Impaired glucose absorption in children with severe malnutrition

Robert H. J. Bandsma*, Martijn N. Spoelstra, Andrea Mari, Marijke Mendel, Patrick F. van Rheenen, Edward Senga, Theo van Dijk, Geert Tom Heikens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Scopus)

Abstract

Objective To quantify intestinal glucose absorption in children with two types of severe malnutrition, kwashiorkor and marasmus, compared with healthy children.

Study design Children with kwashiorkor (n = 6) and marasmus (n = 9) and control subjects (n = 3) received a primed (13 mg/kg), constant infusion (0.15 mg/kg/min) of [6,6H2]glucose for 4.5 hours. Two hours after start of the infusion an oral bolus of glucose 1.75 g/kg labeled with [U-13C]glucose 10 mg/g was given and was followed by periodic blood sampling. Mathematical modeling was applied to determine oral glucose absorption.

Results Median total glucose absorption was 5.9 mmol/kg, interquartile range (IQR) 4.5-6.7 mmol/kg and 4.4 (IQR 2.9-5.9) mmol/kg in children with kwashiorkor and marasmus compared with 7.7 (IQR 5.8-9.0) mmol/kg in control subjects; P = .03 compared with marasmus). Children with the lowest glucose absorption were found specifically in the kwashiorkor group and marasmic children with hypoalbuminemia. Severe impairment in absorption correlated with urinary 8-hydroxydeoxyguanosine secretion (r = -0.62, P = .01).

Conclusions Severe malnutrition is associated with an impaired glucose absorption and decreased glucose absorption correlates with oxidative stress in these children. (J Pediatr 2011; 158: 282-7).

Original languageEnglish
Pages (from-to)282-U148
Number of pages7
JournalJournal of Pediatrics
Volume158
Issue number2
DOIs
Publication statusPublished - Feb-2011

Keywords

  • MALNOURISHED CHILDREN
  • SYNDROME KWASHIORKOR
  • OXIDATIVE STRESS
  • FREE-RADICALS
  • METABOLISM
  • MORTALITY
  • RECOVERY
  • MARASMUS
  • DIARRHEA
  • BLOOD

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