NUTRITIONAL STATUS AFFECTS CO2 PROD DURING ACUTE INFECTION IN MALAWIAN CHILDREN

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。我们测试了这样的假设，即急性感染的消瘦儿童与营养良好的儿童相比，二氧化碳的产生率更低，但与未感染的消瘦儿童相比，二氧化碳的产生率更高。研究了57名儿童，其中28名患有消瘦并急性感染，17名患有消瘦，12名营养良好并急性感染。急性感染的患者有疟疾、肺炎或败血症。在儿童接受喂养时，使用稳定同位素示踪剂稀释法测量二氧化碳产生率。二氧化碳生产速率被归一化为预测的基础代谢率，用比率表示。急性感染的营养良好的儿童产生的CO2比有或没有感染的贫血症儿童多（1.76 0.42 vs 1.46 0.35和1.56 0.24,p 0.05）。然而，急性感染的麻风患儿的CO2产率并不比未感染的麻风患儿高。回归分析发现，疟疾和ight Z得分的权重是二氧化碳产出率的重要预测因子。能量消耗大于膳食能量摄入（440 kJkg1d1 vs 418 kJkg1d1）。浪费与二氧化碳产生率之间的相关性提供了证据，表明当营养物质缺乏时存在一种保存能量的代谢机制，而有关疟疾的发现表明，特定感染对能量代谢的影响不同。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We tested the hypotheses that the rate of CO2 production is less in marasmic children with acute infection when compared to wellnourished children, but greater when compared to uninfected marasmic children. Fiftyseven children were studied, 28 with marasmus and acute infection, 17 with marasmus, and 12 wellnourished with acute infection. Those with acute infection had malaria, pneumonia or sepsis. The rate of CO2 production was measured using a stable isotope tracer dilution method while the children received feedings. The rate of CO2 production was normalized to the predicted basal metabolic rate, expressed as a ratio. Wellnourished children with acute infection produced more CO2 than marasmic children with or without infection (1.76 0.42 vs 1.46 0.35 and 1.56 0.24, p 0.05). However the rate of CO2 production in marasmic children with acute infection was not greater than in uninfected marasmic children. Regression analyses found that malaria and weightforhe ight Z score were significant predictors of the rate of CO2 production. Energy expenditure was greater than the dietary energy intake (440 kJkg1d1 vs 418 kJkg1d1). The correlation between wasting and the rate of CO2 production provides evidence that there is a metabolic mechanism to conserve energy when nutrients are scarce, and the findings concerning malaria suggest that specific infections effect energy metabolism differently.