Fatty acid composition of plasma lipids in acrodermatitis enteropathica before and after zinc supplementation

The fatty acid composition of different plasma lipid fractions has been estimated in a 6-month-old girl with acrodermatitis enteropathica before and after zinc supplementation.Linoleic acid and its metabolites were extremely reduced in triglycerides and sterol-esters. In contrast, n-3-fatty acids were increased in sterol-esters and phospholipids.Zinc supplementation led to quick clinical improvement, and linoleic and arachidonic acid increased rapidly in triglycerides and sterol-esters to the values of healthy infants. Fatty acids of phospholipids remained relatively stable.Our finding could be explained by impaired enteral absorption of linoleic acid. Further attention should be directed to the supply and metabolism of essential fatty acids in acrodermatitis enteropathica.Abbreviations AE acrodermatitis enterophatica - FA fatty acids - OFC occipito-frontal circumference - PL phospholipids - STE sterol-esters - TG triglycerides     

Effects of malnutrition on the erythrocyte fatty acid composition and plasma vitamin E levels of Pakistani children

Abstract Erythrocyte fatty acids and plasma vitamin E concentrations were determined in 47 grade 2 and 21 grade 3 malnourished Pakistani children (ages 4–56 months). Data were compared with those of 26 age- and sex-matched apparently healthy controls. Evaluation with three statistical approaches revealed that both grade 2 and grade 3 malnourished children had decreased erythrocyte ω6 fatty acids and to a lesser extent decreased ω3 fatty acids. These decreases were compensated for by increased ω9 fatty acids. The patients tended to have lower plasma vitamin E concentrations. We conclude that malnourished Pakistani children have low essential fatty acid status, notably those of the ω6 series. The combination of low erythrocyte 22:6ω3 and a low 22:5ω6/22:4ω6 ratio in grade 2 patients suggests low Δ4-desaturation activity, which may be due to impaired peroxisomal β-oxidation.     

Fatty acid composition of plasma lipids in HIV-infected children. Comparison with seroreverters

Children infected with the type-1 human immunodeficiency virus (HIV) are at risk of nutritional deficiencies leading to an impaired polyunsaturated fatty acid (PUFA) status. The aim of the present study was to compare the PUFA composition of plasma lipid classes (total lipids, phospholipids (PL), cholesteryl esters (CE) and triglycerides) in well-growing HIV-infected children with an age-matched group of HIV-seroreverter children born to infected mothers. Eighteen HIV children, of both sexes, mean age 4.6 y, most of whom under combined antiretroviral regimen, were compared with 18 seroreverters, mean age 5.4 y, comparable for demographic, anthropometric and dietary characteristics. All children had adequate growth parameters (weight and height > 3rd percentile). The plasma fatty acid content was similar in the two groups. HIV seropositive subjects showed lower linoleic acid (LA) levels in all the plasma lipid fractions, with higher 20:3n-9 and 20:5n-3 levels in PL and CE. The plasma PL triene/tetraene ratio (marker of relative LA deficiency) related positively to the viral load and negatively to the blood CD4+ lymphocyte count. Compared to age-matched seroreverter subjects, HIV-seropositive children show a lipid fatty acid status suggestive of relative LA deficiency and increased turnover of the PUFA series.     

Fatty acid composition of serum lecithin in healthy children

Serum concentrations of cholesterol, triglycerides, phospholipids and the fatty acid composition of lecithin were determined in 107 children aged 1–15 years. The major aim of the study was to find out the normal ranges of the proportions of the essential fatty acids in lecithin for further studies of nutritional and metabolic disorders. The population contained partly children admitted for general anaesthesia, partly healthy school children. The series was considered to be representative of normal children of the ages in question.The fatty acid composition of lecithin did not differ with sex, but changed with increasing age. Linoleic acid increased and arachidonic acid decreased, both significantly (P<0.001 and P<0.01, respectively). Palmitic acid decreased with increasing age (P<0.05). The changes were small. At all ages palmitic acid was the largest proportion of the fatty acids in lecithin and linoleic acid the second largest. In all the age groups there was an inverse relationship between linoleic acid and oleic acid, and between palmitic acid and stearic acid.The mean values of cholesterol varied between 3.9 and 4.6 mmol/l and triglycerides between 0.6 and 1.0 mmol/l. The concentration of these two lipids increased with increasing age. The mean phospholipid concentration varied between 2.4 and 2.8 mmol/l and did not vary with age.The parents and patients gave their full consent to the blood sampling, which was done before operation or at the same time as the examination. Permission for the study was also given by the Ethical Committee of the University of Gothenburg     

