LEUKOTRIENES AND ESSENTIAL FATTY ACIDS PATTERNS IN CHILDREN WITH SEVERE PROTEIN – ENERGY MALNUTRITION

Barakat SH, Madkour AA, Heiba DA, Jsmail HM*

Department of Pediatrics,

Department of Food Analysis Faculty of Medicine

Alexandria University, Alexandria, Egypt

 

Objective : to investigate the roles of leukotrienes (LTs) and essential fatty acids (EFA) in the pathophysiology of severe protein – energy malnutrition (PEM) .

Methods: Blood cysteinyl LTs (LTC4, LTD4, LTE4) and plasma EFA levels were measured (by ELISA and gas liquid chromatography after plasma extraction respectively) in 40 severely malnourished children with kwashiorkor (n=20) and marasmus (n=20). Normalby nourished children of the same age (n= 10) served as controls.

Results : the cysteinyl LTs level was significantly higher in both marasmic and kwashiorkor groups than in controls. The highest value was detected in kwashiorkor group (P<0.05). The plasma fatty acid patterns in malnourished children indicated changes characteristic of EFA defeciency, with lower   linoleic acid (LA) , arachidonic acid (AA) and docosahexaenoic acid (DHA) levels, accompanied by significantly higher oleic acid levels in both malnourished groups . the lowest value of LA was detected in marasmic group and the lowest levels of AA and DHA were in kwashiorkor group (P<0.05). There was an inverse corrlation between AA level and LTs level (r= -0.74) in children with PEM. Clinical problems associated with PEM such as hair and skin changes, edema, psychomotor alteration and hepatomegaly were significantly correlated directly with LTs level and in versely with AA level.

Conclusion: The findings of this study suggested that cysteingl LTs and EFA defecieney are involved in the pathophysiology of PEM particularly kwashiorkor and that severe PEM is associated with impaired FA desaturation and elongation pathway.

 
2200