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Plasma fibronectin levels in acute and recovering malnourished children
Insights
Plasma fibronectin levels in malnourished children are significantly lower than in controls. Higher initial fibronectin levels correlate with better survival rates and indicate successful recovery during treatment.
Area of Science:
- Biochemistry
- Pediatrics
- Clinical Nutrition
Background:
- Malnutrition, including marasmus and kwashiorkor, is a significant health concern in children.
- Assessing nutritional status and prognosis in malnourished children requires reliable biomarkers.
Purpose of the Study:
- To investigate plasma fibronectin levels in malnourished children.
- To evaluate the prognostic value of plasma fibronectin in predicting survival and treatment response.
Main Methods:
- Studied 58 malnourished children (marasmus/kwashiorkor) aged 18 months.
- Measured plasma fibronectin, total solids, hematocrits, anthropometrics, and compared with controls.
- Analyzed correlations between fibronectin levels, clinical parameters, and survival rates.
Main Results:
- Malnourished children had significantly lower mean plasma fibronectin (96 µg/ml) vs. controls (253 µg/ml).
- Higher initial fibronectin levels (>100 µg/ml) were associated with improved survival (92% vs. 69%).
- Fibronectin levels rose rapidly with successful therapy, often preceding other clinical improvements, and even exceeding normal levels post-treatment.
Conclusions:
- Plasma fibronectin is a valuable prognostic marker for malnourished children.
- It reliably indicates successful therapy and recovery, showing rapid increases post-treatment.
Abstract:
58 malnourished children (mean age 18 months) with a clinical diagnosis of marasmus or kwashiorkor were studied with respect to plasma fibronectin levels, plasma total solids, spun hematocrits, heights, weights, mid-arm circumferences, and head circumferences. Bimodal distributions were demonstrated for plasma fibronectin versus weight deficits, total solids, hematocrits, and mid-arm circumference in children 12 months of age and older (p less than 0.003 for all). The mean plasma fibronectin level for controls was 253 micrograms/ml. The mean level for the malnourished group was 96 micrograms/ml (p less than 0.0001). Malnourished children with initial plasma fibronectin levels above 100 micrograms/ml had a higher survival rate than those with levels less than 100 (92 versus 69%). With successful therapy, plasma fibronectin levels rose quickly in most children often before detectable changes were noted in clinical and other laboratory parameters. An overshoot of the mean normal levels was observed with successful treatment wherein the mean levels rose to 315 micrograms/ml (p less than 0.05). Plasma fibronectin determinations on malnourished children can serve as an important prognostic marker as well as a reliable indicator of successful therapy and recovery.