Fatty acid composition of lipid classes in maternal and cord plasma at birth

The fatty acid composition of plasma phospholipids, triglycerides, cholesterol esters and nonesterified fatty acids was determined by high-resolution capillary gas-liquid chromatography in 41 pairs of mothers and their term infants at time of birth. The total free fatty acid content in maternal and cord plasma was positively correlated, possibly reflecting a passive, gradient dependent transplacental passage of nonesterified fatty acids. Higher percentage values of several saturated and monounsaturated fatty acids in cord than in maternal plasma phospholipids, triglycerides and nonesterified fatty acids may have resulted from an active fetal fatty acid synthesis. Trans fatty acids were found in every lipid class at similar or slightly lower percentages in neonatal as in maternal plasma, thus confirming their placental passage. Long-chain n-6 and n-3 polyunsaturated fatty acids are preferentially incorporated into phospholipids and sterolesters of both maternal and cord plasma. Linoleic and α-linolenic acids were found in smaller portions in cord than in maternal fatty acids, in contrast to strikingly higher proportions of their long-chain polyunsaturated metabolites, which may indicate a discriminating placental transport for certain physiologically important long-chain polyunsaturated fatty acids. Conclusion The fetus appears to obtain fatty acids from a combination of de novo synthesis, a passive gradient dependent transplacental passage of nonesterified fatty acids and a selective materno-fetal placental transport for certain fatty acids, such as physiologically important long-chain polyunsaturated fatty acids. Received: 17 June 1997 / Accepted in revised form: 3 November 1997     

Polyunsaturated fatty acids in erythrocyte and plasma lipids of children with severe protein–energy malnutrition

The fatty acid composition of plasma cholesterol esters, plasma phospholipids, erythrocyte phosphatidylcholine and erythrocyte phosphatidylethanolamine was investigated in severely malnourished Nigerian children with kwashiorkor (n = 12) and marasmus (n = 32). Normally nourished children from the same area (n = 23) served as controls. The malnourished children showed a significant reduction of highly polyunsaturated fatty acids in cholesterol esters, phospholipids and phosphatidylcholine. No differences between the groups were found in erythrocyte phosphatidylethanolamine. Children with kwashiorkor had lower levels of linoleic acid metabolites and docosahexaenoic acid than marasmic children. The results suggest that the kwashiorkor syndrome is associated with impaired desaturation and elongation of PUFA and/or increased lipid peroxidation.     

Fatty acid composition of plasma lipid classes in healthy subjects from birth to young adulthood

The fatty acid (FA) composition of plasma phospholipids, triglycerides and cholesterol esters (STE) was determined by high resolution capillary gas-chromatography in 115 apparently healthy subjects from birth to young adulthood. After birth, percentage contributions of linoleic and alpha-linolenic acid increased, whereas long-chain polyunsaturated fatty acids decreased in all FA fractions. No difference in plasma FA composition was seen between groups of children aged 1-<5, 5-<10 and 10-<15 years, except for a decrease of total saturated FA in STE between 1-<5 years (18.5%, wt/wt) and 10-<15 years (14.5%,P<0.005). No difference was observed for the values of boys and girls. The results on plasma lipid FA distribution in children aged 1–15 years may be used as reference values for metabolic and nutritional investigations.     

