Changes in serum β-lipoprotein concentration during the development of kwashiorkor and in recovery

Abstract

1. Serum β-lipoprotein and cholesterol have been measured in children ‘at risk’ to severe protein-calorie malnutrition and in others with kwashiorkor or marasmus. β-Lipoprotein was estimated by an immunological technique. In children recovering from kwashiorkor, serum triglyceride estimations and lipoprotein electrophoretic separations were also carried out.2. β-Lipoprotein concentrations did not fall significantly until serum albumin concentration was less than 2.5 g/100 ml; cholesterol concentration fell before β-lipoprotein.3. In frank kwashiorkor, serum β-lipoprotein concentration was reduced by about 30%, whereas cholesterol and triglyceride concentrations were reduced by about 50% in comparison with apparently normal children. Electrophoretic evidence showed that serum α-lipoprotein concentration was also reduced or absent altogether. Marasmic children had normal serum concentrations of β-lipoprotein and the other lipid components measured.4. The metabolic significance of this degree of reduction in serum β-lipoprotein concentration in the pathogenesis of the fatty liver of kwashiorkor has been discussed. It was concluded that, in Ugandan children with serum albumin concentrations below 2.50 g/100 ml, the β-lipoprotein concentration was probably insufficient for normal mobilization of fat from the liver and the children could therefore be considered susceptible to the development of a fatty liver.5. The recovery from kwashiorkor was marked by a rapid rise in serum β-lipoprotein concentration and hypertriglyceridaemia but a slower rise in cholesterol concentration. This confirmed the results of previous investigations.