Plasma free amino acid levels during the initial rehabilitation of protein-energy malnutrtion with protracted diarrhoea using a free amino acid--glucose diet.

This study intends to assess, by ion-exchange chromatography of free amino acid levels of peripheral blood plasma, the amino acid absorption of severely growth retarded infants with protracted diarrhoea, during the initial period of rehabilitation. Eleven infants from a very low socio-economic group of a developing country, with nutritional marasmic growth retardation and prolonged diarrhoea, were treated for a period of 10 days with a commercially available free amino acid--glucose diet (Vivonex, Pfrimmer Co., Erlangen, Germany). Excessive hyperprolinaemia characterized the plasma aminogram before treatment. After initial rehabilitation with this diet, the plasma analyses showed very low branch-chained and cystine levels, and marginally high alanine, glycine, and proline levels. It seemed that the free amino acids could not be absorbed quickly enough to meet with the high supply of glucose. Furthermore, this investigation supports the assumption that cystine is an essential amino acid in malnourished infants. In spite of normal or high human growth hormone levels, somatomedin was not detectable in pooled samples from these severely growth retarded infants.