Leucocyte ascorbic acid levels in Nigerian children with protein-energy malnutrition

Leucocyte ascorbic acid (LAA) levels were estimated in 26 Nigerian infants and preschool children with protein energy malnutrition (PEM) in order to ascertain their ascorbic acid status. The children included eight with kwashiorkor, 12 with marasmus and six with marasmic kwashiorkor. The mean (SD) LAA level of 13.7 (8.2) micrograms/10(8) leucocytes in the malnourished children did not vary significantly from the mean level of 14.4 (8.8) micrograms/10(8) leucocytes found in 26 age-matched controls, and the values were unrelated to the presence or absence of megaloblastic change in the 14 bone marrows examined. It was concluded that ascorbic acid deficiency was not prevalent amongst children with PEM in Lagos, and was therefore not usually contributory to the anaemia, megaloblastic changes or other features of the syndrome seen in Nigerian children in Lagos.     

Fatty acid composition of erythrocyte membrane lipids in healthy subjects from birth to young adulthood

The fatty acid composition of erythrocyte membrane lipids may better reflect the fatty acid status of the organism than the fatty acid composition of plasma lipids. The present study aimed to provide normal values for erythrocyte fatty acid composition in a sizeable group of healthy subjects throughout the paediatric age group. The fatty acid composition of erythrocyte membrane phosphatidylcholine (PC) and phosphatidylethanolamine (PE) lipids was determined by high-resolution capillary gas chromatography in 188 apparently healthy subjects from birth to young adulthood (newborns: n = 17, infants: n = 97, children: n = 38, young adults: n = 36). The values of linoleic acid (C18:2n-6) increased steadily between birth and young adulthood (newborns: 6.49 [2.45], infants: 14.51 [4.32], children: 18.10 [3.25], young adults: 19.87 [2.03], PC lipids, shown as median [interquartile range, IQR], p < 0.001]. In contrast, the values of arachidonic acid (C20:4n-6) were significantly higher in children than in young adults (PC: 9.48 [6.64] versus 8.00 [1.85], PE: 26.38 [3.98] versus 24.46 [2.44], p < 0.05). The values of alpha-linolenic acid (C18:3n-3) decreased significantly between children and young adults (0.14 [0.11] versus 0.08 [0.07], PE lipids, p < 0.05). The values of docosahexaenoic acid (C22:6n-3) increased significantly from infancy through childhood up to young adulthood (PE: 4.20 [2.41] and 4.55 [0.97] and 6.66 [1.81], p < 0.05 and 0.001, respectively). We found significantly higher total trans isomeric fatty acid values in newborns than in infants (PC: 0.60 [0.27] versus 0.43 [0.19], p < 0.05; PE: 0.66 [0.76] versus 0.30 [0.26], p < 0.001). From the results, we conclude that: (1) the data obtained in the present study may serve as reference values in the evaluation of the fatty acid status from birth to young adulthood; (2) the significantly higher values of trans fatty acids at birth than at later stages of life may be of concern, because previous studies suggested that trans fatty acids may interfere with essential fatty acid metabolism during the perinatal period.     

Fatty acid composition of plasma and red cell phospholipids of preterm babies fed on breast milk and formulae

Fatty acids of plasma and red cells of preterm babies, gestational age 28–33 weeks, weighing less than 2200 g were studied between birth and the expected date of delivery (EDD). Babies were fed either mothers' breast milk, or if they were unable, or chose not to breastfeed, randomly assigned to milk formula A or B. Milk B had 26% oleic acid, 0.5% docosahexaenoic acid (DHA) and 0.12% arachidonic (AA); A had 13% oleic acid, less than 0.05% AA and no DHA. The proportions of gamma linoleic and the other fatty acids, and the ratio of linoleic acid (LA)/alpha linolenic acid (ALA) were comparable in the two formulae. Diet and/or physiological adaptation seemed to be responsible for the significant changes in the proportions of certain fatty acids between birth and EDD. Incorporation of DHA in formula B increased its concentration in plasma and red cells, and reduced the conversion of LA to AA. With respect to maintenance of DHA status, milk B was superior to milk A but did not match breast milk.Conclusion Fortification of formula with DHA without concomitant incorporation of AA may precipitate AA insufficiency and may have developmental implications.     

