ABSTRACI'. Lipid metabolism in marasmus has been poorly studied compared with that in kwashiorkor. Published studies show normal or high plasma.
Lipoprotein Mauritania1’2 Fran#{231}ois
and Michel
metabolism
Feillet, Henri-Joseph Vidailhet
ABSTRACI’
Lipid
poorly
studied
studies
show
lesterol
concentrations.
including
total,
with
or high
LDL
marasmus
some
and
plasma
cholesterol;
marasmic in
cholesterol and normal Lp A-I concentrations, that the cholesterol reverse transport system observed
normal
increased particles.
Lp C-III:B These data
quantitative lipoproteins,
triglyceride and Lp suggest
E:B, that
related
with LDL
which suggest is not altered. We and
ofthe
triglyceride-rich composition,
Am
to undercatabolism.
J C/in
to and
Nutr
Lipoprotein malnutrition,
particles, marasmus
lipids,
compared is
Over
apolipoproteins,
the
induced
by a global
been poorly kwashiorkor affected
of protein-energy
energetic
deficiency.
Lipid
compared
metabolism
with
kwashiorkor
(1-3).
metabolism: functional induce
is frequent
All these
many
interact
Lipoprotein
hepatopathy
(synthesis), and
few
found
years
there
has
studies the composition
been
a new
lipoproteins (1 1-14).
poproteins (HDLs), for example, comprise 1) Lp A-I:A-II, which contain apolipoprotein apolipoprotein A-I! (apo A-I!) as the main and
2) Lp A-I, which These two fractions
ferently
by drug
A-I!
contains apo have different
treatment
concentration with lower
concentrations
(15).
that
approach
A-I but no apo A-I!. roles and are affected
In a previous
( 14).
unaffected
cholesterol
efflux
li-
main subclasses: A-I (apo A-I) and protein components
clinical
from
This
dif-
study
in patients with coronary artery Lp A-I concentrations, whereas were
to
characterized High-density
two
us to hypothesize that Lp A-I may represent lipoprotein particle, a premise that fits showing
in anorexia
(8-10).
the
disease Lp A-I:
observation
led
the antiatherogenic with in vitro studies
adipose
cells
is mediated
factors
growth hormone, and diet, which induces dysfunction for which
aim
metabolism defined
changes protein
ofour
in different composition.
study
was to explore
in marasmus, by their
Subjects
and
particles
with
apolipoprotein
with
triglyceride
emphasis
the same and
on lipoprotein
density
cholesterol particles
composition.
methods
Patients Thirty-nine
marasmic
children
(24 boys,
1 5 girls)
aged
mo (22 ± 8 y, I ± SD) were studied on their admittance Nouadhibou Hospital in Northern Mauritania. They were
9-44 to hos-
(4).
factors
metabolism. (regulation)(5-7). triglycerides
has
very poor lipid intake, inpancreatic deficiency, stress
epinephrine, low-energy
a
In PEM
hypoglycemia and hypoinsulinemia. Liver important in marasmus than in kwashiorkor,
steatosis
(PEM)
studied in marasmus, which is not the case with In marasmus biological indexes are more mildly
and infection-which glucagon increases-and
with
intake,
metabolism and
hormonal
absorption,
and
is affected
by malnutrition,
responses
to malnutrition
Published studies have shown low cholesterol concentrations
subjects with marasmus triglycerides concentrations never been explained. 484
malnutrition
( 1 ).
can interfere with lipid testinal malabsorption,
chronic is less
past
Fruchart,
hypercholesterolemia
unexplained
lipid metabolism, which by their apolipoprotein
The is a type
with
also
essarily show but different
Introduction Marasmus
Jean-Charles
by Lp A-I but not by Lp A-I:A-II (1 2, 16). In addition, different apo B-containing lipoprotein particles such as Lp C-III:B and Lp E:B do not behave in the same way with regard to the lowdensity-lipoprotein (LDL) receptor pathway (17). Thus, studies of lipoproteins defined by their hydrated density will not nec-
1993:58:484-8.
KEY WORDS protein-energy
rasmus
lower HDL was linked
significantly
which are triglyceride-rich the marasmic state led
and structural modifications defined by their apolipoprotein
probably
apo-
compared HDL, and
concentrations
Bard,
cho-
particles Lp C-III:B,
of Northern
Jean-Marie
nervosa
indexes,
triglycerides;
children low total,
patients
been
low
lipid
A-I, A-Il, B, C-Ill, and E; and lipoprotein apo A-I, apo A-I and A-Il (Lp A-I:A-II)
and Lp E:B in Mauritanian a control group. We found
was
has
Published
triglycerides
studied
and
Kamian,
in kwashiorkor.
plasma
We
HDL,
in
that
Kadiatou
children
lipid
normal or high in plasma in
(1-4).
This apparent paradox of high in an extreme energy deficiency has Low cholesterol concentrations in maAm
J C/in Nuir
From the Service de M#{233}decineInfantile III, H#{244}pitald’Enfants, Vandoeuvre; the Service de Recherche sur les Lipoproteines et I’Ath#{233}roscl#{233}rose (SERLIA), INSERM U325, Institut Pasteur, Lille; and the Laboratoire de Biochimie Cliniqueet Mol#{233}culaire,Facult#{233}dePharmacie, Lille, France. 2 Address reprint requests to F Feillet, Service de M#{233}decineInfantile III, H#{244}pital d’Enfants, rue du Morvan, Vandoeuvre 5451 1, France. Received January 14, 1993.
1993:58:484-8.
Accepted
Printed
for publication
March
6, 1993.
in USA.
© 1993 American
Society
for Clinical
Nutrition
Downloaded from www.ajcn.org by guest on July 13, 2011
lipoproteins containing
Parra,
metabolism
compared normal
in marasmic
LIPOPROTEIN TABLE 1 Anthropometric
data
of patients
and control
(%)t
57 89 8.9 20.3
Height (%)t Quetelet index Age (mo) *
10j
99 ±
7
±
4 1 6.9
±
compared
t Significantly § In kg/rn2.
height or ideal body weight for sex and age the National Center for Health Statistics (18).
different
from
and inflammatory
patients,
P
0.001
