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Serum Zinc, Copper, Magnesium & Phosphorus Level in Children with Severe Acute Malnutrition (SAM)
B Chowdhury1, M A Hoque, M A Hossain
1Dr Biswajit Chowdhury, Resident Physician/Junior Consultant, Pediatrics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh.
Insights
Malnourished hospitalized children (SAM) in Bangladesh show significantly lower serum zinc, copper, magnesium, and phosphorus levels compared to healthy children. Early biochemical monitoring is crucial for children with severe acute malnutrition (SAM).
Area of Science:
- Pediatric Nutrition
- Clinical Biochemistry
- Public Health
Background:
- Malnutrition is a significant health issue in hospitalized children in developing countries like Bangladesh.
- Severe acute malnutrition (SAM) contributes to high under-5 mortality rates but is often overlooked.
- Understanding micronutrient deficiencies in SAM is critical for effective management.
Purpose of the Study:
- To compare serum levels of zinc, copper, magnesium, and phosphorus in hospitalized children with SAM versus a healthy reference group.
- To highlight the prevalence and biochemical profile of malnutrition in pediatric patients.
Main Methods:
- A comparative cross-sectional study was conducted at Mymensingh Medical College Hospital.
- Children aged 1-5 years were categorized into a study group (SAM) based on WHO criteria and a reference group with normal growth.
- Serum mineral levels (Zn, Cu, Mg, P) were measured using Atomic Absorption Spectrometry.
Main Results:
- The study included 90 children with SAM and 30 in the reference group.
- Children with SAM exhibited significantly lower mean serum levels for zinc (60.33±11.08μg/dl vs 103.80±8.86μg/dl), copper (80.60±15.46μg/dl vs 135.92±13.57μg/dl), magnesium (1.47±0.22mg/dl vs 2.31±0.18mg/dl), and phosphorus (2.00±0.52mg/dl vs 3.96±0.22mg/dl) compared to the reference group.
- Statistical analysis confirmed significant differences in all measured parameters between the groups.
Conclusions:
- Hospitalized children with severe acute malnutrition (SAM) in Bangladesh have marked deficiencies in serum zinc, copper, magnesium, and phosphorus.
- These findings underscore the importance of biochemical monitoring for these micronutrients in children diagnosed with SAM.
- Close follow-up and biochemical assessment are recommended for improved management of pediatric malnutrition.
Abstract:
Malnutrition is widely prevalent among hospitalized children in most developing countries including Bangladesh. Though malnutrition accounts for the high rate of under 5 mortality sometimes it is overlooked. Keeping in this in mind A comparative cross sectional study was done in Mymensingh Medical College Hospital from 1st October 2009 to 31st May 2011. Children aged 1-5 years with presence of one or more criteria WHM <70%, WHZ-score <-3SD, Bipedal edema & Mid upper arm circumference <110mm were taken as study group and children aged 1-5 years with normal growth allowable normal range of variation is between 3rd and 97th centile curve or median (50th centile) ±2SD of weight for age growth chart (CDC growth chart, USA, 2000) were taken as reference group. Persistent diarrhea, Patients taking medications containing zinc, copper, magnesium, phosphorus & calcium, PEM with shock were excluded from study group. Nutritional assessment was done according to WHO criteria of SAM. Serum Zinc, Copper Magnesium and Phosphorus level were determined by Atomic Absorption Spectrometry using UNICAM - AA Spectrometer, model no. 969, Spain. Total 120 study populations were taken. Ninety Out of 120 were taken as a study group (SAM) & 30 were reference group. In reference group serum Zn, Cu, Mg, P value was 103.80±8.86μg/dl, 135.92±13.57μg/dl, 2.31±0.18mg/dl, 3.96±0.22mg/dl respectively. In study group serum Zn, Cu, Mg, P value was 60.33±11.08μg/dl, 80.60±15.46μg/dl, 1.47±0.22mg/dl, 2.00±0.52mg/dl respectively. All these results show that there is significant difference between study group & reference group. Considering the decreased level of these parameters, close biochemical monitoring and follow up should be emphasized for the children with SAM.
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