RESUMO
Carbohydrate metabolism was studied in Jamaican children who had been admitted to hospital with protein-calorie malnutrition. Analysis of liver biopsies showed that levels of protein and glycogen were low in malnutrition and rose with recovery. Hepatic glucose-6-phosphatase was elevated in malnutrition but phosphorylase levels were normal. In the malnourished child there was normal hepatic glycogenolysis as shown by a normal blood glucose response to intravenous glucagon without any detectable rise in blood pyruvate and lactate. Fasting levels of blood lactate as well as lactate-pyruvate ratios rose with recovery from malnutrition. Galactose tolerance tests showed a delayed disappearance of injected galactose, but the maximum increase in blood glucose after galactose injection was the same in all clinical states. Glucose disappearance was delayed after both glucagon and galactose. Muscle glycogen was initially reduced, but there was a markeed "overshot" to supranormal levels during the recovery phase. (AU)