Assessment of Biochemical Parameters as Indicators of Protein Energy Malnutrition in Turkish Children: A Comprehensive and Retrospective Study
Year 2024,
Volume: 7 Issue: 5, 173 - 180, 15.09.2024
Eda Gülbetekin
,
Namık Kılınç
Abstract
This study aims to address this research gap by meticulously analyzing the biochemical parameters of children aged 0-59 months diagnosed with Protein Energy Malnutrition (PEM) within the confines of a state hospital over a two-year period. This study is a retrospective study evaluating the biochemistry and hormone laboratory findings of 302 children aged 0-59 months who were diagnosed with Protein Energy Malnutrition between the years 2020-2022 in the pediatric health and diseases clinic of Iğdır State Hospital. This study investigated the distribution of various biochemical parameters in children diagnosed with protein-energy malnutrition (PEM) and explored their significance within this context. The findings, based on reference values, revealed substantial proportions of children with abnormal values for iron, immunoglobulin (IgM and IgA), liver enzymes (ALT and AST), creatinine, CRP, and vitamin D. Gender-based differences were observed for calcium, IgM, Folate, and TSH, with notable variations between male and female children. Correlations between age and various parameters were identified, underscoring the complex interplay between developmental stages and biochemical values. The study highlights the importance of addressing deficiencies, potential complications, and demographic influences in managing PEM. The absence of demographic data integration in existing studies serves as a limitation, emphasizing the need for comprehensive research in this domain. Overall, these insights contribute to a deeper understanding of biochemical dynamics in children with PEM, aiding targeted interventions for improved health outcomes.
Ethical Statement
This study was approved by Ethics Committee of Igdır University (Approval No: E-37077861-900-119343, Date: 27.10.2023). Before collecting study data, written permissions were obtained from the relevant hospital (Permission date: 19.01.2023).
Supporting Institution
Igdır Nevruz Erez State Hospital
Thanks
We would like to thank the Iğdır Nevruz Erez State Hospital administration and the Pediatric Health and Diseases clinic physicians for sharing the data with us.
References
- Acar A. 2012. A different look at the prevalence of malnutrition in preschool children under 6 years of age in Şırnak province. MSc Thesis, Necmettin Erbakan University, Institute of health Science, Konya, Türkiye, pp: 76.
- Amira Sayed R, Abdel SS. 2004. Vitamin D level in children with rickets and protein-energy malnutrition. Medic J Cairo Univ, 72(1): 103-108.
- Ashok E, Ramesh S, Prakash RS. 2020. Biochemical profile of children with severe acute malnutrition. Int J Paediat Geriat, 3(2): 154-156.
- Benjamin DR. 1989. Laboratory tests and nutritional assessment. Protein-energy status. Pediatr Clin North Amer, 36:139-161.
- Binkley N, Novotny R, Krueger D, Kawahara T, Daida YG, Lensmeyer G. 2007. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metabol, 92(6): 2130-2135.
- Borelli P, Blatt SL, Rogero MM, Fock RA. 2004. Haematological alterations in protein malnutrition. Revista Brasil Hematol Hemoter, 26: 49-56.
- Chaki O. 2017. Calcium and bone metabolism across women's life stages. Changes of biochemical markers of bone turnover in life cycle of women. Clin Calcium, 7(5): 623-633.
- Edwards JK, Thiongo A, Van den Bergh R, Kizito W, Kosgei RJ, Sobry A. 2014. Preventable but neglected: Rickets in an informal settlement, Nairobi, Kenya. Pub Health Action, 4(2): 122-127.
- Elkholy AT, Naglaa HM, Rasha H. 2012. Demographic, socio-economic factors and physical activity affecting the nutritional status of young children under five years. Life Sci J, 9(4): 3604- 3614.
- Figueroa R. 1993. Clinical and laboratory assessment of the malnourished child; in Suskind RM and Levinter-Suskind L (eds). Textbook of Pediatric Nutrition (2nd Ed) Raven Press Ltd., New York, US, pp: 191-205.
- Gulec SG, Urgancı N, Polat S, Yagar G, Hatipoglu N. 2011. Evaluation of malnutrition status in hospitalized children under three years of age. Şişli Etfal Hospital Medic Bull, 45(4): 124-129.
- Ikizler TA, Greene JH, Wingard RL, Parker RA, Hakim RM. 1995. Spontaneous dietary protein intake during progression of chronic renal failure. J Amer Soc Nephrol, 6(5): 1386-1391.
- Jain A, Jadhav AA, Varma M. 2013. Relation of oxidative stress, zinc and alkaline phosphatase in protein energy malnutrition. Arch Physiol Biochem, 119: 15-21.
- Jones KDJ, Hachmeister CU, Khasira M, Cox L, Schoenmakers I, Munyi C, Nassir HS. 2018. Vitamin D deficiency causes rickets in an urban informal settlement in Kenya and is associated with malnutrition. Maternal Child Nutrit, 14(1): e12452.
- Kilic M, Taskin E, UstundagB, Gurgoze MK, Kurt NC, Aygun AD. 2004. Evaluation of serum leptin lipid and protein levels and anthropometric measurements in children with malnutrition. Turkish Pediat Arch, 39: 14-20.
