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American Journal of Clinical Nutrition, Vol 22, 568-576, Copyright © 1969 by The American Society for Clinical Nutrition, Inc.

Relation of Serum Lipids and Lipoproteins to Fatty Liver in Kwashiorkor

A. STEWART TRUSWELL M.D., M.R.C.P.1, JOHN D. L. HANSEN M.D., F.R.C.P., D.C.H.1, COLIN E. WATSON B.SC., M.B., CH.B., M.MED., M.C. PATH.1, and PATICIA WANNENBURG 1

1 From the Departments of Medicine, Child Health and Pathology, and the Council for Scientific and Industrial Research Clinical Nutrition Unit, University of Cape Town, and The Red Cross Memorial Children's Hospital, Cape Town, South Africa

In 19 children with kwashiorkor, before and during treatment with high protein, very low fat diets, measurements were made of serum hipoproteins (by paper electrophoresis), phospholipid fractions (by thin-layer chromatography), and total cholesterol, triglyceride, and phospholipid.

The group with more severe fatty liver (by needle biopsy) had lower mean initial serum beta-lipoprotein cholesterol, triglycerides, and albumin, but alpha-lipoprotein and phosphatidyl choline were not reduced.

During treatment, serum lipids rose above normal levels, triglyceride before cholesterol, and pre-beta-lipoprotein appeared.

Our results are consistent with the hypothesis that reduced synthesis of low density lipoproteins is a major cause of the fatty liver in kwashiorkor. No evidence was found to implicate lipotropic factor deficiency.




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