TRANSFERRIN KINETICS ARE ALTERED IN CHILDREN WITH SEVERE PROTEIN-ENERGY MALNUTRITION

This study was undertaken to determine the following: 1) the kinetic c hanges responsible for the depletion and repletion of plasma transferr in (Tr) concentration in children with protein-energy malnutrition (PE M); 2) the role of infection in mediating these changes; and 3) whethe r plasma Tr concentration is related to body protein status. We measur ed plasma Tr concentration, and fractional (FSR) and absolute (ASR) Tr synthesis rates with the use of a constant intragastric infusion of H -2(3)-leucine in 14 children with PEM, at 2 d postadmission (study 1), 8 d postadmission when infections were under control (study 2), and a t recovery (study 3). In studies 1 and 2, the children synthesized les s Tr and had lower Tr concentrations compared with values at recovery. When infections were controlled, plasma Tr concentration rose, but Tr synthesis was unchanged, There were only fair correlations (P < 0.05) between plasma Tr concentrations and indices of wasting. Concerning m alnourished children, we reached the following conclusions: 1) changes in the Tr pool size are achieved mainly through changes in synthesis rate; 2) infections play a minor role in reducing the Tr pool through either changes in the rate of catabolism or loss from the intravascula r space; and 3) Tr concentration is not a very good indicator of prote in nutritional status.