Blood keto-acids in kwashiorkor

Serum transaminases and isocitric dehydrogenase in kwashiorkor

Serum glutamic oxalacetic transaminase (G-OT), glutamic-pyruvic transaminase (G-PT), and isocitric dehydrogenase (ICD) have been estimated in six groups of subjects, namely, normal British adults, normal Nigerian adults, undernourished Nigerian adults and children, Nigerian children with florid protein malnutrition (kwashiorkor), and cases of protein malnutrition after treatment. The normal range in Nigerian adults was apparently slightly lower than in European adults.A marked increase in serum enzyme activity was found in florid malnutrition, and a slight rise in undernutrition. In all cases serum G-PT showed lesser changes than G-OT and ICD. The causes of these abnormalities are discussed. The increased serum enzyme activity is thought to be derived primarily from the liver and possibly also from voluntary muscle. Estimation of serum enzymes is recommended in the investigation of protein malnutrition.

Microdetermination of 2-ketoglutaric acid in plasma and cerebrospinal fluid by capillary gas chromatography mass spectrometry; application to pediatrics

Quantification of 2-ketoglutaric acid in plasma and cerebrospinal fluid as its O-trimethylsilyl++-quinoxalinol derivative by gas chromatography chemical ionization mass spectrometry is described with benzoylformic acid as internal standard. This technique, with ammonia as reactant gas, only detects the protonated molecular ions. The recovery of 2-ketoglutarate from perchloric-deproteinized plasma is 99.7 +/- 1.2%. The normal value of 2-ketoglutarate in children is 8.6 +/- 2.6 mumol l-1 (mean +/- standard deviation) in plasma (n = 25) and 4.8 +/- 1.4 mumol l-1 in cerebrospinal fluid (n = 20). The plasma level of 2-ketoglutarate is correlated with urea concentration (r = 0.96; p less than 0.001) in healthy subjects and in patients with chronic renal insufficiency. Increased values are found in one case of pyruvate carboxylase deficiency, and inconstantly in diabetes; physiological variations are described during fasting and after an oral glucose load.