Plasma thyroxine binding prealbumin as an index of mild protein-energy malnutrition in Nigerian children

Abstract

Weight, height, midarm circumference (AC), midarm muscle circumference (AMC), triceps skinfold thickness (TSF), and plasma thyroxine binding (TBPA) were measured in 73 children free from any clinical evidence of disease and in 15 severe protein-energy malnourished (PEM) (marasmus, marasmic kwashiorkor, and kwashiorkor) Nigerian preschool children. The children were divided into various groups according to both Wellcome and Waterlow's classification. All measurements made on them were then compared between the various groups within each classification. It was found that plasma TBPA values were not only able to distinguish various grades of PEM but was the only parameter studied which can distinguish mild PEM from normals when weight, height, TSF, AC, and AMC were not sensitive enough to do so. TBPA was also found to be significantly related to body weight, deficit in weight for age, AC, and AMC. Both marasmic and kwashiorkor groups had significantly lower TBPA levels than undernourished group. The marasmic children also had significantly lower body weight but higher TBPA levels than kwashiorkor, while the TBPA values for marasmic kwashiorkor children were in between the two. Considerable overlapping of individual TBPA values were found between normals and undernourished in Wellcome classification but very little overlapping was found between normals and mild PEM in Waterlow's classification.