Lack of a significant change in caffeine metabolism in underweight children as determined by the caffeine breath test

Abstract

ObjectiveLimited data from pharmacokinetic studies in underweight and severely malnourished children have indicated an impaired activity of their hepatic enzymes. We used the caffeine breath test to assess the metabolising activity of cytochrome P450 1A2 (CYP1A2) enzyme in underweight children.MethodsUnderweight children from the paediatric outpatient clinic, Lagos State University Teaching Hospital, Ikeja in Nigeria, were studied. After an overnight fast, 15 underweight children took 3 mg/kg labelled caffeine orally. Breath samples were collected in duplicate at −20, −10 and −1 min and at 15 min intervals for 2 h. The mean cumulative per cent dose recovered (CPDR) of labelled caffeine in the expired carbon dioxide was determined over the study period. This was repeated after 2–6 weeks of nutritional rehabilitation.ResultsThe mean areas under the enrichment-time curve before and after nutritional rehabilitation were 0.539±0.320 and 0.620±0.322 atom per cent excess minute, respectively. The difference between the two values was not statistically significant (p=0.528). The mean CPDR in the exhaled carbon dioxide of the underweight children over a period of 2 h was 7.56±4.01% and 7.95±3.68% before and after nutritional rehabilitation, respectively, and there was no significant difference in the mean values (p=0.603).ConclusionsThe metabolism of caffeine was not significantly affected in underweight children compared with after 2–6 weeks of nutritional rehabilitation. This suggests that hepatic CYP1A2-metabolising activity was not significantly impaired in underweight children.

Clinical features of the impact of eating disorders on the results of 13C-methacetin breath test for assessment of liver function in girls with anorexia nervosa

“…Similarly, Oshikoya et al described significant differences of caffeine metabolism in the breath test in children with different types of chronic malnutrition (marasmus, kwashiorkor, marasmic kwashiorkor) -lower values before than after realimentation [18]. The same authors, employing also a breath test with caffeine, investigated a group of children with weight deficiency and did not reveal significant differences of the metabolic activity of the liver initially and after 2-6 weeks of realimentation [10]. As was noted by the researchers, malnutrition includes a number of disorders leading to improper nutritional status, but with different mechanisms.…”

“…As was noted by the researchers, malnutrition includes a number of disorders leading to improper nutritional status, but with different mechanisms. Depending on the pathogenesis of the disease, the systemic consequences of malnutrition, including the impact on the hepatic metabolism, may also vary [10]. In the case of AN ED the weight loss is intentional and all behaviours of the patient aim to intensify the decline of weight [7].…”

“…MBT was performed in patients and controls using an IRIS device according to the methodology recommended by the manufacturer [10]. The investigation was carried out in the morning, after fasting.…”