Effects of Severe Protein-Calorie Deficiency on the Endocrine Control of Carbohydrate Metabolism

Severe protein-calorie deficiency resembling human syndromes (e.g., marasmus and kwashiorkor) has been produced in young pigs by manipulation of dietary protein and carbohydrate levels. These animals show impaired glucose tolerance; increased insulin sensitivity, including hypoglycemia nonresponsiveness; accumulation of glycogen in the liver and deficiency of hepatic glucose-6-phosphatase; normal or raised excretion of urinary corticosteroids. Tissue water content is elevated but fat accumulates only in animals receiving extra carbohydrate. It is suggested that a deficiency of insulin and of thyroid and growth hormones and a consequent relative excess of adrenocortical hormones is characteristic of severe protein-calorie deficiency in humans and experimental animals and explains many of the biochemical changes.