The effect of diet on plasma somatomedin-C (IGF-I) in Jamaican and Nigerian children recovering from oedematous and non-oedematous malnutrition - abstract

ABSTRACT

Plasma somatomedin -C (PSm-C) was measured by radioimmunoassay in children with marasmus or kwashiorkor (4-24 months) and during rehabilitation. PSm-C (U/ml) was compared with that of normal children of the same age range (4-6 months, 0.175ñ0.04 7-12 months, 0.288ñ0.35 13-18 months 0.289ñ0.120 19-24 months, 0.598ñ0.160). Initially, Jamaican children were offered one of two isocaloric diets (468J/kg body weight per day), which differed principally in their protein contents A-0.9gB-3.5/kg body weight per day) at levels which did not permit anabolism. During this phase, oedematous children lost their oedema. They were then offered an energy dense diet (C-1046 KJ and 5.7g protein/kg body weight per day) and gained weight rapidly to achieve the weight of a normal child of the same height. The malnourished Nigerian children were treated with a vegetable-protein based diet which provided a mean intake of 4.3ñ0.2 gm protein and 556+34 KJ/kg body weight per day. PSm-C concentration in both Jamaica and Nigerian children was determined on admission and at weekly intervals during rehabilitation to examine the response to, and hence nutritional adequacy of both types of diets. In Jamaica children, PSm-C was slightly higher in admission but did not differ significantly in marasmic or kwashiorkor children (0.202ñ0.04 (n=9) vs 0.155ñ0.3 U/ml (n=18) respectively). In Nigerian children, PSm-C was higher in marasmic children (0.29ñ0.03 U/ml (n=7) than those with oedematous manutrition (0.15ñ0.03 U/ml (n=18) p<0.05). In both Jamaican and Nigerian children, PSm-C gradually rose after a small initial decline 1 week after admission. In Jamaican children, the increase in PSm-C after 4 weeks in hospital was significantly greater in marasmus than in kwashiorkor (0.431ñ0.71 (n=7) vs 0.269ñ0.05 U/ml (n=16) p<0.01). This difference could be attributed to dietary treatment, since oedematous children were kept from one to three weeks on a maintenance diet (either A or B) until oedema was lost. There was no significant difference in PSm-C on either diet A or B (A-0.165+0021 (n=26). B-0 150+0.019 U/ml (n=29). After 1 week on Diet C, PSm-C was 0.259ñ0.044 (n=21); significantly greater than PSm-C on diet A or B. In Nigerian children, eight days after admission, PSm-C had risen to 0.21ñ0.06 U/ml. In both Jamaican and Nigerian children, after 4 weeks PSm-C rose to normal values for their age range 0.337ñ0.34 U/ml (n=21) in Jamaican children and 0.30ñ0.07 U/ml (n=25) in Nigerian children. The higher PSm-C shown in marasmic Jamaican children may be related to the early introduction of high energy Diet C (AU)