Published online by Cambridge University Press: 09 March 2007
1. The mechanisms by which an oral dose of glucose can stimulate the uptake of essential amino acids from serum was found to be operative even in children with severe, untreated kwashiorkor.
2. Although the percentage fall in the concentration of the essential amino acids in response to glucose was the same before and after treatment, the absolute fall was greater on discharge. The results indicated that the magnitude of this fall might depend on the initial fasting concentration of each individual amino acid.
3. These results have been discussed on the basis of possible long-term pathological effects of a distorted serum amino acid pattern typified by low concentrations of valine, leucine and threonine. The protein-sparing action of carbohydrate, achieved by the preferential synthesis of muscle protein in response to insulin secretion, might be less effective because of substrate limitation.
4. Of the non-essential amino acids, the concentrations of alanine and glycine also fell markedly before treatment, but this did not occur on discharge. The significance of this difference is also discussed.
5. The results also indicate that slightly high, spurious amino acid ratios can be obtained if a child is given a drink containing sugar before a blood sample is taken.