-ketoisocaproic acid
• Deuterium
• Leucine

Topics

• Deuterium
• Edema (complications)
• Female
• Humans
• Infant
• Infections (complications)
• Keto Acids (blood)
• Kinetics
• Leucine (metabolism)
• Male
• Protein Biosynthesis
• Protein-Energy Malnutrition (complications, metabolism, therapy)
• Proteins (metabolism)
• Splanchnic Circulation
• Weight Gain