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Open AccessArticle

Impact of Treatment with RUTF on Plasma Lipid Profiles of Severely Malnourished Pakistani Children

1
Department of Pediatrics, Ludwig-Maximilians-University Paediatrics, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, 80337 Munich, Germany
2
Department of Pediatrics & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
3
Center of Excellence in Women & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
4
Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
*
Authors to whom correspondence should be addressed.
Nutrients 2020, 12(7), 2163; https://doi.org/10.3390/nu12072163
Received: 9 June 2020 / Revised: 10 July 2020 / Accepted: 16 July 2020 / Published: 21 July 2020
(This article belongs to the Special Issue Early Nutrition and Re-programming of Health and Disease)
(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. View Full-Text
Keywords: severe acute malnutrition (SAM); metabolomics; glycerophospholipids; essential fatty acids (EFA); lysophosphatidylcholines (LysoPC) severe acute malnutrition (SAM); metabolomics; glycerophospholipids; essential fatty acids (EFA); lysophosphatidylcholines (LysoPC)
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    Doi: 10.5281/zenodo.3879744
    Description: Supplementary Figure S1: Polar lipid composition. Median and interquartile ranges shown for baseline (Before) and after three months of treatment with RUTF (After). Legend: p-values after FDR adjustment are expressed as ***p<0.001, ** p<0.01, * p<0.05, ns non-significant. Supplementary Table S1. Median and interquartile ranges of total glycerophospholipid Fatty acids of severe malnourished children (n=41), pre- and post- treatment with RUTF versus heathy European children as reported by Glaser et al.† Supplementary Table S2. Metabolites (a) Total glycerophospholipid Fatty acids (b) phospholipid species identified as significant features between fatty acid profiles of severe malnourished children (n=41), pre- and post- treatment with RUTF using significance analysis of microarray and empirical bayesian analysis of microarray (EBAM). Supplementary Table S3. Significant results from the linear models for the change in total glycerophospholipid fatty acids with child age at baseline in severe malnourished children treated with RUTF. Supplementary Table S4. Significant results from the linear models for the change in total glycerophospholipid fatty acids with breastfeeding status at baseline in severe malnourished children treated with RUTF. Supplementary Table S5. Significant results from the linear models for the change in total glycerophospholipid fatty acids with child hemoglobin level at baseline in severe malnourished children treated with RUTF. Supplementary Table S6. Significant results from the linear models for the change in polar lipid species with child age at baseline in severe malnourished children treated with RUTF. Supplementary Table S7. Significant results from the linear models for the change in polar lipid species with child breastfeeding status at baseline in severe malnourished children treated with RUTF. Supplementary Table S8. Significant results from the linear models for the change in polar lipid species with child hemoglobin level at baseline in severe malnourished children treated with RUTF.
MDPI and ACS Style

Shokry, E.; Sadiq, K.; Soofi, S.; Habib, A.; Bhutto, N.; Rizvi, A.; Ahmad, I.; Demmelmair, H.; Uhl, O.; Bhutta, Z.A.; Koletzko, B. Impact of Treatment with RUTF on Plasma Lipid Profiles of Severely Malnourished Pakistani Children. Nutrients 2020, 12, 2163.

AMA Style

Shokry E, Sadiq K, Soofi S, Habib A, Bhutto N, Rizvi A, Ahmad I, Demmelmair H, Uhl O, Bhutta ZA, Koletzko B. Impact of Treatment with RUTF on Plasma Lipid Profiles of Severely Malnourished Pakistani Children. Nutrients. 2020; 12(7):2163.

Chicago/Turabian Style

Shokry, Engy; Sadiq, Kamran; Soofi, Sajid; Habib, Atif; Bhutto, Naveed; Rizvi, Arjumand; Ahmad, Imran; Demmelmair, Hans; Uhl, Olaf; Bhutta, Zulfiqar A.; Koletzko, Berthold. 2020. "Impact of Treatment with RUTF on Plasma Lipid Profiles of Severely Malnourished Pakistani Children" Nutrients 12, no. 7: 2163.

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