Albumin kinetics in edematous and nonedematous protein-energy malnourished children

Morlese, John; Forrester, Terrence; Badaloo, Asha; Rosario, Melanie Del; Frazer, Margaret; Jahoor, Farook

doi:10.1093/ajcn/64.6.952

Cited by 47 publications

(26 citation statements)

References 19 publications

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“…Consistent with the general finding that younger persons have higher metabolic rates than do adults, a higher albumin FSR, ranging from 15%/d to 20%/d, has been found in 12-mo-old infants (43,44). Bunt et al (21) found values of 14%/d on the first postnatal day in fasted premature infants with a gestational age of 28 wk.…”

Section: Discussionsupporting

confidence: 52%

Albumin synthesis in premature neonates is stimulated by parenterally administered amino acids during the first days of life

Akker¹,

Braake²,

Schierbeek³

et al. 2007

The American Journal of Clinical Nutrition

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Background:We recently showed that parenteral administration of amino acids to premature infants immediately after birth is safe and results in a positive nitrogen balance and increased whole-body protein synthesis. However, we did not determine organ-specific effects; albumin, produced by the liver, is an important protein, but its concentration is often low in premature neonates during the first few days after birth. Objective: The objective of the study was to test the hypothesis that the fractional and absolute albumin synthesis rates would increase with the administration of amino acids after birth, even at low nonprotein energy intake. Design: Premature infants (1500 g birth weight), who were on ventilation, received from birth onward either glucose only (control group, n ҃ 7) or glucose and 2.4 g amino acid ⅐ kg Ҁ1 ⅐ d Ҁ1 (intervention group, n ҃ 8). On postnatal day 2, all infants received a primed continuous infusion of [1-13 C]leucine, and mass spectrometry techniques were used to determine the incorporation of the leucine into albumin. Results are expressed as medians and 25th and 75th percentiles. Results: Albumin fractional synthesis rates in the intervention group were significantly higher than those in the control group [22.9% (17.6 -28.0%)/d and 12.6% (11.0 -19.4%)/d, respectively; P ҃ 0.029]. Likewise, the albumin absolute synthesis rates in the intervention group were significantly higher than those in the control group [228 (187-289)

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Section: Discussionsupporting

confidence: 52%

Albumin synthesis in premature neonates is stimulated by parenterally administered amino acids during the first days of life

Akker¹,

Braake²,

Schierbeek³

et al. 2007

The American Journal of Clinical Nutrition

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“…Marasmus is defined by clinical wasting, while kwashiorkor is typically accompanied by more complex characteristics such as 21 pitting edema, hair discoloration, skin lesions and hepatomegaly, although considerable overlap with marasmus often exists. Biochemical features typically present in kwashiorkor include hepatic steatosis [34,35], a reduced protein turnover [36] and decreased albumin synthesis [37].…”

Section: Discussionmentioning

confidence: 99%

Malnutrition-associated liver steatosis and ATP depletion is caused by peroxisomal and mitochondrial dysfunction

Zutphen

Čiapaitė

Bloks

et al. 2016

Journal of Hepatology

156

125

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“…The first measurement was made in the infected-malnourished state ,2 days post-admission (experiment 1), the second when their infections were clear and the oedematous children had lost their oedema, ,8 days post-admission (experiment 2), and the third measurement was performed when the children were fully recovered, ,54 days post-admission (experiment 3). [17][18][19][20] Albumin and transthyretin (TTR)…”

Section: Synthesis Of Plasma Proteinsmentioning

confidence: 99%

Protein metabolism in severe childhood malnutrition

Jahoor

Badaloo

Reid

et al. 2008

Annals of Tropical Paediatrics

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The major clinical syndromes of severe childhood malnutrition (SCM) are marasmus (non-oedematous SCM), kwashiorkor and marasmic-kwashiorkor (oedematous SCM). Whereas treatment of marasmus is straightforward and the associated mortality is low, kwashiorkor and marasmic-kwashiorkor are difficult to treat and have high morbidity and mortality rates. Despite extensive research, the pathogenic factors which cause a child to develop the oedematous instead of the non-oedematous form of SCM in response to food deprivation are still not clear. Over the years, two attractive hypotheses have been put forward. The first proposed that a dysadaptation in protein metabolism was involved and the second proposed that free radical damage of cellular membranes might be involved. To address aspects of these hypotheses, in this article we have reviewed work done by our group and by others on protein metabolism and pro-oxidant/anti-oxidant homeostasis in children with the oedematous and non-oedematous syndromes of SCM. A significant finding is that when there is chronic food deprivation children with non-oedematous SCM can maintain body protein breakdown at the same rate as when they are well nourished, but children with oedematous SCM cannot. The slower protein breakdown rate of children with oedematous SCM reduces the supply of most amino acids, resulting in decreased availability for the synthesis of plasma proteins involved in nutrient transport and the acute phase response to infection. Another consistent finding is that children with oedematous SCM have oxidative stress as there is evidence of oxidant-induced cellular damage and impaired synthesis of the primary cellular anti-oxidant glutathione.

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Albumin kinetics in edematous and nonedematous protein-energy malnourished children

Cited by 47 publications

References 19 publications

Albumin synthesis in premature neonates is stimulated by parenterally administered amino acids during the first days of life

Albumin synthesis in premature neonates is stimulated by parenterally administered amino acids during the first days of life

Malnutrition-associated liver steatosis and ATP depletion is caused by peroxisomal and mitochondrial dysfunction

Protein metabolism in severe childhood malnutrition

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