PROTEIN-METABOLISM IN CHILDREN WITH EDEMATOUS MALNUTRITION AND ACUTE LOWER RESPIRATORY-INFECTION

This study tested the hypothesis that whole- nutrition body protein ki netics remain low in children with edematous measured. malnutrition an d acute infection. Thirteen children with edematous malnutrition and a cute infection (subjects) were compared with 14 uninfected children wi th edematous malnutrition early in recovery (control children). Protei n kinetics were determined by using a primed, constant intravenous inf usion of [C-13]leucine and [N-15(2)]urea in the postabsorptive state. Calculations of rates of whole-body protein synthesis and breakdown we re based on the rate of leucine appearance; the rate of leucine oxidat ion was estimated from the rate of urea appearance. Protein synthesis and breakdown rates were lower in subjects than in control children (9 7 +/- 30 compared with 153 +/- 67, P < 0.01, and 103 +/- 30 compared w ith 160 +/- 67 mu mol leucine . kg(-1). h(-1), P < 0.01). No differenc e was found between the two groups in the rate of urea appearance, but this analysis only had a statistical power of 54%. The absence of the expected increase in the rate of protein turnover during acute infect ion in edematous malnutrition implies that acute phase proteins are ma de with a corresponding depletion of muscle, hepatic, and other body p roteins such as albumin, and that there may also be a blunting of the acute phase response.