- Kopple JD. 1999. Pathophysiology of protein-energy wasting in chronic renal failure. J Nutrit, 129(1): 247-251.
- Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K. 2016. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metabol, 101(2): 394-415.
- Nielsen RA, Hejgaard M. 2011. Immunoglobulin deficiency and its impact on infection risk. J Clin Immunol, 31(2): 143-149.
- Nkrumah F, Nathoo KJ, Sanders D. 1988. Iron, folate and vitamin B12 in severe protein-energy malnutrition. Central African J Medic, 34(3): 39-43.
- Onal S, Ozdemir A, Mese C, Ozer BK. 2016. Evaluatıion of the prevalence of obesity and malnutrition in preschool children: The case of Ankara. DTCFJ, 56(1): 210-225.
- Pepys MB, Hirschfield GM. 2003. C-reactive protein: a critical update. J Clin Invest, 111(12): 1805-1812.
- Said A, El-Hawary M, Sakr R, Khalek M, El-Shobaki F, Noseir M. 1975. Biochemical and haematological aspects of anaemia associating protein energy malnutrition (PEM). Gazette Egyptian Paediat Assoc, 23(2): 139-144.
- Sauerwein RW, Mulder JA, Mulder L, Lowe B, Peshu N, Demacker P. 1997. Inflammatory mediators in children with protein-energy malnutrition. Amer J Clin Nutrit, 65(5): 1534-1539.
- Singh M. 2004. Role of micronutrients for physical growth and mental development. Indian J Pediatr, 71(1): 59-62.
- Soucie JM, McClellan WM. 1996. Early death in dialysis patients: risk factors and impact on incidence and mortality rates. J Amer Soc Nephrol, 7(10): 2169-2175.
- Thacher TD, Fischer PR, Pettifor JM. 2002. The usefulness of clinical features to identify active rickets. Annals Tropical Paediat, 22(3): 229-237.
- Thakur S, Gupta N, Kakkar P. 2004. Serum copper and zinc concentration and their relation to superoxide dismutase in severe malnutrition. Eur J Pediatr, 163: 742-744.
- Uckun U. 2016. Evaluatıon of case of severe length short (Size Sds < -3). MSC Thesis, Istanbul University, Institute of Health Science, Istanbul, Türkiye, pp: 102.
- UNICEF.2013. Improving Child Nutrition: The Achievable Imperative for Global Progress. Geneva: UNICEF, 5-23.
- Waly MI. 2014. Nutrition assessment of preschool children using Z-score analysis. Canadian J Clin Nutrit, 2(2): 50-59.
- WHO. 2011. Country Office for India, NRHM. Facility Based Care of Severe Acute Malnutrition. New Delhi: WHO- country Office for India, NRHM, 33-35.
Assessment of Biochemical Parameters as Indicators of Protein Energy Malnutrition in Turkish Children: A Comprehensive and Retrospective Study
Year 2024,
Volume: 7 Issue: 5, 173 - 180, 15.09.2024
Eda Gülbetekin
,
Namık Kılınç
Abstract
This study aims to address this research gap by meticulously analyzing the biochemical parameters of children aged 0-59 months diagnosed with Protein Energy Malnutrition (PEM) within the confines of a state hospital over a two-year period. This study is a retrospective study evaluating the biochemistry and hormone laboratory findings of 302 children aged 0-59 months who were diagnosed with Protein Energy Malnutrition between the years 2020-2022 in the pediatric health and diseases clinic of Iğdır State Hospital. This study investigated the distribution of various biochemical parameters in children diagnosed with protein-energy malnutrition (PEM) and explored their significance within this context. The findings, based on reference values, revealed substantial proportions of children with abnormal values for iron, immunoglobulin (IgM and IgA), liver enzymes (ALT and AST), creatinine, CRP, and vitamin D. Gender-based differences were observed for calcium, IgM, Folate, and TSH, with notable variations between male and female children. Correlations between age and various parameters were identified, underscoring the complex interplay between developmental stages and biochemical values. The study highlights the importance of addressing deficiencies, potential complications, and demographic influences in managing PEM. The absence of demographic data integration in existing studies serves as a limitation, emphasizing the need for comprehensive research in this domain. Overall, these insights contribute to a deeper understanding of biochemical dynamics in children with PEM, aiding targeted interventions for improved health outcomes.
References
- Acar A. 2012. A different look at the prevalence of malnutrition in preschool children under 6 years of age in Şırnak province. MSc Thesis, Necmettin Erbakan University, Institute of health Science, Konya, Türkiye, pp: 76.
- Amira Sayed R, Abdel SS. 2004. Vitamin D level in children with rickets and protein-energy malnutrition. Medic J Cairo Univ, 72(1): 103-108.
- Ashok E, Ramesh S, Prakash RS. 2020. Biochemical profile of children with severe acute malnutrition. Int J Paediat Geriat, 3(2): 154-156.
- Benjamin DR. 1989. Laboratory tests and nutritional assessment. Protein-energy status. Pediatr Clin North Amer, 36:139-161.
