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Aflatoxins and kwashiorkor: a study in Sudanese children
Insights
Children with kwashiorkor show higher aflatoxin levels in their blood, suggesting increased exposure or impaired excretion. Aflatoxicol, a metabolite, was found in malnourished children, indicating metabolic differences.
Area of Science:
- Toxicology
- Pediatric Nutrition
- Biochemistry
Background:
- Aflatoxins are toxic metabolites produced by fungi, commonly found in food staples.
- Malnutrition, particularly kwashiorkor, is prevalent in many developing regions.
- Understanding the link between aflatoxin exposure and malnutrition is crucial for public health.
Purpose of the Study:
- To investigate aflatoxin and aflatoxicol levels in Sudanese children with different forms of malnutrition.
- To compare aflatoxin exposure and metabolism in malnourished children versus healthy controls.
- To explore potential mechanisms linking aflatoxin exposure to kwashiorkor.
Main Methods:
- High-performance liquid chromatography (HPLC) was used to analyze aflatoxin content.
- Blood (serum) and urine samples were collected from 252 Sudanese children.
- Participants included children with kwashiorkor, marasmic kwashiorkor, marasmus, and healthy controls.
Main Results:
- Aflatoxins were detected more frequently and at higher concentrations in the sera of children with kwashiorkor.
- Aflatoxicol was present in the sera of children with kwashiorkor and marasmic kwashiorkor, but not in controls.
- Urinary aflatoxin was most common in kwashiorkor cases, though concentrations were lower.
Conclusions:
- Kwashiorkor patients may have higher aflatoxin exposure or impaired aflatoxin excretion due to metabolic disturbances.
- The presence of aflatoxicol suggests altered aflatoxin metabolism in children with kwashiorkor.
- Further research, including food analysis, is needed to confirm these findings.
Abstract:
Blood and urine samples from 252 Sudanese children were investigated for their aflatoxin content by high-performance liquid chromatography. The children comprised 44 with kwashiorkor, 32 with marasmic kwashiorkor, 70 with marasmus, and 106 age-matched, normally nourished controls. Aflatoxins were detected more often and at higher concentrations in sera from children with kwashiorkor than in the other malnourished and control groups. Aflatoxicol, a metabolite of aflatoxins B1 and B2, was detected in the sera of children with kwashiorkor and marasmic kwashiorkor but not in the controls and only once in a marasmic child. The difference between children with kwashiorkor or marasmic kwashiorkor and those in the control or marasmus groups was significant. Urinary aflatoxin was most often detected in children with kwashiorkor but their mean concentration was lower than in the other groups. Aflatoxicol was not detected in urine in any group. These findings suggest either that the children with kwashiorkor have a greater exposure to aflatoxins or that their ability to transport and excrete aflatoxins is impaired by the metabolic derangements associated with kwashiorkor. The presence of aflatoxicol in the sera of children with kwashiorkor but not in the others suggests a difference in metabolism between the two groups. Further studies are needed, and measurement of aflatoxins in the food eaten by these children is already underway.