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Causes of inadequate protein-energy status in thalassemic children

V S Tanphaichitr1, B Visuthi, V Tanphaichitr

  • 1Division of Hematology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.

Asia Pacific Journal of Clinical Nutrition
|January 8, 2014
PubMed

Insights

Protein-energy malnutrition (PEM) is prevalent in thalassemic children, linked to chronic hypoxia, zinc deficiency, and low energy intake. These factors significantly impact growth indicators like height-for-age and mid-upper arm circumference.

Area of Science:

  • Pediatric Nutrition
  • Hematology
  • Clinical Biochemistry

Background:

  • Thalassemia is a genetic blood disorder requiring lifelong management.
  • Nutritional status is crucial for growth and development in children with chronic illnesses.
  • Protein-energy malnutrition (PEM) is a concern in pediatric populations with chronic conditions.

Purpose of the Study:

  • To assess the nutritional status of thalassemic children aged 4-5 years.
  • To determine the prevalence of protein-energy malnutrition (PEM) in this cohort.
  • To investigate potential contributing factors to malnutrition, including hypoxia, zinc status, and energy intake.

Main Methods:

  • Anthropometric measurements including height-for-age, weight-for-age, triceps skinfold thickness (TST), mid-upper arm circumference (MUAC), and mid-upper arm muscle circumference (UAMC) were taken.
  • Biochemical markers such as hemoglobin and plasma/urinary zinc levels were analyzed.
  • Correlations between nutritional indicators, hemoglobin, zinc levels, and energy intake were examined.

Main Results:

  • Thalassemic children exhibited significantly lower mean values for height-for-age, weight-for-age, TST, MUAC, and UAMC compared to standard values.
  • High prevalences of PEM were observed, ranging from 53.7% (TST) to 82.9% (UAMC).
  • Significant positive correlations were found between hemoglobin levels and multiple anthropometric measures, indicating hypoxia's impact. Plasma and urinary zinc levels also showed significant correlations with growth parameters, suggesting zinc deficiency. Mean energy intake was only 65% of recommended levels.

Conclusions:

  • Thalassemic children aged 4-5 years suffer from significant protein-energy malnutrition.
  • Chronic hypoxia, zinc deficiency, and inadequate energy intake are key contributors to the poor nutritional status.
  • Comprehensive nutritional support and monitoring are essential for managing thalassemic children.

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