- Binkley N, Novotny R, Krueger D, Kawahara T, Daida YG, Lensmeyer G. 2007. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metabol, 92(6): 2130-2135.
- Borelli P, Blatt SL, Rogero MM, Fock RA. 2004. Haematological alterations in protein malnutrition. Revista Brasil Hematol Hemoter, 26: 49-56.
- Chaki O. 2017. Calcium and bone metabolism across women's life stages. Changes of biochemical markers of bone turnover in life cycle of women. Clin Calcium, 7(5): 623-633.
- Edwards JK, Thiongo A, Van den Bergh R, Kizito W, Kosgei RJ, Sobry A. 2014. Preventable but neglected: Rickets in an informal settlement, Nairobi, Kenya. Pub Health Action, 4(2): 122-127.
- Elkholy AT, Naglaa HM, Rasha H. 2012. Demographic, socio-economic factors and physical activity affecting the nutritional status of young children under five years. Life Sci J, 9(4): 3604- 3614.
- Figueroa R. 1993. Clinical and laboratory assessment of the malnourished child; in Suskind RM and Levinter-Suskind L (eds). Textbook of Pediatric Nutrition (2nd Ed) Raven Press Ltd., New York, US, pp: 191-205.
- Gulec SG, Urgancı N, Polat S, Yagar G, Hatipoglu N. 2011. Evaluation of malnutrition status in hospitalized children under three years of age. Şişli Etfal Hospital Medic Bull, 45(4): 124-129.
- Ikizler TA, Greene JH, Wingard RL, Parker RA, Hakim RM. 1995. Spontaneous dietary protein intake during progression of chronic renal failure. J Amer Soc Nephrol, 6(5): 1386-1391.
- Jain A, Jadhav AA, Varma M. 2013. Relation of oxidative stress, zinc and alkaline phosphatase in protein energy malnutrition. Arch Physiol Biochem, 119: 15-21.
- Jones KDJ, Hachmeister CU, Khasira M, Cox L, Schoenmakers I, Munyi C, Nassir HS. 2018. Vitamin D deficiency causes rickets in an urban informal settlement in Kenya and is associated with malnutrition. Maternal Child Nutrit, 14(1): e12452.
- Kilic M, Taskin E, UstundagB, Gurgoze MK, Kurt NC, Aygun AD. 2004. Evaluation of serum leptin lipid and protein levels and anthropometric measurements in children with malnutrition. Turkish Pediat Arch, 39: 14-20.
- Kopple JD. 1999. Pathophysiology of protein-energy wasting in chronic renal failure. J Nutrit, 129(1): 247-251.
- Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K. 2016. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metabol, 101(2): 394-415.
- Nielsen RA, Hejgaard M. 2011. Immunoglobulin deficiency and its impact on infection risk. J Clin Immunol, 31(2): 143-149.
- Nkrumah F, Nathoo KJ, Sanders D. 1988. Iron, folate and vitamin B12 in severe protein-energy malnutrition. Central African J Medic, 34(3): 39-43.
- Onal S, Ozdemir A, Mese C, Ozer BK. 2016. Evaluatıion of the prevalence of obesity and malnutrition in preschool children: The case of Ankara. DTCFJ, 56(1): 210-225.
- Pepys MB, Hirschfield GM. 2003. C-reactive protein: a critical update. J Clin Invest, 111(12): 1805-1812.
- Said A, El-Hawary M, Sakr R, Khalek M, El-Shobaki F, Noseir M. 1975. Biochemical and haematological aspects of anaemia associating protein energy malnutrition (PEM). Gazette Egyptian Paediat Assoc, 23(2): 139-144.
- Sauerwein RW, Mulder JA, Mulder L, Lowe B, Peshu N, Demacker P. 1997. Inflammatory mediators in children with protein-energy malnutrition. Amer J Clin Nutrit, 65(5): 1534-1539.
- Singh M. 2004. Role of micronutrients for physical growth and mental development. Indian J Pediatr, 71(1): 59-62.
- Soucie JM, McClellan WM. 1996. Early death in dialysis patients: risk factors and impact on incidence and mortality rates. J Amer Soc Nephrol, 7(10): 2169-2175.
- Thacher TD, Fischer PR, Pettifor JM. 2002. The usefulness of clinical features to identify active rickets. Annals Tropical Paediat, 22(3): 229-237.
- Thakur S, Gupta N, Kakkar P. 2004. Serum copper and zinc concentration and their relation to superoxide dismutase in severe malnutrition. Eur J Pediatr, 163: 742-744.
- Uckun U. 2016. Evaluatıon of case of severe length short (Size Sds < -3). MSC Thesis, Istanbul University, Institute of Health Science, Istanbul, Türkiye, pp: 102.
- UNICEF.2013. Improving Child Nutrition: The Achievable Imperative for Global Progress. Geneva: UNICEF, 5-23.
- Waly MI. 2014. Nutrition assessment of preschool children using Z-score analysis. Canadian J Clin Nutrit, 2(2): 50-59.
- WHO. 2011. Country Office for India, NRHM. Facility Based Care of Severe Acute Malnutrition. New Delhi: WHO- country Office for India, NRHM, 33-35.