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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Kwashiorkor and marasmus are both associated with impaired glucose clearance related to pancreatic β-cell dysfunction
Metabolism: Clinical and Experimental, Volume 61, No. 9, Year 2012
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Description
Severe malnutrition is a major health problem in developing countries and can present as kwashiorkor or marasmus. Kwashiorkor is associated with septicaemia, profound metabolic changes including hepatic steatosis, altered protein metabolism and increased oxidative stress. Limited data suggest that children with kwashiorkor have an impaired glucose tolerance and insulin secretion. Our objective was to determine glucose tolerance in children with kwashiorkor compared to marasmus and its relation to insulin secretion and sensitivity. Six children with kwashiorkor and 8 children with marasmus were studied. We were also able to include 3 healthy children for comparison. They received a primed (13 mg/kg), constant infusion (0.15 mg/kg/min) of [6,6- 2H 2]glucose for 4 h with serial blood sampling. In addition, an oral glucose tolerance test (OGTT) was performed with labeled 10 mg/g [U- 13C]glucose. Glucose clearance was determined using mathematical modeling. Glucose clearance rates during the OGTT were -392 (range 309) mL/kg in children with kwashiorkor, -156 (426) mL/kg in marasmus and 279 (345) mL/kg in the control group. Glucose clearance rates correlated with plasma albumin concentrations (r = 0.67, P = .001). Insulin responses were strongly impaired in both kwashiorkor and marasmus. There was no indication of peripheral or hepatic insulin resistance in the malnourished groups. We show that glucose clearance rates are affected in both children with marasmus as well as kwashiorkor, which correlate with plasma albumin concentrations. The disturbed glucose clearance in malnutrition is related to an impairment in insulin availability. © 2012 Elsevier Inc.
Authors & Co-Authors
Spoelstra, Martijn N.
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Mari, Andrea
Italy, Padua
National Council of Researches
Mendel, Marijke
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Senga, Edward L.
Malawi, Zomba
University of Malawi
van Rheenen, Patrick Ferry
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Van Dijk, Theo H.
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Reijngoud, Dirk Jan
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Zegers, Remco G.T.
United States, East Lansing
Michigan State University
Heikens, Geert Tom
Malawi, Zomba
University of Malawi
Bandsma, Robert H.J.
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Malawi, Zomba
University of Malawi
Statistics
Citations: 42
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1016/j.metabol.2012.01.019
ISSN:
00260495
Research Areas
Food Security
Health System And Policy
Maternal And Child Health
Noncommunicable Diseases
Study Design
Randomised Control Trial