Plasma fatty acids in children with grade III protein-energy malnutrition in its different clinical forms: Marasmus, marasmic kwashiorkor, and kwashiorkor

Plasma fatty acid patterns were analysed in 15 children aged 2 to 42 months (median =12 months) admitted to the University Hospital, Faculty of Medici ne of Ribeirao Preto, University of Sao Paulo, suffering from grade III pro tein-energy malnutrition in its different clinical forms: marasmus (n = 5), marasmic kwashiorkor (n = 5), and kwashiorkor (n = 5), A control group of eight children from the same population aged 3 to 22 months (median = 12 mo nths) was also studied. Plasma fatty acids were analysed by gas liquid chro matography, The plasma fatty acid patterns detected in grade III protein-en ergy malnutrition indicated changes characteristic of essential fatty acid deficiency, with lower linoleic acid (C18:2) levels in the three groups (p < 0.05), The major metabolite of linoleic acid, arachidonic acid (C20:4), w as lower in the kwashiorkor group than in the control group (p < 0.05), Lin oleic acid (C18:2) levels were lower in the marasmus group than in the kwas hiorkor group (p < 0.05), Several factors may have contributed to these cha nges, such as a decreased content of linoleic acid in the diet, plus malabs orption and/or poor utilization of fats, and changes in the synthesis or de gradation of these fatty acids, Although many questions remain unanswered, we suggest that an adequate amount of linoleic acid be added to the rehabil itation diet of these children in the form of vegetable fat.