Hostname: page-component-5c6d5d7d68-thh2z Total loading time: 0 Render date: 2024-08-07T05:35:42.495Z Has data issue: false hasContentIssue false
  • English
  • Français

Progressive changes in serum cortisol, insulin and growth hormone concentrations and their relationship to the distorted amino acid pattern during the development of kwashiorkor

Published online by Cambridge University Press:  09 March 2007

P. G. Lunn ,
R. G. Whitehead ,
R. W. Hay  and
B. A. Barer
P. G. Lunn
Affiliation:
Medical Research Council Child Nutrition Unit, PO Box 6717, Kampala, Uganda
R. G. Whitehead
Affiliation:
Medical Research Council Child Nutrition Unit, PO Box 6717, Kampala, Uganda
R. W. Hay
Affiliation:
Medical Research Council Child Nutrition Unit, PO Box 6717, Kampala, Uganda
B. A. Barer
Affiliation:
Medical Research Council Child Nutrition Unit, PO Box 6717, Kampala, Uganda
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

1. During the initial stages of the development of hypoalbuminaemia, with concentrations between 25 and 30 g/l, fasting serum cortisol and growth hormone values remained normal. Corresponding fasting serum insulin concentrations were, however, significantly above normal. During the same period, called phase B, valine concentrations were moderately low but alanine concentrations were raised.

2. In more severe hypoalbuminaemia, culminating in kwashiorkor, a marked switch in hormonal balance occurred. Insulin concentrations fell to subnormal levels whereas cortisol became raised. Eventually growth hormone concentrations also increased rapidly to values similar to those found in acromegaly. By this time, phase C, alanine concentrations as well as those of valine were falling to very low levels.

3. The possible causes of these changes in hormonal balance, their role in the development of the distorted fasting serum amino acid pattern and their consequent effect on serum albumin synthesis and the appearance of clinical kwashiorkor are discussed.

4. Information is also presented on the differences between these components in kwashiorkor and marasmus. Attempts have been made to rationalize apparent inconsistencies in the literature.

Type
Research Article
Information
British Journal of Nutrition , Volume 29 , Issue 3 , May 1973 , pp. 399 - 422
Copyright
Copyright © The Nutrition Society 1973

