THE INFLUENCE OF ALANINE INFUSION ON GLUCOSE-PRODUCTION IN MALNOURISHED AFRICAN CHILDREN WITH FALCIPARUM-MALARIA

By US standards, about half of African children are malnourished, alth ough most appear clinically normal. It is possible that precursor supp ly for gluconeogenesis is limited to a greater extent in these seeming ly malnourished African children than in healthy children, consequentl y limiting glucose production. Since in malaria peripheral glucose uti lization is increased, precursor supply could play an even more critic al role in maintaining glucose production in African children sufferin g from falciparum malaria. We studied the effect of alanine infusion ( 1.5 mg/kg/min) on glucose production (measured by infusion of [6,6-H-2 (2)]glucose) and plasma glucose concentration in 10 consecutive childr en with acute, uncomplicated falciparum malaria. By US standards, six children were below the 10th percentile of weight for height and seven were below the 10th percentile of height for age. Plasma concentratio ns of alanine increased during alanine infusion from 153 +/- 21 to 468 +/- 39 mu mol/l, whereas plasma lactate concentrations did (1.4 +/- 0 .2 vs. 1.3 +/- 0.2 mmol/l), concentration and glucose production did n ot change during alanine infusion: 4.6 +/- 0.3 vs. 4.5 +/- 0.3 mmol/l and 5.8 +/- 0.4 vs. 5.7 +/- 0.3 mg/kg/min, respectively. Gluconeogenic precursor supply is sufficient for maintainance of glucose production in African children with uncomplicated malaria who are malnourished b y US standards.