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Nutritional repletion of children with severe acute malnutrition does not affect VLDL apolipoprotein B-100 synthesis

Asha V Badaloo1, Terrence Forrester, Marvin Reid

  • 1University of the West Indies, Tropical Metabolism Research Unit, Mona, Kingston, Jamaica. asha.badaloo@uwimona.edu.jm

The Journal of Nutrition
|March 23, 2012
PubMed

Insights

VLDL apo B-100 synthesis is not impaired in children with severe acute malnutrition (SAM), regardless of edema. This finding challenges the assumption that reduced VLDL apo B-100 synthesis contributes to fatty liver in SAM.

Area of Science:

  • Biochemistry
  • Pediatric Nutrition
  • Metabolic Disorders

Background:

  • Very-low-density lipoprotein apolipoprotein B-100 (VLDL apo B-100) is crucial for liver fat secretion.
  • Impaired VLDL apo B-100 synthesis is hypothesized to cause hepatic steatosis in severe acute malnutrition (SAM), particularly edematous forms.
  • Previous studies lacked confirmation of reduced VLDL apo B-100 synthesis in edematous SAM compared to non-edematous SAM or well-nourished children.

Purpose of the Study:

  • To investigate VLDL apo B-100 kinetics in children with SAM.
  • To compare VLDL apo B-100 synthesis rates between edematous and non-edematous SAM.
  • To determine if VLDL apo B-100 synthesis is impaired in malnourished versus well-nourished states.

Main Methods:

  • Measured VLDL apo B-100 kinetics in 22 children with SAM (15 edematous, 7 non-edematous) aged 4-20 months.
  • Assessed kinetics at three treatment stages: post-admission, mid catch-up growth, and recovery.
  • Utilized stable isotope methodology (2H3-leucine incorporation) to quantify VLDL apo B-100 synthesis rates.

Main Results:

  • Fractional and absolute VLDL apo B-100 synthesis rates did not differ between edematous and non-edematous SAM groups.
  • Synthesis rates remained consistent from the initial malnourished stage through recovery.
  • VLDL apo B-100 concentrations were higher in the edematous group (P < 0.04) but did not change significantly during treatment.

Conclusions:

  • VLDL apo B-100 synthesis is not reduced in children with edematous or non-edematous severe acute malnutrition.
  • The common occurrence of hepatic steatosis in SAM may not be due to impaired VLDL apo B-100 synthesis.
  • Further research is needed to elucidate the mechanisms of hepatic steatosis in SAM.

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