Plasma and Red Blood Cell Fatty Acid Composition in Children with Protein-Calorie Malnutrition

Wolff, Jon A.; Margolis, Simeón; Bujdoso-Wolff, Katalin; Matusick, Edward; MacLean, William C.

doi:10.1203/00006450-198402000-00010

Cited by 53 publications

(19 citation statements)

References 9 publications

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“…To investigate possible differences between kwashiorkor and marasmus we concentrated on patients with these two syndromes only, that represent the two ends of a continous spectrum of pathological conditions resulting from malnutrition. In contrast to Wolff et al [69], who reported lower values of linoleic acid in marasmus and of arachidonic acid in kwashiorkor, we did not find a clear difference although arachidonic acid tended to lower proportionskwashiorkor in STE and PL (cf. Table 4).…”

Section: Discussioncontrasting

confidence: 85%

“…However, today there are still only scanty data on the supply and metabolism of EFA in PEM children. In plasma total lipids linoleic acid and its functionally important metabolites have been found to be decreased, accompanied by an increase of the saturated and the non-essential monoenoic FA, in Nigerian children with kwashiorkor [47,59] and in Peruvian and Honduran children with different types of malnutrition [10,69]. In PEM the relative distribution of the distinct plasma lipid classes, which differ in EFA content, is markedly altered [43,59,64], which may influence the FA composition of plasma total lipids.…”

Section: Introductionmentioning

confidence: 99%

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

Koletzko

Laryea

et al. 1986

Eur J Pediatr

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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.

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Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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

Koletzko

Laryea

et al. 1986

Eur J Pediatr

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“…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).…”

Section: Metabolism Of Essential Fatty Acids In Malnourished Childrenmentioning

confidence: 99%

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

1998

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Both protein-energy malnutrition (PEM) and obesity represent major challenges for paediatric nutrition. The aim of this review is to summarise available data regarding the effect of PEM and obesity on the availability of essential-and long-chain polyunsaturated fatty acids (LC-PUFAs) in childhood.Signi®cantly lower arachidonate (C20: 4n-6, AA) values in malnourished children than in controls is a consistent ®nding in all studies, whereas it is controversial whether the availability of docosahexaenoate (C22: 6n-3, DHA) is also affected. We found signi®cantly lower percentages (% wt/wt) of both AA and DHA in plasma phospholipids [AA: 7.0 (0.7) vs 8.7 (0.8); DHA: 0.90 (0.2) vs 2.6 (0.7), median (interquartile range), P`0.001] in severely malnourished children aged 29 (7) months than in control subjects. Product/substrate ratios indicated reduced delta-5-desaturation in children with PEM. We speculate that severely malnourished children may bene®t from enhanced dietary supply of both n-6 and n-3 LC-PUFAs.In obese adults AA has been reported to constitute a lower percentage of plasma phospholipid fatty acids, and AA supplementation of weight reduction diets has been suggested. In contrast, we found signi®cantly higher plasma phospholipid AA values [12.6 (2.4) vs 8.3 (1.4), P`0.001] in markedly obese children aged 13.8 (1.1) years than in non-obese controls. Product/substrate ratios of the delta-6-desaturase enzyme indicated enhanced conversion activity. These data suggest that obese children do not require LC-PUFA supplementation to low fat diets.The available data indicates that both PEM and obesity alter fatty acid composition of plasma and erythrocyte membrane lipids. The underlying mechanism appears to be altered activity of the bioconversion of essential fatty acids to their LC-PUFA metabolites. Sponsorship:

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“…Patients with end-stage liver disease (ESLD), particularly those in Child-Pugh class C, characteristically have very low levels of AA, eicosapentaenoic acid (EPA), and DHA, in plasma lipids, and, presumably, but not yet proven, lipids in tissue membranes compared with hospitalized controls without liver disease [9]. Insufficient food intake, malnutrition [10,11], and impairment of subsequent desaturation steps that regulate very-long-chain polyunsaturated fatty acid biosynthesis [12,13] also contribute to the very-long-chain polyunsaturated fatty acid deficiency found in patients with advanced liver cirrhosis. However, DHA and AA are of particular importance for the development of the central nervous system (CNS) in mammals [14] and its absorption is also influenced by obstructive jaundice.…”

Section: Introductionmentioning

confidence: 99%

Reduced Brain Content of Arachidonic Acid and Docosahexaenoic Acid Is Related to the Severity of Liver Fibrosis

et al. 2010

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Plasma and Red Blood Cell Fatty Acid Composition in Children with Protein-Calorie Malnutrition

Cited by 53 publications

References 9 publications

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

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

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

Reduced Brain Content of Arachidonic Acid and Docosahexaenoic Acid Is Related to the Severity of Liver Fibrosis

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