Severe acute malnutrition (SAM), due to poor energy and/or protein intake, is associated with poor growth, depressed immune function, and long-term impacts on metabolic function. As the liver is a major metabolic organ and malnutrition poses metabolic stress, we hypothesize that SAM will be associated with alterations in the hepatic metabolome reflective of oxidative stress, gluconeogenesis, and ketogenesis. Thus, the purpose of this secondary analysis was to understand how SAM alters hepatic metabolism using a piglet model.

Weanling piglets were feed either a reference (REF) or protein-energy deficient diet (MAL) for 5 weeks. After dietary treatment MAL piglets were severely underweight (weight-for-age Z-score of -3.29, Welch's t test, P = .0007), moderately wasted (weight-for-length Z-score of-2.49, Welch's t test, P = .003), and tended toward higher hepatic triglyceride content (Welch's t test, P = .07). Hematologic and blood biochemical measurements were assessed at baseline and after dietary treatment. The hepatic metabolome was investigated using ¹H-NMR spectroscopy. Hepatic concentrations of betaine, cysteine, and glutathione tended to be lower in MAL (Welch's t test with FDR correction, P < .1), while inosine, lactate, and methionine sulfoxide concentrations were higher in MAL (inosine: P = .0448, lactate: P = .0258, methionine sulfoxide: P = .0337). These changes suggest that SAM is associated with elevated hepatic oxidative stress, increased gluconeogenesis, and alterations in 1-carbon metabolism.

由于能量和/或蛋白质摄入不足而导致的严重急性营养不良 (SAM) 与生长不良、免疫功能下降以及对代谢功能的长期影响有关。由于肝脏是主要的代谢器官，营养不良会造成代谢压力，我们假设 SAM 将与反映氧化应激、糖异生和酮生成的肝脏代谢组变化有关。因此，此二次分析的目的是了解 SAM 如何使用仔猪模型改变肝脏代谢。

断奶仔猪饲喂参考（REF）或蛋白质能量缺乏饮食（MAL）5周。经过日粮处理后，MAL 仔猪体重严重不足（年龄别体重 Z 评分为 -3.29，Welch t检验，P  = .0007），中度消瘦（身长 Z 评分为-2.49，Welch t检验，P  = .003），并倾向于更高的肝脏甘油三酯含量（Welch t检验，P  = .07）。在基线和饮食治疗后评估血液学和血液生化测量。使用¹ H-NMR 光谱研究肝脏代谢组。在 MAL 中，甜菜碱、半胱氨酸和谷胱甘肽的肝脏浓度往往较低（Welch'sFDR 校正的t检验，P < .1)，而 MAL 中肌苷、乳酸和蛋氨酸亚砜的浓度较高（肌苷：P  = .0448，乳酸：P  = .0258，蛋氨酸亚砜：P  = .0337）。这些变化表明 SAM 与肝脏氧化应激升高、糖异生增加和 1-碳代谢改变有关。