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Acute phase reactants in Sudanese children with severe protein-energy malnutrition

Omer S M Suliman1, Mustafa A M Salih1, Zein A Karrar1

  • 1(1) Department of Paediatrics and Child Health , Faculty of Medicine, University of Khartoum , Sudan .

Sudanese Journal of Paediatrics
|August 6, 2016
PubMed

Insights

Severe protein energy malnutrition in Sudanese children is linked to higher levels of acute phase proteins (APP), except fibrinogen, especially with infections. Rehabilitation significantly reduced CRP and ORO levels.

Area of Science:

  • Biochemistry
  • Pediatrics
  • Nutritional Science

Background:

  • Severe protein energy malnutrition (PEM) is prevalent in Sudanese children.
  • PEM is often associated with infections like acute respiratory infection (ARI), diarrheal diseases, and intestinal parasites.
  • Acute phase proteins (APP) are key indicators of inflammation and nutritional status.

Purpose of the Study:

  • To compare pre-dietary rehabilitation levels of specific acute phase proteins (APPs) in malnourished children versus controls.
  • To assess APP levels after dietary rehabilitation and antimicrobial treatment.
  • To investigate the association between APP levels and co-existing infections in malnourished children.

Main Methods:

  • Plasma levels of alpha-1-antitrypsin (AAT), orosomucoid (ORO), haptoglobin (HAP), fibrinogen (FIB), and C-reactive protein (CRP) were measured.
  • Study included 49 children with severe PEM, 13 with tuberculosis (TB), and 19 healthy controls.
  • Measurements were taken before and after two weeks of dietary rehabilitation and antimicrobial treatment.

Main Results:

  • Malnourished children had significantly lower albumin levels compared to controls, particularly those with kwashiorkor.
  • APP levels (except FIB) were significantly higher in malnourished children, correlating with ARI and fever.
  • Malnourished children with TB showed elevated APP levels; HAP and AAT were lower with diarrhea, indicating potential loss.
  • After rehabilitation, CRP and ORO levels significantly decreased, while FIB levels increased.

Conclusions:

  • Hypoalbuminemia in malnourished children is associated with infections.
  • Elevated APP levels in PEM reflect inflammatory responses to infections.
  • Dietary rehabilitation and treatment effectively reduced certain APP levels, indicating improved inflammatory status.

Keywords:
Acute phase proteinsAcute respiratory infectionProtein-energy malnutritionSudanese childrenTuberculosis

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