{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:37:26Z","timestamp":1789263446635,"version":"build-2803163510"},"reference-count":59,"publisher":"American Society for Clinical Investigation","issue":"24","license":[{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"vor","delay-in-days":1207,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centre for Global Child Health, Hospital for Sick children","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,17]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Severe acute malnutrition (SAM) is a major contributor to global mortality in children under 5 years. Mortality has decreased; however, the long-term cardiometabolic consequences of SAM and its subtypes, severe wasting (SW) and edematous malnutrition (EM), are not well understood. We evaluated the metabolic profiles of adult SAM survivors using targeted metabolomic analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This cohort study of 122 adult SAM survivors (SW = 69, EM = 53) and 90 age-, sex-, and BMI-matched community participants (CPs) quantified serum metabolites using direct flow injection mass spectrometry combined with reverse-phase liquid chromatography. Univariate and sparse partial least square discriminant analyses (sPLS-DAs) assessed differences in metabolic profiles and identified the most discriminative metabolites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Seventy-seven metabolite variables were significant in distinguishing between SAM survivors (28.4 \u00b1 8.8 years, 24.0 \u00b1 6.1 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) and CPs (28.4 \u00b1 8.9 years, 23.3 \u00b1 4.4 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) (mean \u00b1 SDs) in univariate and sPLS-DA models. Compared with CPs, SAM survivors had less liver fat; higher branched-chain amino acids (BCAAs), urea cycle metabolites, and kynurenine\/tryptophan (KT) ratio (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001); and lower \u03b2-hydroxybutyric acid and acylcarnitine\/free carnitine ratio (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), which were both associated with hepatic steatosis (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). SW and EM survivors had similar metabolic profiles as did stunted and nonstunted SAM survivors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Adult SAM survivors have distinct metabolic profiles that suggest reduced \u03b2-oxidation and greater risk of type 2 diabetes (BCAAs, KT ratio, urea cycle metabolites) compared with CPs. This indicates that early childhood SAM exposure has long-term metabolic consequences that may worsen with age and require targeted clinical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>FUNDING<\/jats:title>\n                    <jats:p>Health Research Council of New Zealand, Caribbean Public Health Agency, Centre for Global Child Health at the Hospital for Sick Children. DST is an Academic Fellow and a Restracomp Fellow at the Centre for Global Child Health. GBG is a postdoctoral fellow of the Research Foundation Flanders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1172\/jci.insight.141316","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T12:28:16Z","timestamp":1605616096000},"source":"Crossref","is-referenced-by-count":35,"title":["Childhood severe acute malnutrition is associated with metabolomic changes in adulthood"],"prefix":"10.1172","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6781-7646","authenticated-orcid":true,"given":"Debbie S.","family":"Thompson","sequence":"first","affiliation":[{"name":"Translational Medicine Program, Hospital for Sick Children, Toronto, Canada."},{"name":"Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada."},{"name":"Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6336-0906","authenticated-orcid":true,"given":"Celine","family":"Bourdon","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, Hospital for Sick Children, Toronto, Canada."},{"name":"The Childhood Acute Illness & Nutrition Network, Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Massara","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, Hospital for Sick Children, Toronto, Canada."},{"name":"Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5227-2492","authenticated-orcid":true,"given":"Michael S.","family":"Boyne","sequence":"additional","affiliation":[{"name":"Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica."},{"name":"Department of Medicine, The University of the West Indies, Kingston, Jamaica."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence E.","family":"Forrester","sequence":"additional","affiliation":[{"name":"University of the West Indies Solutions for Developing Countries, Kingston, Jamaica."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6614-3520","authenticated-orcid":true,"given":"Gerard Bryan","family":"Gonzales","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, Hospital for Sick Children, Toronto, Canada."},{"name":"Gastroenterology, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium."},{"name":"Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H. 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