Department of Pediatrics, Ludwig-Maximilians-University Paediatrics, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, 80337 Munich, Germany.
Department of Pediatrics & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.
Nutrients. 2020 Jul 21;12(7):2163. doi: 10.3390/nu12072163.
(1) Background: Little is known on impacts of ready-to-use therapeutic food (RUTF) treatment on lipid metabolism in children with severe acute malnutrition (SAM). (2) Methods: We analyzed glycerophospholipid fatty acids (FA) and polar lipids in plasma of 41 Pakistani children with SAM before and after 3 months of RUTF treatment using gas chromatography and flow-injection analysis tandem mass spectrometry, respectively. Statistical analysis was performed using univariate, multivariate tests and evaluated for the impact of age, sex, breastfeeding status, hemoglobin, and anthropometry. (3) Results: Essential fatty acid (EFA) depletion at baseline was corrected by RUTF treatment which increased EFA. In addition, long-chain polyunsaturated fatty acids (LC-PUFA) and the ratio of arachidonic acid (AA)/linoleic acid increased reflecting greater EFA conversion to LC-PUFA, whereas Mead acid/AA decreased. Among phospholipids, lysophosphatidylcholines (lyso.PC) were most impacted by treatment; in particular, saturated lyso.PC decreased. Higher child age and breastfeeding were associated with great decrease in total saturated FA (ΣSFA) and lesser decrease in monounsaturated FA and total phosphatidylcholines (ΣPC). Conclusions: RUTF treatment improves EFA deficiency in SAM, appears to enhance EFA conversion to biologically active LC-PUFA, and reduces lipolysis reflected in decreased ΣSFA and saturated lyso.PC. Child age and breastfeeding modify treatment-induced changes in ΣSFA and ΣPC.
(1) 背景：对于严重急性营养不良（SAM）儿童，人们对即食治疗食品（RUTF）治疗对脂质代谢的影响知之甚少。(2) 方法：我们使用气相色谱法和流动注射分析串联质谱法，分别分析了 41 名巴基斯坦 SAM 儿童在 RUTF 治疗前后 3 个月血浆中的甘油磷脂脂肪酸（FA）和极性脂质。使用单变量、多变量检验进行统计分析，并评估年龄、性别、母乳喂养状态、血红蛋白和人体测量学的影响。(3) 结果：RUTF 治疗纠正了基线时的必需脂肪酸（EFA）耗竭，增加了 EFA。此外，长链多不饱和脂肪酸（LC-PUFA）和花生四烯酸（AA）/亚油酸的比例增加，表明更多的 EFA 转化为 LC-PUFA，而 Mead 酸/AA 减少。在磷脂中，溶血磷脂酰胆碱（lyso.PC）受治疗影响最大；特别是饱和 lyso.PC 减少。儿童年龄较高和母乳喂养与总饱和脂肪酸（ΣSFA）的大幅减少和单不饱和脂肪酸和总磷脂酰胆碱（ΣPC）的减少有关。结论：RUTF 治疗可改善 SAM 中的 EFA 缺乏，似乎可增强 EFA 向生物活性 LC-PUFA 的转化，并减少ΣSFA 和饱和 lyso.PC 反映的脂肪分解。儿童年龄和母乳喂养会改变 ΣSFA 和 ΣPC 治疗诱导的变化。
