FIGURE 2.

Serum metabolites of acylcarnitines, sphingomyelins, lysophosphatidylcholines, amino acids, and biogenic amines, as well as other markers, were compared between children with kwashiorkor compared with marasmus (A), children with SAM at admission compared with after clinical stabilization (B), and children after nutritional stabilization compared with community controls (including both stunted and nonstunted children) (C). SEs and SEMs were obtained from either mixed linear regression models that accounted for age, sex, and repeated measures (i.e., when comparing children at admission with after nutritional stabilization) or linear regression models adjusted for age and sex. Group numbers are as follows: kwashiorkor, n = 21; marasmus, n = 18; admission, n = 39; stabilization, n = 40; community controls, n = 157. Metabolites are ordered on the basis of Pearson hierarchal clustering of all metabolites within each compound class from patients with SAM at admission and after nutritional stabilization, and this clustering is represented by the dendrograms. Scaled estimates and SEMs allowed for the comparison of effect sizes across different metabolites. The direction of the bar indicates which diagnostic group had higher metabolite concentrations, and the metabolites that reached false discovery rate–adjusted significance are labeled in dark gray. All metabolite abbreviations are detailed in Supplemental Tables 1–8. Adm, admission; Kwa, kwashiorkor; Mara, marasmus; Stab, stabilization.