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Childhood severe acute malnutrition is associated with metabolomic changes in adulthood

Debbie S Thompson1,2,3, Celine Bourdon1,4, Paraskevi Massara1,5

  • 1Translational Medicine Program, Hospital for Sick Children, Toronto, Canada.

JCI Insight
|November 17, 2020
PubMed

Insights

Adults who survived severe acute malnutrition (SAM) show distinct metabolic profiles, indicating a higher risk for type 2 diabetes. Early childhood SAM exposure leads to long-term metabolic changes requiring clinical attention.

Area of Science:

  • Metabolomics
  • Pediatric Nutrition
  • Endocrinology

Background:

  • Severe acute malnutrition (SAM) is a leading cause of under-5 mortality globally.
  • Long-term cardiometabolic effects of SAM subtypes, severe wasting (SW) and edematous malnutrition (EM), remain poorly understood.
  • Targeted metabolomic analysis is crucial for understanding these long-term consequences.

Purpose of the Study:

  • To evaluate the metabolic profiles of adult SAM survivors.
  • To identify metabolic differences between SAM survivors and community participants (CPs).
  • To assess the long-term cardiometabolic risks associated with childhood SAM.

Main Methods:

  • A cohort study involving 122 adult SAM survivors (SW=69, EM=53) and 90 matched CPs.
  • Serum metabolite quantification using mass spectrometry and liquid chromatography.
  • Univariate and sparse partial least square discriminant analyses (sPLS-DAs) to identify discriminative metabolites.

Main Results:

  • Seventy-seven metabolite variables significantly distinguished SAM survivors from CPs.
  • SAM survivors exhibited lower liver fat, higher branched-chain amino acids (BCAAs), urea cycle metabolites, and kynurenine/tryptophan (KT) ratio.
  • Lower β-hydroxybutyric acid and acylcarnitine/free carnitine ratio in SAM survivors were linked to hepatic steatosis.

Conclusions:

  • Adult SAM survivors possess distinct metabolic profiles suggesting reduced β-oxidation and increased type 2 diabetes risk.
  • Childhood SAM exposure has lasting metabolic consequences that may progress with age.
  • Targeted clinical management is necessary for adult SAM survivors to address these metabolic risks.

Keywords:
Cardiovascular diseaseDiabetesMetabolism

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