Interface of protein nutrition and medicine in the tropics

Chronic undernutrition may accentuate the beta cell dysfunction of type 2 diabetes

Seven undernourished and seven obese, insulin-requiring type 2 diabetic subjects, who were matched for age, sex, and duration of diabetes, were subjected to oral glucose tolerance tests. Although fasting glucose and free insulin levels were similar in both groups, glucose tolerance was markedly worse in the undernourished subjects, with a mean incremental glucose area (+/- SE) of 22.8 +/- 2.3 mmol/l.h vs. 12.4 +/- 1.3 in the obese diabetic subjects (P less than 0.001). The incremental insulin response (area under the curve) to oral glucose in the undernourished group (39.3 +/- 7.9 mU/l.h) was 50% lower than the response in both the obese group (89.2 +/- 19.9, P less than 0.001) and a group of non-diabetic, normal weight-for-height subjects (77.1 +/- 5.7, P less than 0.01). Peak insulin levels were similarly reduced to approximately half the levels seen in the obese and control groups (P less than 0.01). Undernutrition is known to impair both glucose tolerance and insulin secretory reserve by reducing the beta cell number, size, and granulation. It is concluded that chronic undernutrition accentuates beta cell dysfunction in undernourished diabetics, leading to increased glucose intolerance.

Cell-mediated immunity in professional and voluntary blood donors

Cell-mediated immunity (CMI) was compared in professional and voluntary blood donors. Depressed CMI in professional donors was revealed by the presence of significantly lower numbers of positive delayed reactive hypersensitivity responses to Candida albicans, streptokinase and streptodornase, as well as a decrease in lymphoblast transformation response to phytohaemagglutinin. Furthermore, the serum protein and albumin levels in professional donors did not correlate with the depression in CMI. The blood of professional blood donors should be considered to be a poor source of therapeutic immune cell fractions.

Endocardial changes produced in Patus monkeys by the ablation of cardiac lymphatics and the administration of a plantain diet

The effect of obliteration of the cardiac lymph drainage and prolonged feeding with a plantain diet in Patus monkeys was studied. Althout obliteration of the cardiac lymph supply produced fibroelastotic lesions the addition of a plantain diet did not usually produce much increase in cardiac fibrosis and the changes of EMF or CUO were not seen. The reasons for this are discussed.

Lymphocyte transformation in malnourished children

In vitro lymphocyte stimulation with phytohaemagglutinin gave subnormal transformation values in children with protein-calorie malnutrition. It is suggested that impaired cell-mediated immunity may be one important mechanism for the susceptibility of malnourished children to infections. Lymphocyte transformation was also subnormal in children with measles and gastroenteritis but tended to be increased in pneumonia.