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  1. Article ; Online: The effect of wasting and stunting during severe acute malnutrition in infancy on insulin sensitivity and insulin clearance in adult life.

    Thompson, Debbie S / Francis-Emmanuel, Patrice M / Barnett, Alan T / Osmond, Clive / Hanson, Mark A / Byrne, Christopher D / Gluckman, Peter D / Forrester, Terrence E / Boyne, Michael S

    Journal of developmental origins of health and disease

    2022  Volume 13, Issue 6, Page(s) 750–756

    Abstract: Adults who had non-edematous severe acute malnutrition (SAM) during infancy (i.e., marasmus) have worse glucose tolerance and beta-cell function than survivors of edematous SAM (i.e., kwashiorkor). We hypothesized that wasting and/or stunting in SAM is ... ...

    Abstract Adults who had non-edematous severe acute malnutrition (SAM) during infancy (i.e., marasmus) have worse glucose tolerance and beta-cell function than survivors of edematous SAM (i.e., kwashiorkor). We hypothesized that wasting and/or stunting in SAM is associated with lower glucose disposal rate (M) and insulin clearance (MCR) in adulthood.We recruited 40 nondiabetic adult SAM survivors (20 marasmus survivors (MS) and 20 kwashiorkor survivors (KS)) and 13 matched community controls. We performed 150-minute hyperinsulinaemic, euglycaemic clamps to estimate M and MCR. We also measured serum adiponectin, anthropometry, and body composition. Data on wasting (weight-for-height) and stunting (height-for-age) were abstracted from the hospital records.Children with marasmus had lower weight-for-height
    MeSH term(s) Adult ; Child ; Humans ; Infant ; Kwashiorkor/complications ; Protein-Energy Malnutrition/complications ; Insulin Resistance ; Insulin ; Adiponectin ; Severe Acute Malnutrition/complications ; Growth Disorders ; Glucose
    Chemical Substances Insulin ; Adiponectin ; Glucose (IY9XDZ35W2)
    Language English
    Publishing date 2022-03-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2554780-X
    ISSN 2040-1752 ; 2040-1744
    ISSN (online) 2040-1752
    ISSN 2040-1744
    DOI 10.1017/S2040174422000034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Glucose metabolism in adult survivors of severe acute malnutrition.

    Francis-Emmanuel, Patrice M / Thompson, Debbie S / Barnett, Alan T / Osmond, Clive / Byrne, Christopher D / Hanson, Mark A / Gluckman, Peter D / Forrester, Terrence E / Boyne, Michael S

    The Journal of clinical endocrinology and metabolism

    2014  Volume 99, Issue 6, Page(s) 2233–2240

    Abstract: Context and objectives: The clinical syndromes of severe acute malnutrition may have early life origins because children with marasmus have lower birth weight than those with kwashiorkor. We hypothesized that resultant metabolic effects may persist into ...

    Abstract Context and objectives: The clinical syndromes of severe acute malnutrition may have early life origins because children with marasmus have lower birth weight than those with kwashiorkor. We hypothesized that resultant metabolic effects may persist into adulthood. We investigated whether marasmus survivors (MS) are more insulin resistant and glucose intolerant than kwashiorkor survivors (KS).
    Research design and setting: This was a case-control study in Jamaican adults.
    Subjects: We performed oral glucose tolerance tests on 191 adults (aged 17-50 y; 52% male; body mass index 24.2 ± 5.5 kg/m(2)). There were 43 MS; 38 KS; 70 age-, sex-, and body mass index-matched community controls; and 40 age- and birth weight-matched controls.
    Measurements: We measured insulin sensitivity with the whole-body insulin sensitivity index, and β-cell function with the insulinogenic index and the oral disposition index.
    Results: Fasting glucose was comparable across groups, but glucose intolerance was significantly more common in MS (19%) than in KS (3%), community controls (11%), and birth weight-matched controls (10%). The whole-body insulin sensitivity index was lower in MS than KS (P = .06) but similar between MS and controls. The insulinogenic index and oral disposition index were lower in MS compared with all three groups (P < .01).
    Conclusions: Marasmus survivors tend to be less insulin sensitive, but have significantly lower insulin secretion and are more glucose intolerant compared with kwashiorkor survivors and controls. This suggests that poor nutrition in early life causes β-cell dysfunction, which may predispose to the development of diabetes.
    MeSH term(s) Acute Disease ; Adolescent ; Adult ; Case-Control Studies ; Female ; Glucose/metabolism ; Humans ; Insulin Resistance ; Jamaica/epidemiology ; Male ; Malnutrition/metabolism ; Malnutrition/mortality ; Middle Aged ; Severity of Illness Index ; Survivors/statistics & numerical data ; Young Adult
    Chemical Substances Glucose (IY9XDZ35W2)
    Language English
    Publishing date 2014-02-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/jc.2013-3511
    Database MEDical Literature Analysis and Retrieval System OnLINE

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