Correlation of some biochemical parameters with clinical features of protein energy malnutrition

The authors report on a study correlating the laboratory findings of children with protein energy malnutrition (PEM) with their clinical presentations. Forty-nine cases of marasmus, 17 of kwashiorkor and 28 of marasmic-kwashiorkor, as well as 20 controls, were studied and monitored in hospital. Fasting plasma samples obtained on days 2, 14 and 21 were analyzed for total proteins, albumin, triglycerides and cholesterol. Blood glucose and haemoglobin were also determined. The total plasma proteins and albumin were significantly lower in all the malnourished cases compared to the controls, with marked hypoproteinaemia among those cases with kwashiorkor. Plasma triglycerides were significantly lower in the malnourished group, when compared to controls. With dietary treatment, plasma triglycerides rose significantly accompanied with regression in liver size. Four out of the 17 children with kwashiorkor, had died; they had the lowest serum albumin concentrations of all the cases studied. The mean haemoglobin concentration of those who died was also significantly lower than that of the survivors.