Lipoprotein lipase activity in marasmic type of protein-calorie malnutrition.

Abstract

Kwashiorkor and marasmus constitute the two major syndromes of protein-calorie malnutrition encountered in infants and young children in many parts of the world.The clinical and metabolic characteristics of these syndromes differ significantly from one another, one difference being the fat metabolism. The increase of free fatty acids (FFA) in plasma has been accepted as the key factor causing fatty liver in kwashiorkor (Korn, 1955;Feigelson et al., 1961;Lewis et al., 1964;Fletcher, 1966;Bar-on and Stein, 1968 Heparin tests. After a fasting period of 12 hours, 12 U/kg. of heparin was administered intravenously. Blood was collected before and at the 15th, 45th, 60th, and 90th minutes after the administration of heparin. Plasma LPL activity, FFA, and glucose levels were determined within one hour of the collection.FFA in plasma were determined according to Dole's method as modified by Burns (Dole and Meinertz, 1960;Burns et al., 1963). Kern's method was used in the determination of LPL activity, details of which were given previously (Kern, Steinmann, and Sanders, 1961; Giirson and Etili, 1968). LPL activity was expressed as the amount of FFA in pEq/ml. per 60 min.produced from the substrate. A glucose oxidase method was used to determine blood glucose (Marks, 1959).Pilocarpine iontophoresis was carried out on all cases in this series.The statistical validity of the results was investigated by using the Student test. Half-life, zero time, extrapolated activity, and K slope constants were calculated in accordance with Boberg and Carlson's formulae (Boberg and Carlson, 1964). ResultsThe mean LFL activity in normal controls was found to be 0-298±0-167 ,uEq/ml. per 60 min. The mean values after heparin at 15, 45, 60, and 90 minutes were 4-013±0-894, 1-289±0-491, 0 544±0 343, and 0-399±0-319 ,uEq/ml. per 60 min., respectively.In cases of marasmus, the results of the first tests were as follows: the mean initial value was 0404±0 299 ,tEq/ml. per 60 min. The values after heparin were 2-125±0-916, 0-678±0-432, 0-469±0 263, and 0 325±0 247 ,uEq/ml. per 60 min. at the 15th, 45th, 60th, and 90th minutes.When the tests were repeated on 9 of the cases 6 weeks later, the mean initial value for LPL activity was found to be 0)294±0t128 ,tEq/ml. per 60 min. and the values after heparin at the same time intervals as above were 2-221±0-964, 087440-470, 0 473±0 208, and 0*270±0 129 ptEq/ml. per 60 min., respectively.

Oxidative Stress in Marasmic Children: Relationships with Leptin

“…In marasmus there is also hypoinsulinemia (2,14) and insulin is the most important activator of lipoprotein lipase (LPL) (23). Some authors have shown LPL deficiency in PEM (26,27). These above mentioned factors suggest that the marasmic children are unable to use triglyceride to generate LDL-C and might explain very low LDL-C and the paradox of higher triglyceride in marasmus.…”

Macromolecular Transport in Jejunal Mucosa of Children with Severe Malnutrition

“…as is usual in PEM (6,20). All the eight child ren whose foll ow-up wa s known improved afte r 3-4 months nutritional rehabilitation , except one (no .…”

Variations in Intralipid Tolerance in Newborn Infants

“…In an attempt to explain the findings in infants who did not achieve their target concentrations, it is possible that Intralipid infusions initiated an enhancement of clearance during the initial h of infusion, as Forget (8) has shown that Intralipid utilization during long term total parenteral nutrition improves. The two infants who exceeded the target plateau concentrations and became hypertriglyceridemic, differed from the others in that they were below the 3rd percentile for weight (28) at the time of study (though appropriate weight at time of birth), thus resembling small for gestational age (1, 16) and marasmic infants (14), who are known to have a delayed lipid clearance.…”