References

REFERENCES

Abbassy, A. S., Mikhail, M. & Zeitoun, M. M. (1967 a). J. trop. Paed. 13, 87.Google Scholar
Abbassy, A. S., Mikhail, M. & Zeitoun, M. M. (1967 b). J. trop. Paed. 13, 154.Google Scholar
Adibi, S. A. & Drash, A. L. (1970). J. Lab. clin. Med. 76, 722.Google Scholar
Alleyne, G. A. O. & Young, V. H. (1967). Clin. Sci. 33, 189.Google Scholar
Arroyave, G. (1962). Am. J. clin. Nutr. 11, 447.CrossRefGoogle Scholar
Baig, H. A. & Edozien, J. C. (1965). Lancet ii, 662.CrossRefGoogle Scholar
Beas, F., Contreras, I., Maccioni, A. & Arenas, S. (1971). Br. J. Nutr. 26, 169.CrossRefGoogle Scholar
Blazquez, E. & Lopez-Quijada, C. (1969). J. Endocr. 4, 107.CrossRefGoogle Scholar
Cahill, G. F. Jr, Nerrera, M. G., Morgan, A. P., Soeldner, J. S., Steinke, J., Levy, P. L., Rcichard, G. A. & Kipnis, D. M. (1966). J. clin. Invest. 45, 1751.CrossRefGoogle Scholar
Castellanos, H. & Arroyave, G. (1961). Am. J. clin. Nutr. 9, 186.CrossRefGoogle Scholar
Catt, K. J. (1970 a). Lancet i, 1275.CrossRefGoogle Scholar
Catt, K. J. (1970 b). Lancet i, 933.CrossRefGoogle Scholar
Cope, C. L. & Pearson, J. (1965). J. clin. Path. 18, 82.CrossRefGoogle Scholar
Coward, D. G., Sawyer, M. B. & Whitehead, R. G. (1971). Am. J. clin. Nutr. 24, 940.CrossRefGoogle Scholar
Dickerman, E., Negro-Vilar, A. & Meites, J. (1969). Endocrinology 84, 814.CrossRefGoogle Scholar
Ely, R. S., Kelly, V. C. & Raile, R. B. (1953). J. Paed. 42, 38.CrossRefGoogle Scholar
Felig, P., Owen, O. E., Wahren, J. & Cahill, G. F. Jr (1969). J. clin. Invest. 48, 584.CrossRefGoogle Scholar
Frood, J. D. L., Whitehead, R. G. & Coward, W. A. (1971). Lancet ii, 1047.CrossRefGoogle Scholar
Grimble, K. F. & Whitehead, R. G. (1970 a). In Technicon Quarterly, Vol. 3, no. 3. New Tork: Technicon Inc.Google Scholar
Grimble, R. F. & Whitehead, R. G. (1970 b). Br. J. Nutr. 24, 557.CrossRefGoogle Scholar
Grimble, R. F. & Whitehead, R. G. (1971 a). Clinica chim. Acta 31, 355.CrossRefGoogle Scholar
Grimble, R. F. & Whitehead, R. G. (1971 b). Br. J. Nutr. 25, 253.CrossRefGoogle Scholar
Hadden, D. R. (1967). Lancet ii, 589.CrossRefGoogle Scholar
Hales, C. N. & Randle, P. J. (1963). Biochem. J. 88, 137.CrossRefGoogle Scholar
Hamwi, G. J. & Tzagournis, M. (1970). Am. J. clin. Nutr. 23, 311.CrossRefGoogle Scholar
Harris, M. M. & Harris, R. S. (1947). Proc. Sot. exp. Biol. Med. 64, 471.CrossRefGoogle Scholar
Holt, L. E., Snyderman, S. E., Norton, P. M., Roitman, E. & Finch, J. (1963). Lancet ii, 1343.CrossRefGoogle Scholar
Huseby, R. A., Reed, F. C. & Smith, T. E. (1959). J. appl. Physiol. 14, 31.CrossRefGoogle Scholar
James, W. P. T. & Coore, H. G. (1970). Am. J. clin. Nutr. 23, 386.CrossRefGoogle Scholar
Kemoff, L. M., Pimstone, B. L., Solomon, J. & Brock, J. F. (1971). Biochem. J. 124, 529.Google Scholar
Kirsch, R., Saunders, S. J., Frith, L., Wicht, S., Kelman, L. & Brock, J. F. (1969). Am. J. clin. Nutr. 22, 1559.CrossRefGoogle Scholar
Lune, A. O. & Jackson, W. P. U. (1962). Clin. Sci. 22, 259.Google Scholar
McCance, R. A. (1971). In Recent Advances in Paediatrics, 4th ed., p. 479 [Gairdner, D and Hull, D., editors]. London: Churchill.Google Scholar
Manchester, K. I., & Young, F. G. (1961). Vitams Horm. 19, 95.CrossRefGoogle Scholar
