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Serum aminotransferases and gamma-glutamyl transferase in protein energy malnutrition
Insights
Protein Energy Malnutrition (PEM) in children often shows elevated aminotransferases, but this moderate rise likely isn't liver damage. Marked elevations in some PEM cases may indicate liver injury from toxins.
Area of Science:
- Biochemistry
- Pediatrics
- Hepatology
Background:
- Protein Energy Malnutrition (PEM) is a significant health concern in children.
- Liver function, assessed by aminotransferase levels, can be affected in malnourished states.
- Understanding the relationship between PEM and liver enzymes is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT) in children with PEM.
- To correlate aminotransferase levels with the severity of malnutrition.
- To determine if elevated aminotransferases in PEM indicate liver damage.
Main Methods:
- Forty-six children with PEM were classified using the Wellcome classification.
- Serum levels of AST, ALT, and GGT were measured.
- A Severity Index was calculated based on height/weight retardation and serum albumin.
Main Results:
- Elevated AST was observed in 43.5% of patients, and elevated ALT in 26%.
- GGT was elevated in only one case of marasmic kwashiorkor, with marked aminotransferase increases.
- Aminotransferase elevation positively correlated with the calculated Severity Index.
Conclusions:
- Moderate aminotransferase elevations in PEM are likely not indicative of liver damage.
- Marked elevations in a minority of PEM patients suggest potential liver injury, possibly due to hepatotoxins.
- Further investigation into hepatotoxin involvement in severe PEM cases is warranted.
Abstract:
Forty six children suffering from Protein Energy Malnutrition (PEM) were classified according to the Wellcome classification. Their aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were measured. Aspartate aminotransferase was raised in 20 patients (43.5%) and alanine aminotransferase was raised in 12 patients (26%). Y-glutamyl transferase was raised in only one patient suffering from marasmic kwashiorkor, who, in contrast to the rest of the patients had a marked rise in aminotransferases. The aminotransferase elevation correlated positively with a Severity Index calculated from height and weight retardation and serum albumin levels. It is suggested that the moderate rise in aminotransferases found in PEM is not due to damage to the liver. However, marked enzyme elevations can occur in a small minority of patients, suggestive of liver injury, probably caused by hepatotoxins.