Serum Cortisol Concentrations in Children with Protein-Energy Malnutrition

Abstract

We measured basal Cortisol levels in 15 children with kwashiorkor, 15 children with marasmic kwashiorkor, and 21 children with marasmus, before and after nutritional rehabilitation, as well as in 10 underweight and 8 normal Egyptian children. Cortisol levels are elevated in kwashiorkor, marasmic kwashiorkor, and marasmus groups, but returned to normal after nutritional rehabilitation. No differences in basal Cortisol were detected between the three severely malnourished groups before refeeding. The percent body weight deficit and the calculated muscle diameter correlated significantly with Cortisol levels in all the children before nutritional rehabilitation, but there was no significant correlation between serum albumin or glucose and Cortisol levels. Increased Cortisol levels appeared not to be related to the type of protein-energy malnutrition, but represent an attempt of the organism to adapt to decreased dietary protein and/or energy supply through breakdown of muscle protein to provide the liver with the necessary amino acids for gluconeogenesis and albumin synthesis. ATM Soliman, AEI Hassan, MK Aref, AD Rogol, Serum Cortisol Concentrations in Children with Protein-Energy Malnutrition. 1989; 9(6): 533-537 Adaption to nutritional deficiency depends substantially on the endocrine control of intermediary metabolism. Marasmus and kwashiorkor, the two major forms of protein-energy malnutrition (PEM), result from proper adaptation and failure to adapt, respectively.