CHANGES IN PROTEIN-TURNOVER AND RESTING ENERGY-EXPENDITURE AFTER TREATMENT OF MALARIA IN GAMBIAN CHILDREN

To explore the changes in resting energy expenditure (REE) and whole b ody protein turnover induced by malaria, 23 children aged 6 to 14 y (2 3.9 +/- 1.0 kg, 1.3 +/- 0.02 m) were studied on three separate days af ter treatment (d 1, d 2, and 15 d later). REE was assessed by indirect calorimetry (hood), whereas whole body protein turnover was estimated using a single dose of [N-15]glycine administered p.o. by measuring t he isotopic[15N]glycine administered p.o. by measuring the isotopic en richment of [N-15]ammonia in urine over 12 h. Within the first 3.5 h a fter treatment, the body temperature dropped from 39.8 +/- 0.1 to 37.8 +/- 0.1 degrees C (p < 0.0001), and REE followed the same pattern, de creasing rapidly from 223 +/- 6 to 187 +/- 4 kJ/kg/d (p < 0.0001). Who le body protein synthesis and breakdown were significantly higher duri ng the Ist day (5.65 +/- 0.38 and 6.21 +/- 0.43 g/kg/d, respectively) than at d 15 (2.95 +/- 0.17 and 2.77 +/- 0.2 g/kg/d). It is concluded that Gambian children suffering from an acute episode of malaria have an increased REE averaging 37% of the control value (d 15) and that th is was associated with a substantial increase (by a factor of 2) in wh ole body protein turnover. A rapid normalization of the hypermetabolis m and protein hypercatabolism states after treatment was observed.