Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition

Abstract

The fatty acid (FA) composition of the main plasma lipids was analysed in eight well-nourished, generally healthy Nigerian children aged 14.1 +/- 7.2 months and in 17 malnourished children (8 marasmus, 9 kwashiorkor) aged 14.6 +/- 3.8 months within the first 2 days of admission at the Dept. of Child Health, University of Benin. In comparison to the control group, the malnourished children showed a marked decrease of polyunsaturated FA with low linoleic acid, mainly in sterol esters (STE), and severely reduced linoleic acid metabolites, including arachidonic acid, in all lipid fractions. omega-3-FA were not altered except for a reduction of docosapentaenoic and docosahexaenoic acids in phospholipids. Clearly increased values were found for saturated FA in STE and for the non-essential monoenoic FA in all lipid classes. This pattern indicates the presence of essential fatty acid deficiency in the malnourished children. There was no significant difference between marasmus and kwashiorkor. Eight malnourished children were followed up in the early phase of recovery during hospital treatment 14.0 +/- 3.1 days after obtaining the first sample. Linoleic acid had increased again in STE, but its metabolites were as low or even lower than before. An impaired activity of delta-6-desaturase, the rate limiting enzyme of linoleic acid metabolism, in suggested by elevated substrate-product-ratios of this enzyme in untreated children with protein energy malnutrition and in the early phase of recovery, which may be due to low insulin levels, protein and zinc deficiency. The trientetraen ratio (20:3 omega 9/20:4 omega 6) thus is not a reliable indicator of essential FA status in protein-energy malnutrition.

The effect of under- and overnutrition on essential fatty acid metabolism in childhood

“…Signi®cantly lower LA and AA values in malnourished children than in controls is a uniform ®nding in most studies, whereas plasma and erythrocyte membrane ALA values appear to be basically unaffected by PEM (Holman et al, 1981;Wolff et al, 1984;Koletzko et al, 1986;Vajreswari et al, 1990;Leichsenring et al, 1992). It is unclear whether the availability of DHA is affected: signi®cantly lower plasma phospholipid DHA values than in healthy controls were reported in Argentine (Holman et al, 1981) and Nigerian (Leichsenring et al, 1995) but not in another group of Nigerian (Koletzko et al, 1986) and in Sudanese (Leichsenring et al, 1992) malnourished children (Table 1).…”

“…To complicate matters, different effects on EFA metabolism of the two major forms of PEM, kwashiorkor and marasmus were reported in some (Vajreswari et al, 1990) but not in other (Koletzko et al, 1986) studies. (Vajreswari et al, 1990 reported subnormally low erythrocyte membrane lipid AA values in marasmic children, but not in children suffering from kwashiorkor.…”

Low levels of essential fatty acids are related to impaired delayed skin hypersensitivity in malnourished chronically ill elderly people

“…FA are also found in triglycerides, cholesterol esters and in free FA. The profile of FA in the various lipids is known to differ [2,21,22]. Accordingly, the total FA composition in serum is related to variations in FA metabolism as well as to the relation between the different lipids.…”

Metabolic derangements identified through untargeted metabolomics in a cross-sectional study of Nigerian children with severe acute malnutrition

“…Children with SAM have decreased desaturase activity, resulting in decreased synthesis of AA and DHA from their precursors (Koletzko et al 1986;). …”