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Manuscript received 27 November 1996. Initial reviews completed 7 January 1997. Revision accepted 5 May 1997.
U.S. Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030 and * Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica
This study was undertaken to determine the following: 1 ) the kinetic changes responsible for the depletion and repletion of plasma transferrin (Tr) concentration in children with protein-energy malnutrition (PEM); 2 ) the role of infection in mediating these changes; and 3 ) whether plasma Tr concentration is related to body protein status. We measured plasma Tr concentration, and fractional (FSR) and absolute (ASR) Tr synthesis rates with the use of a constant intragastric infusion of 2H3-leucine in 14 children with PEM, at 2 d postadmission (study 1), 8 d postadmission when infections were under control (study 2), and at recovery (study 3). In studies 1 and 2, the children synthesized less 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 malnourished 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 intravascular space; and 3 ) Tr concentration is not a very good indicator of protein nutritional status.
Key words: transferrin concentration, transferrin synthesis, protein-energy malnutrition, children.
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