Effect of PEM on thyroid status, serum total protein and A/G ratio in pre-school going children

Sumesh Prasad Sah; Manisha Arora; Sudeep Kumar; Jyoti Batra; Imran Mustafa; Lalendra Yadav

doi:10.18203/2320-6012.ijrms20174582

Authors

Sumesh Prasad Sah Department of Biochemistry, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
Manisha Arora Department of Biochemistry, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
Sudeep Kumar Department of Biochemistry, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
Jyoti Batra Department of Biochemistry, Santosh Medical College, Ghaziabad, NCR, Uttar Pradesh, India
Imran Mustafa Department of Biochemistry, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
Lalendra Yadav Department of Pharmacology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20174582

Keywords:

PEM, T3, T4, Thyroid stimulating hormone, Total proteins

Abstract

Objective: The objective of the study was to evaluate and compare serum total protein, serum albumin and thyroid hormones in children with Protein Energy Malnutrition (PEM) and in healthy controls.

Methods: Present study was a cross sectional hospital based case control study, total 75 children of age group 1-5 years were included in this study. Triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) was estimated by electro-chemiluminescence immunoassay method, serum total protein by biuret method, albumin by BCG method and plasma hemoglobin by CMG method.

Result: In malnourished children, there is significant decrease in serum total protein (4.76 gm %), albumin (2.24 gm %) and Hb (10.57 gm %) as compared to normal healthy children. Serum T3 (0.51 ng/ml), and T4 (3.93 µg/ml) levels were significantly decreased and non-significant changes in TSH (4.26 µUI/ml) levels in children with PEM was observed as compared to healthy controls.

Conclusion: The reduction in protein is due to decreased intake of proteins and reduced biosynthesis. The decreased in T3 and T4 levels in malnourished children is probably due to a decrease in circulating plasma proteins.

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References

Onis, Monteiro C, Clugston G. The worldwide magnitude of protein-energy malnutrition: an overview from the WHO global database on child growth. Bulletin of the World Health Organization. 1993;71(6):703-12.

Gragnolati M, Shekar M, Gupta MD, Bredenkamp C, Lee YK. India's undernourished children: a call for reform and action. Washington, DC: World Bank; 2005.

Park K. Textbook of preventive and social medicine. 19th ed. Jabalpur: Banarsidas Bhanot; 2007.

Stirling GA. Thyroid status in malnutrition. Arch Dis Child. 1962;37:99-102.

Ganong WF. Review of Medical Physiology. 22 ed. USA; Prentice Hall Internatinal, Inc; 2005.

Montogomery RD. Muscle morphology in infantile protein energy malnutrition. J Clin Path 1962;15(5):11-21.

Nutrition Sub-committee of Indian Academy of Pediatrics. Report. Indian Pediatr. 1972;9:360.

Adegbusi H, Sule MS. Anthropometric and biochemical assessment among under five children in Kusada local government area, Katsina state, Nigeria. Bajopas. 2011;4(2):137-40.

Sandeep M, Krishnamurthy B. Thyroid hormone status in children with protein energy malnutrition. Int J Contemp Pediatr. 2016;3:193-9.

Gamit AM, Khubchandani AS, Gamit MR, Parmar U, Adarsh A, Gaadhe P. A study of serum total protein, serum albumin and thyroid hormones in protein-energy malnutrition in children. Int J Med Sci Public Health. 2017;6:409-12.

Mishra SK, Bastola SP, Jha B. Biochemical nutritional indicators in children with protein energy malnutrition attending Kanti Children Hospital, Kathmandu, Nepal. Kathmandu Univ Med J. 2009;7(26):129-34.

Rahman MA, Mannan MA, Rahman MH. Serum iron and total iron binding capacity in severely malnourished children. Bangladesh J Pharmacol. 2007;2:61-5.

Chowdhury MSI, Akhter N, Haque M, Aziz R, Nahar N. Serum total protein and albumin levels in different grades of protein energy malnutrition. J Bangladesh Soc Physiol. 2008;(3):58-60.

Abrol P, Verma A, Hooda HS. Thyroid hormone status in protein energy malnutrition in Indian children. Indian J Clin Biochem. 2001;16(2):221-3.

Turkay S, Kus S, Gokalp A, Baskin E, Onal A. Effects of protein energy malnutrition on circulating thyroid hormones. Indian Pediat. 1995;32(2):193-7.

Kumar S, Nadkarni J, Dwivedi R. Thyroid hormone status in malnourished children. Indian Pediatr. 2009;46(3):263-4.

Orbak Z, Akin Y, Varoglu E, Tan H. Serum thyroid hormone and thyroid gland weight measurements in protein-energy malnutrition. J Pediatr Endocrinol Metab. 1998;11(6):719-24.

Das BK, Panda BK, Dhingra R, Mishra OP, Agarwal JK. Thyroid hormone studies in protein energy malnutrition. J Trop Pediatr. 1999;45(6):375-6.