Metabolic Substrates and Hormones During Starvation Ketosis in Children

Abstract

A study has been undertaken to obtain some insight into the metabolic events occurring during the development of nondiabetic ketosis in children. Blood sugar and plasma FFA, glycerol, insulin, GH, and 11-OHCS concentrations were assessed in 12 children admitted to the hospital with ketosis associated with persistent vomiting and markedly restricted food intake. Similar determinations were performed a few days later, following the disappearance of the ketosis. Thus, each ketotic child served as his own control when he was in the recovery phase. An adjustment to a new fuel mixture, which contained an increased proportion of FFA and glycerol, took place during the ketotic period. At the same time, blood sugar remained within the normal range. No demonstrable elevation of plasma GH was found in the ketotic state. This fact casts some doubt on any possible effect of GH on the disposition of metabolic fuels during this type of nondiabetic ketosis in children. However, the relative decrease in insulin and the increase in 11-OHCS observed during the ketotic stage suggest that these hormones may play a role in the regulation of energy metabolism during fasting.