Question: Fatty Change

[Arctic Char]

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Why is it that you see fatty change in the liver of an individual with kwashiorkor, but NOT in a patient with anorexia nervosa?

the best explanation i can come up with is that in kwashiorkor the individual is still taking in calories in the form of carbs so therefore still has substrates available for fatty acid synthesis; whereas the anorexic has a deficiency of substrates altogether.

 

[Taus]

basically the same as the differences you see w/ kwash vs. marasmus.....in kwash you don't even have enough protein to make apoB lipoproteins....so any sythesized TG and cholest can't exit the liver....kinda like abetalipoproteinemia

 

[Arctic Char]

right, thats kind of what i was getting at. since they both can't synthesize protein (kwash vs anorexia or marasmus), the difference is whether or not they have substrates available to make triglycerides in the first place (i.e. anorexia, or marasmus). so, no calories = no fatty change.