Endocrine Function in Protein‐calorie Malnutrition

Abstract

Undernutrition is widespread. In spite of the research and development being directed towards its prevention and alleviation, the weight of numbers as well as social, cultural, economic and technological considerations make eradication unlikely in the foreseeable future. Ironically, malnutrition is often endemic in areas in which sophisticated medical facilities exist; the problem clearly goes deeper than the mere availability of medical care. But this curious juxtaposition of poverty and medical sophistication has allowed numerous workers to study endocrine function in protein-calorie malnutrition (PCM). As hormones such as glucagon, insulin, growth hormone and cortisol are concerned with the efficient utilization of food, storage and expenditure of energy, and the latter three hormones with synthesis of body protein, it has been suggested that adaptive changes based on alterations in hormone secretion of function might allow for better survival of the threatened individual (Monckeberg, 1968); this conclusion, however, must be regarded as speculative at present; an alternative explanation might be that they are non-specific consequences of severe nutritional deprivation.This review is not primarily concerned with hormonal changes in prolonged fasting, nor will it refer in great depth to animal models of malnutrition which, while they have the advantage of producing more precise quantitation of the deficit, may not always be relevant to the situation in man. For infantile malnutrition is not merely the deprivation of proteins and calories ; it is inevitably associated with variable degrees of vitamin and mineral deficiency, intercurrent infection and electrolyte changes. To what extent hormonal changes are attributable to malnutrition as opposed to associated phenomena is not always apparent, but these might be very relevant in considering the pathogenesis of endocrine dysfunction in the human as opposed to the experimental context.

Morphometrical quantitation of pancrearic endocrine cells in patients with carcinoma of the pancreas.

“…Loss of trophic factors to islets by damage of exocrine parenchyma and changes in islet vascularization and glucose diffusion have been proposed (Bommer et al 1976;Seifert et al 1977). Other factors such as inactivity and stress (Lipman et al 1972), weight loss (Pimstone 1976), or an unknown factor related to malignancy in general (Lisker et al 1966) could be implied. We believe, however, that these other factors could have, at most, a secondary role in this process.…”

Effect of protein deficiency on some hypothalamic and pituitary hormones in growing male lambs. An immunohistochemical study

“…Protein malnutrition during the postnatal period has been claimed to cause significant abnormalities in the developing central nervous system, as well as changes in the endocrine system (Morgane et al, 1978;Primstone, 1976). Recent data, obtained from female rats, monkeys and sheep, confirm that the nutritional state of immature animals delays puberty by inhibiting gonadotropin secretion (e.g.…”

Short-term low-protein diet during pregnancy alters islet area and protein content of phosphatidylinositol 3-kinase pathway in rats

“…Protein deficiency leads to reduced β-cell mass due to a decrease in the proliferation rate and an increase in apoptosis (Swenne et al 1992, Petrik et al 1999. Additionally, when the data are corrected for age and weight, a reduction in β-cell size and total islet volume, a lower proportion of β-cells per islet, a degranulation of β-cells and β-cells with a preponderance of abnormal pale granules have been observed (Heard and Stewart 1971, Pimstone 1976, Weinkove et al 1977.…”