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Hormonal changes in severely malnourished children.

A A Laditan

    African Journal of Medicine and Medical Sciences
    |September 1, 1983
    PubMed
    Summary

    Hormonal profiles in severe childhood malnutrition differ between kwashiorkor and marasmus. Growth hormone (GH) was elevated and insulin depressed in kwashiorkor, with levels normalizing upon nutritional recovery.

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    Area of Science:

    • Pediatric Endocrinology
    • Nutritional Science

    Background:

    • Protein-energy malnutrition (PEM) significantly impacts hormonal regulation in young children.
    • Distinct clinical forms of PEM, such as kwashiorkor and marasmus, may exhibit unique physiological responses.

    Purpose of the Study:

    • To investigate and compare hormonal changes during the acute phase and recovery of protein-energy malnutrition (PEM) in infants and young children.
    • To differentiate hormonal profiles between kwashiorkor and marasmus in relation to severity and recovery.

    Main Methods:

    • Serum hormone levels (cortisol, insulin, growth hormone (GH), thyroxine) were measured in 34 children (≤3 years) with severe PEM (24 kwashiorkor, 10 marasmus).
    • Hormonal concentrations were analyzed during the acute phase and correlated with anthropometric recovery.
    • Statistical comparisons were made between kwashiorkor and marasmus groups and their subgroups.

    Main Results:

    • Kwashiorkor patients showed significantly depressed insulin and elevated growth hormone (GH) levels, particularly in severe cases.
    • Marasmic children also had elevated GH, but at lower concentrations than in kwashiorkor.
    • Cortisol and thyroxine levels did not significantly differ between kwashiorkor and marasmus, potentially due to concurrent infections.
    • During nutritional recovery, GH levels decreased while insulin levels increased, especially in kwashiorkor.

    Conclusions:

    • Hormonal dysregulation, particularly involving GH and insulin, is a key feature distinguishing kwashiorkor from marasmus in severe pediatric malnutrition.
    • These hormonal shifts play a crucial role during the acute phase and subsequent recovery from PEM.
    • Monitoring these hormonal changes can provide insights into the pathophysiology and recovery process of different forms of childhood malnutrition.

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