Lipid transport in kwashiorkor

Abstract

1. In an attempt to elucidate the pathogenic mechanism of the fatty liver of kwashiorkor some aspects of lipid metabolism were studied in ten patients with kwashiorkor and nine with marasmus, so classified according to the clinical and laboratory findings. 2. Plasma lipid levels, especially those of triglycerides, were low in patients with kwashiorkor; they showed a marked rise very early during treatment. 3. The changes in the plasma lipid levels occurred mainly in the serum lipoprotein fraction of density < 1.063. The elevation of plasma lipid levels during treatment coincided with a loss of liver lipids and a marked rise in serum protein concentration. 4. The findings support the suggestion that the primary mechanism in the production of the fatty liver of kwashiorkor is an impairment in the synthesis of lipoprotein of very low density, probably due to the rate-limiting synthesis of its protein moiety. 5. In patients with marasmus no modifications in lipid metabolism were detected by the methods used.