Plasma biochemical parameters in Nigerian children with protein energy malnutrition

Abstract

Eleven plasma biochemical parameters were estimated in a total of 28 children with protein-energy malnutrition (PEM): 7 children each category of marasmus, kwashiorkor, marasmic-kwashiorkor and undernutrition with ages between 8 and 48 months. The estimations were performed on admission and 8 to 24 days after treatment at the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria. Plasma sodium, potassium, chloride, bicarbonate and albumin levels were significantly (p < 0.05) higher after treatment than on admission. Calcium however, showed no significant change. Total protein and cholesterol were significantly (p < 0.05) raised after treatment for all the PEM types except undernutrition and kwashiorkor respectively. Globulin, urea and creatinine were significantly (p < 0.05) raised after treatment for kwashiorkor. These biochemical findings support the claims of clinical improvement in PEM children after a minimum of 18 days of treatment at the OAUTHC in Nigeria.

PIP: 11 plasma biochemical parameters were estimated in 28 children aged between 8 and 48 months with protein-energy malnutrition (PEM): 7 children each in the categories of marasmus, kwashiorkor, marasmic-kwashiorkor, and undernutrition. 8 ml of blood was obtained from each of the 7 children with marasmus, kwashiorkor, marasmic-kwashiorkor, and undernutrition, respectively, on admission to the children's ward of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria, and put into lithium heparinized tubes. The children were hospitalized for 18 and 24 days and fed the diet for PEM in the OAUTHC. 8 ml of blood was again taken from the children just before they were discharged. The percentage of recovery weight ranged between 74.4 and 86.4. Analysis of variance showed significance (p 0.05) for all types of PEM for plasma sodium, bicarbonate, urea, total protein, albumin, and globulin. The levels of plasma electrolytes comprising potassium, sodium, chloride, and bicarbonate were significantly (p 0.05) higher after recovery for all 4 types of PEM. There was also a significant (p 0.05) increase in plasma albumin levels in all 4 types of PEM. Plasma total protein levels were significantly increased in all types of PEM except undernutrition. The plasma globulin fraction which contains immune elements for body defense may be more tenaciously retained in PEM than albumin and only kwashiorkor showed a significant (p 0.05) increase after treatment. Plasma urea levels were significantly (p 0.05) higher after treatment than before for marasmus and kwashiorkor, the most protein deficient states in PEM. Plasma creatinine levels after treatment were significantly (p 0.01) lower for marasmic-kwashiorkor after treatment than on admission. The observed rise in kwashiorkor may reflect the increase in muscle formation and activity, while its decrease in marasmic-kwashiorkor possibly reflects increased renal function and efficiency.