Serum,zinc and copper levels in children with protein energy malnutrition

Serum zinc and copper were measured by atomic absorption spectrophotometry in 58 children (3 months-5 years); of these, 46 children had protein energy malnutrition (PEM), and 12 children served as controls. The levels of serum zinc and copper were found to be significantly low in children with severe malnutrition (grades III and IV PEM). There was a significant positive correlation between serum zinc and height-for-age (r=0.8809, p<0.001). Serum copper was found low only in children exhibiting marked linear growth retardation (height-for-age <85% of the normal). Hypoalbuminemia (serum albumin <2.5 g/dl), and anemia (hemoglobin ≤8.0 g/dl) in malnourished children were associated with significant decline in serum zinc and copper levels, respectively.     

Serum leptin concentrations in children with mild protein-energy malnutrition and catch-up growth

BACKGROUND: The aim of the present study was to clarify the relationship between changing nutritional anthropometric data and serum leptin concentrations during the catch-up growth process in children. METHODS: Thirty children with mild protein-energy malnutrition (PEM) were followed for 6 months and their anthropometric measurements and serum leptin concentrations were recorded during follow up. RESULTS: Twenty-two (73.3%) of the 30 children showed catch-up growth. All parameters and serum leptin concentrations increased during the period of catch-up growth. In the remaining eight children, weight for height, percentage standard body mass index, percentage standard body height and mean serum leptin concentrations did not show any significant increase at the 6 month follow-up. Mean serum leptin concentration was higher in children with catch-up growth than in the controls. CONCLUSION: During recovery from malnutrition, leptin concentrations increase in relation to fat mass if the fat mass reaches a critical point, and leptin might trigger catch-up growth with its regulator effects on growth. Although weight gain was noted in both groups, an increase in leptin concentration was observed only in children who showed catch-up growth. More interestingly, the mean leptin concentration was much higher in children with PEM who had catch-up growth compared to the control group and in children who failed to have catch-up growth. In children with catch-up growth, the higher serum leptin concentrations compared to healthy children and to children without catch-up growth despite significant weight gain suggests that leptin affects nutritional status in catch-up growth as a dynamic process, rather than merely being an index of body fat content.     

Brainstem auditory and visual evoked potentials in children with protein-energy malnutrition

BACKGROUND: To determine the effects of malnutrition on the developing brain with brainstem auditory evoked potentials (BAEP) and flash visual evoked potentials (fVEP). METHODS: The BAEP and fVEP of 11 kwashiorkor (8 +/- 1.56 months) and 10 marasmus (7.9 +/- 1.27 months) patients and 10 healthy control subjects (7.65 +/- 0.82 months) were recorded and the measurements were compared with each other in relation with plasma total protein and albumin levels. RESULTS: There were no differences between the mean latencies of the waves I, II, III and IV and mean interpeak latencies (IPL) of the waves I-III of the BAEP and the wave IV (N2) of the fVEP between the three groups. Mean latency of the wave V and mean IPL of the waves I-V and the waves III-V were significantly different between the three groups. The kwashiorkor group had significantly longer mean latency of the wave V than the marasmus group on the right ear and the control group on the both of the ears. The kwashiorkor group had significantly longer mean IPL of the waves I-V than the marasmus group on the right ear and than the control group on the left ear. The kwashiorkor group had also significantly longer mean IPL of the waves III-V than the control group on the left. CONCLUSIONS: The BAEP and fVEP are non-invasive electrophysiologic methods reflecting the integrity or disruption of the central neurologic pathways. The present results confirm the disruption of the central nervous system with the BAEP in children with protein-energy malnutrition, especially in kwashiorkor patients.     

Fatty acid composition of phospholipids of plasma and of mononuclear blood cells in children with allergic asthma and the influence of glucocorticoids

Fatty acid (FA) composition of plasma phospholipids and phospholipids extracted from peripheral mononuclear white blood cells (MNC) was investigated in 11 allergic asthmatic children (age 8.9±4.6 years), in 10 age-matched non-allergic healthy controls and in 14 allergic and non-allergic children with an acute attack of asthma, who had received prednisolone medication for 2–4 days. In allergic asthmatics eicosapentaenoic acid (205n–3) was significantly elevated in both plasma and MNC. The relative amount of 205n–3 in MNC as well as in plasma correlated positively with increasing levels of total serum IgE (P<0.02). The pattern of the other FAs in plasma and of MNC phospholipids did not differ between allergic asthmatic and non-allergic control children. In children with an acute attack of asthma, who had been treated with glucocorticoids (2 mg prednisolone/kg body weight for 2–4 days), distinct changes of relative FA composition of phospholipids were restricted to plasma, where some very long chain FA (224n–6, 225n–6) were elevated. No significant changes in FA from MNC phospholipids could be observed after glucocorticoid treatment. These findings may indicate a possible role of 205n–3, the precursor of group 3 eicosanoids, in allergic asthmatic children.     