Marks, V., Howorth, N. & Greenwood, F. C. (1965). Nature, Lond. 208, 686.CrossRefGoogle Scholar
Milner, R. D. G. (1970). In Hormones and the Environment Memoirs of the Society for Endocrinology, no. 18, p. 191 [Benson, G. K and Phillips, J. G, editors]. London: Cambride University Press.Google Scholar
Milner, R. D. G. (1971). Paediat. Res. 5, 33.CrossRefGoogle Scholar
Mimura, T., Yamada, C. & Swendseid, M. E. (1968). J. Nutr. 95, 493.CrossRefGoogle Scholar
Molinatti, G. M., Massara, F., Strumia, E., Pennisi, F., Scasellati, G. A. & Vancheri, L. (1969). J. nucl. Biol. Me. 13, 1.Google Scholar
Munro, H. N. (1956). Scott. med. J. 1, 285.CrossRefGoogle Scholar
Munro, H. N. (1964). In Mammalian Protein Metabolism, Vol. I, ch. 10 [Munro, H. N. and Allison, J. B., editors]. New York and London: Academic Press Inc.Google Scholar
Munro, H. N., Black, J. G. & Thomson, W. S. T. (1959). Br. J. Nutr. 13, 475.CrossRefGoogle Scholar
Murphey, B. E. P. (1967). J. clin. Endocr. 27, 973.CrossRefGoogle Scholar
Neale, R. J. (1971). Nature, New Biology 231, 177.CrossRefGoogle Scholar
Pereira, S. M., Begum, A., Sundararaj, R. & Dumm, M. E. (1968). Am. J. clin. Nutr. 21, 167.CrossRefGoogle Scholar
Pimstone, B. L., Barbezat, G., Hansen, J. D. L. & Murray, P. (1967). Lancet ii, 1333.CrossRefGoogle Scholar
Pimstone, B. L., Barbezat, G., Hansen, J. D. L. & Murray, P. (1968). Am. J. clin. Nutr. 21, 482.CrossRefGoogle Scholar
Pimstone, B. L., Wittman, W., Hansen, J. D. L. & Murray, P. (1966). Lancet ii, 779.CrossRefGoogle Scholar
Raiti, S. & Blizzard, R. M. (1970). Adv. Paed. 17, 99.Google Scholar
Rao, K. S. J., Srikantia, S. G. & Gopalan, C. (1968). Arch Dis. Childh. 43, 365.Google Scholar
Reid, R. H. P. (1966). In Techniques in Amino Acid Analysis, p. 43. Chertsey, England: Technicon.Google Scholar
Rutishauser, I. H. E. & Whitchead, R. G. (1972). Br. J. Nutr. 28, 145.CrossRefGoogle Scholar
Schmidt, E. G. & Eastland, J. S. (1935). J. Lab. clin. Med. 20, 1.Google Scholar
Staff, T. H. E. (1968). E. Afr. med. J. 45, 399.Google Scholar
Stuart, H. C. & Stevenson, S. S. (1954). In Textbook of Pediatrics, 8th ed., p. 48 [Nelson, W. E., editor]. Philadelphia: Saunders.Google Scholar
Swendseid, M. E., Tuttle, S. G., Drenick, E. J., Joven, C. B. & Massey, F. J. (1967). Am. J. clin. Nutr. 20, 243.CrossRefGoogle Scholar
Swendseid, M. E., Tuttle, S. G., Figueroa, W. S., Mulcare, D., Clark, A. J. & Massey, F. J. (1966). J. Nutr. 88, 239.CrossRefGoogle Scholar
Tejada, C. & Russfield, A. B. (1957). Archs Dis. Childh. 32, 343.CrossRefGoogle Scholar
Trowell, H. C., Davies, J. N. P. & Dean, R. F. A. (1954). In Kwashiorkor. London: Arnold.CrossRefGoogle ScholarPubMed
Vance, J. E., Buchanan, K. O. & Williams, R. H. (1968). J. Lab. clin. Med. 72, 290.Google Scholar
Van Stekelenburg, G. J. & Desplanque, J. (1966). In Techniques in Amino Acid Analysis, p. 51. Chertsey, England: Technicon.Google Scholar
Waterlow, J. C. & Alleyne, G. A. O. (1971). Adv. Protein Chem. 25, 117.CrossRefGoogle Scholar
Wellcome Trust Working Party (1970). Lancet ii, 302.Google Scholar
Young, V. R. & Scrimshaw, N. S. (1968). Br. J. Nutr. 22, 9.CrossRefGoogle Scholar