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Category: Volume 4 Issue 01 Jan 2016
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Title: Thyroid Status and Serum Protein Levels in Severe and Moderate Acute Malnourished Children

Authors: Dr S.K.Valinjkar, Dr N R Sutay, Dr Prachi, Dr Vikas

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i1.44

Abstract

Aims And OBJECTIVES;

1.      To estimate and compare blood thyroid hormone levels and proteins in Protein Energy Malnutrition ( PEM ) patients with normal values

2.      To find correlation between blood thyroid hormone levels and protein abnormalities in children with PEM and to compare it with normal values.

STUDY DESIGN: It was a Prospective Observational Study done at a tertiary care hospital in a  metropolitan city over a period of 3 years. This study comprised  Of 100 patients who were divided on the basis of WHO staging for PEM into SAM (severe acute malnutrition) and MAM (moderate acute malnutrition) on the basis of weight for height ,height  for age ,mid arm circumference  and wasting or oedema. Assessment of total Serum Proteins was done with Albumin and Globulin Albumin /Globulin ratio estimation, Thyroid Function test –TSH, Free T3, Free T4 was done. These values were compared in children with PEM and the values were correlated with children with PEM.

RESULTS: Serum proteins were low  in both SAM and MAM ,the decrease in the serum proteins was more with the severity of malnutrition that is more decrease in SAM and borderline low in MAM ,there was highly significant correlation  (p<0.001) between the decreased serum proteins and the type of malnutrition. Serum Free T3 values was low in SAM patients and normal in MAM, showing highly significant correlation (p<0.001) between the decreased Free T3 and the severity of malnutrition.

Serum Free T4 values were within normal limits both in SAM and MAM patients, but there was highly significant correlation (p<0.001) between the low value in SAM as compared with MAM patients i.e., the value was less in SAM patients as compared with MAM patients .Serum TSH values were normal in both SAM and MAM patients and there was no correlation between the TSH values and the malnutrition.

CONCLUSION: Serum albumin and globulin levels were low along with a decrease in A:G ratio in PEM cases and severity of hypoprotinemia was directly proportional to severity of PEM. Free T3 was decreased indicating that there was low conversion of T4 to T3. There was a direct correlation with the decrease in A:G ratio and decrease in Free T3 and Free T4 values.          

 

KEY WORDS: Hypoprotinemia, Thyroid function test, hypoprotinemia, severe acute malnutrition

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Corresponding Author

Dr S.K.Valinjkar

Associate Professor Dept of Pediatrics

Grant Medical College & Sir J. J. Group of Hospitals, Mumbai