Characteristics of obese children with low content of arachidonic acid in plasma lipids

BACKGROUND: Although there have been many studies on the relationship between obesity and long-chain polyunsaturated fatty acid (LCPUFA), the results and their interpretation are controversial, especially in children. Arachidonic acid (AA), the product of n-6 LCPUFA, is reported to be related to insulin resistance. The purpose of the present paper was to investigate the LCPUFA profile in obese children and mechanisms that contribute to reduced AA content. METHOD: An age- and sex-matched control study was performed. The study subjects were 59 obese children (mean age, 11.8 years) and 53 healthy non-obese children (mean age, 12.5 years). The study parameters included anthropometric measurements, serum lipids, leptin and fatty acid composition in plasma. RESULTS: Plasma fatty acids in obese children had lower linoleic acid (P < 0.0001) and higher dihomo-gamma-linolenic acid (P = 0.0004) than those in non-obese children. In all subjects combined, delta-6 desaturase (D6D) index (ratios of [C 18:3n-6+C 20:2n-6]/C 20:4n-6 or C 20:4n-6/C 18: 2n-6) correlated with leptin (P < 0.0001). There was no significant difference in AA content between obese and non-obese. However, the AA content was low (相似文献   

(n-6)-Fatty acids in plasma lipids of children with atopic bronchial asthma

It has been suggested that atopy is associated with an impairment in the δ6-desaturation of (n-6)-polyunsaturated fatty acids and subsequently low levels of eicosanoid precursors. To evaluate this hypothesis we analyzed the fatty acid composition of plasma phospholipids and plasma cholesterolest-ers in a well-defined group of children with atopic bronchial asthma (n = 17) and age-matched healthy controls (n = 10). Atopic children showed significantly higher levels of linoleic acid and lower proportions of arachidonic acid in plasma lipids. No differences were observed with respect to γ-lino-lenic acid (GLA) and dihomo-γ-linolenic acid (DHLA). It is concluded that there is no biochemical evidence for a δ6-desaturation defect in atopic children and therefore no justification for the supplementation of GLA and DHLA; e.g. by the use of evening primrose oil preparations.     

Fatty acid deficiency profile in children with food allergy managed with elimination diets

Aim: To evaluate plasma fatty acid (FA) composition of children with food allergy undergoing elimination diets that avoided the offending antigens. Methods: Twenty‐five children (14 male, 11 female) aged 3.8 ± 1.6 years (range 2–7 years) affected of multiple food allergy and managed with elimination diets participated in a cross‐sectional study. Results of plasma fatty acids were compared with data obtained in 61 healthy children. Results: The patients had significantly lower values for plasma content in total polyunsaturated fatty acids, ω3 polyunsaturated fatty acids and long‐chain ω3 polyunsaturated fatty acids (p < 0.001) and particularly, in eicosapentaenoic acid (EPA) (20:5ω3) and docosahexaenoic acid (DHA) (22:6ω3) (p < 0.001). Moreover, all established indices (essential fatty acid [EFA] index ((ω3 +ω6)/(ω7 +ω9)) (p < 0.001) and sufficiency of docosahexaenoic acid index (C22:6ω3/C22:5ω6) (p < 0.001)) confirmed the presence of EFA deficiency. Conclusion: Children with food allergy managed with restricted intake of foods such as milk, egg, fish and vegetables are at risk of developing a deficiency in EFA and particularly in ω3 long‐chain polyunsaturated fatty acids, which are especially necessary for adequate growth, neurological development and cardiovascular health.     

