Thyroid hormone and carrier protein interrelationships in children recovering from kwashiorkor

Kalk, W. J.; Hofman, Kurt; Smit, A. M.; Drimmelen, M. van; Walt, L. A. van der; Moore, Ray

doi:10.1093/ajcn/43.3.406

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…On the contrary, subnormal RBP values were recorded in 11 of 32 (34%) patients and subnormal TTR values in only 5 out of 32 (16%). The mean values of RBP (43.3 ± 6.7 pg/mL) and of TTR (24.2 ± 4.4 mg/dL) were close to the lower limit accepted for normal subjects (20,21). The linear regression analysis revealed that RBP and retinol/RBP ratio, but not TTR, and TSH levels were closely correlated (r = -0.514; p < 0.0026 and r = -0.6559; p < 0.0001, respectively).…”

Section: Resultssupporting

confidence: 74%

Combined Impairment of Nutritional Parameters and Thyroid Homeostasis in Mildly Iodine-Deficient Children

Centanni

Maiani

Vermiglio

et al. 1998

Thyroid

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The relation between thyroid homeostasis and the biochemical parameters of subclinical protein malnutrition has been analyzed in schoolchildren in a rural area in the south of Italy, known to be moderately iodine-deficient. The sera of 32 children (15 males and 17 females aged 6 to 11 years) have been analyzed. These children were divided into two groups, according to thyroid function: (1) 16 euthyroid children (mean thyrotropin [TSH] 2.38 +/- .35 mU/L; 6 with goiter) and (2) 16 subclinical hypothyroid children (mean TSH 7.32 +/- 1.68 mU/L; 6 with goiter). Retinol circulating complex (RCC) components were determined in serum by high-performance liquid chromatography (HPLC) and radial immunodiffusion and the essential and nonessential amino acid levels by ion exchange chromatography. Reduced retinol binding protein (RBP) and transthyretin (TTR) levels were recorded in the sera of 11 of 32 (34%) and in 5 of 32 (16%) patients, respectively. The linear regression analysis revealed that RBP and TSH levels were inversely correlated (r = -0.514; p < 0.0026). The RBP levels were subnormal in 2 of 16 euthyroid and in 9 of 16 hypothyroid patients (Fisher test p < 0.023), and the mean RBP levels were significantly reduced in the hypothyroid patients when compared with those of the euthyroid group (p < 0.0026). The retinol/RBP ratio was also significantly different between euthyroid and hypothyroid children (0.75 vs. 0.95; p < 0.0002). The mean essential amino acid levels, with the exception of methionine, were all in the normal range. The selected amino acid ratios confirmed that the patients were exposed to mild protein malnutrition. These results provide evidence that even mild protein-energy malnutrition may have detrimental effects on thyroid homeostasis in iodine-deficient areas.

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Section: Resultssupporting

confidence: 74%

Combined Impairment of Nutritional Parameters and Thyroid Homeostasis in Mildly Iodine-Deficient Children

Centanni

Maiani

Vermiglio

et al. 1998

Thyroid

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“…Low levels of thyroid hormones binding proteins in malnutrition are thought to be due to decreased protein intake and their reduced hepatic biosynthesis (11). The rise in serum total T 3 and T 4 levels that occur on re-feeding can be largely accounted for by the increasing concentration of TBG, TBPA and albumin.…”

Section: Result8 and Discu8810nmentioning

confidence: 99%

Thyroid hormone status in protein energy malnutrition in Indian children

Abrol

Verma

Hooda

2001

Indian J Clin Biochem

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Thyroid hormonal status was measured in 80 malnourished children of different grades (I-IV) of protein energy malnutrition (PEM). Serum levels of tri-iodo thyronine (T3) , thyroxine (T 4) and thyroid stimulating hormone (TSH) were measured by radioimmunoassay. The results were compared with 20 healthy, age and sex matched controls. Levels of T 3 and T 4 were significantly low in PEM cases whereas TSH levels were similar in PEM cases when compared to controls.

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“…In general, cortisol levels in children with severe malnutrition are similar to levels in children without malnutrition or are increased, which is likely related to stress and indicates that the hypothalamic-pituitary-adrenal axis is preserved in children with severe malnutrition and is probably not responsible for the development of hypoglycaemia 64,74,75 . Most studies have shown a reduction in thyroid function in children with severe malnutrition, but the clinical relevance of this remains unclear 76,77 . In addition, leptin concentrations are low in children with severe malnutrition, reflecting the extent of adipose tissue loss.…”

Section: Underlying Mechanismsmentioning

confidence: 99%

Severe childhood malnutrition

Bhutta

Berkley

Bandsma

et al. 2017

Nat Rev Dis Primers

347

301

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The main forms of childhood malnutrition occur predominantly in children <5 years of age living in low-income and middle-income countries and include stunting, wasting and kwashiorkor, of which severe wasting and kwashiorkor are commonly referred to as severe acute malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

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Thyroid hormone and carrier protein interrelationships in children recovering from kwashiorkor

Cited by 10 publications

References 34 publications

Combined Impairment of Nutritional Parameters and Thyroid Homeostasis in Mildly Iodine-Deficient Children

Combined Impairment of Nutritional Parameters and Thyroid Homeostasis in Mildly Iodine-Deficient Children

Thyroid hormone status in protein energy malnutrition in Indian children

Severe childhood malnutrition

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