Plasma fatty acid status in Moroccan children: increased lipid peroxidation and impaired polyunsaturated fatty acid metabolism in protein-calorie malnutrition

In previous studies on plasma fatty acid and antioxidant status in 29 malno urished Moroccan children (12 with mild protein-calorie malnutrition, 17 wi th severe protein-calorie malnutrition) compared to 15 healthy control chil dren from the same area, we pointed out that these populations were heterog eneous in terms of their essential fatty acid and antioxidant status. The a im of the present study was to classify the children using the Waterlow cla ssification and their essential fatty acid status. The discrepancies in lip id parameters, nutritional and inflammatory markers, blood oxidative indexe s, antioxidant micronutrients or trace elements (selenium, zinc, vitamin E) related to polyunsaturated fatty acids were checked in these populations. Eight of the control subjects and nine of the severe protein-calorie malnut rition children were essential fatty acid-deficient, compared to only one o f the mild protein-calorie malnutrition group. Examination of the essential fatty acid-sufficient subjects with mild prote in-calorie malnutrition, compared to the essential fatty acid-sufficient co ntrol subjects, showed only a decrease in Z scores and a non-significant de crease in selenium and vitamin E, in severely malnourished children, albumi n, cholesterol and low density lipoprotein (LDL) cholesterol, plasma seleni um, vitamin E and zinc were low, whereas inflammatory proteins and triglyce rides were high. These features worsened with essential fatty acid deficien cy. In all protein-calorie malnutrition subjects, there was oxidative stress (i ncrease in thiobarbituric-acid reactants, imbalance between plasma polyunsa turated fatty acid, vitamin E and selenium levels), even in the absence of essential fatty acid deficiency. Monounsaturated fatty acids, oleic acid/st earic acid (C18:1 n-9/C18:0) Delta9 desaturase and n-3 and n-6 elongase act ivity indexes increased. The C18:1/C18:0 Delta9 desaturase activity index w as negatively correlated to Z scores (r = -0.44, P < 0.01 for Z score weigh t, r = -0.39, P < 0.01 for Z score height), albumin (r = -0.82, P < 0.01) a nd zinc (r = -0.51. P < 0.01) levels. In essential fatty acid-deficient, severe protein-calorie malnutrition subj ects, Delta6 desaturase activity was impaired, and there was a non-signific ant decrease in arachidonic acid. Essential fatty acid deficiency is a type of malnutrition, and is associated with an aggravation of all parameters i n severe protein-calorie malnutrition. The increase in the C18:1/C18:0 Delt a9 desaturase activity and enhanced lipid peroxidation without any essentia l fatty acid deficiency could be early markers of protein-calorie malnutrit ion. (C) 2001 Editions scientifiques et medicales Elsevier SAS.