Abnormal fatty acid pattern of the plasma cholesterol ester fraction in cystic fibrosis patients with and without pancreatic insufficiency

In our previous work it was found that in cystic fibrosis patients with and without pancreatic insufficiency, the fatty acid pattern of the plasma long chain, non-esterified fatty acid fraction is strikingly abnormal in comparison with the corresponding pattern of healthy subjects. However, other investigators have shown abnormal fatty acid patterns only in patients with pancreatic insufficiency. Therefore, we studied the plasma cholesterol ester fraction in cystic fibrosis patients of both types by gas liquid chromatography. It was found that the absolute total concentration of the plasma cholesterol esters in cystic fibrosis patients with and also without pancreatic insufficiency is significantly lower than in healthy subjects.Furthermore, the fatty acid pattern of this lipid fraction is significantly abnormal in both groups of patients, although to a lesser extent in patients without pancreatic insufficiency.     

Early development in children with moderate acute malnutrition: A cross‐sectional study in Burkina Faso

Malnutrition impairs cognitive, communication, and motor development, but it is not known how nutrition and health are associated with development in children with moderate acute malnutrition (MAM). We aimed to describe motor and language development of children with MAM and explore its nutrition and health‐related correlates. This cross‐sectional study used baseline data from a nutritional trial in children with MAM aged 6–23 months in Burkina Faso. Motor and language skills were assessed using the Malawi Development Assessment Tool (MDAT). Linear mixed models were used to explore potential correlates of MDAT including socio‐economic status, anthropometry, body composition, whole‐blood polyunsaturated fatty acids (PUFA), haemoglobin (Hb), iron status, and morbidity. We also assessed child and caregiver participation during MDAT procedures and their associations with correlates and development. MDAT data were available for 1.608 children. Mean (95% CI) MDAT z‐scores were ?0.39 (?0.45, ?0.34) for gross motor, 0.54 (0.48, 0.59) for fine motor, and ?0.91 (?0.96, ?0.86) for language skills. Children with higher mid‐upper arm circumference, weight‐for‐height, height‐for‐age, fat‐free mass, n‐3 PUFAs, Hb, and iron status had better MDAT z‐scores, whereas children with more fat mass index, anaemia, illness, and inflammation had poorer z‐scores. In addition, children living in larger households or with an unmarried mother had poorer MDAT z‐scores. Associations between morbidity and z‐scores were largely explained by children's poorer participation during MDAT assessment. The identified factors associated with child development may inform interventions needed to stimulate development during or after management of MAM.     

Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition

OBJECTIVE: This study was undertaken to assess the left ventricular mass (LV Mass) and systolic and diastolic functions of the left ventricle in children with protein energy malnutrition (PEM). METHODOLOGY: Thirty children, aged between 2 months and 2 years with PEM (four kwashiorkor, seven marasmic- kwashiorkor, 19 marasmus), and 17 healthy, age-matched children, using Doppler echocardiography were studied. RESULTS: The mean LV Mass in the patients was lower than that in the controls (14.5 +/- 5.2 vs 19.8 +/- 4.7 g, P < 0.05). However, the LV Mass/body surface area was not different in the patients with PEM and in the control group (52 +/- 9.2 vs 53.9 +/- 8.2g/m(2), P > 0.05), indicating that LV Mass was reduced in proportion to decrease in body size in malnutrition. Left ventricular septal and posterior wall thickness in PEM were also lower than that in the controls, and the most significant reduction in the LV Mass, septal and posterior wall thickness were found in the kwashiorkor group. Cardiac output was reduced in proportion to decrease in body size in the patient group (1.6 +/- 0.5 vs 2.1 +/- 0.8 L/min, P < 0.05), therefore cardiac index was not significantly different between the patients and the control subjects (5.9 +/- 1.4 vs 5.7 +/- 1.6 L/min/m(2), P > 0.05). Systolic function indices including ejection fraction, fractional shortening, and diastolic function indices were not significantly different in the groups. CONCLUSIONS: We demonstrated that LV Mass and cardiac output were reduced in proportion to decrease in body size in patients with PEM, and LV systolic and diastolic functions were preserved in atrophic hearts.