ABSTRACT
To assess the role of enzymatic antioxidants in the pathogenesis of protein energy malnutrition [PEM] and the effect of nutritional rehabilitation, we studied 30 infants with PEM [mean age 10.63 +/- 4.39 months: 10 marasmic; 8 with kwashiorkor; 12 with marasmic kwashiorkor] and 15 controls. All underwent clinical examination and laboratory investigations, including superoxide dismutase [SOD] and glutathione peroxidase [GPx] estimation before and after nutrition rehabilitation. SOD and GPx were significantly lower in all malnourished infants compared to controls, and significantly increased after nutritional rehabilitation. These significant correlations suggest that antioxidants could be introduced during PEM nutritional rehabilitation to decrease morbidity and mortality
Subject(s)
Female , Humans , Infant , Male , Anthropometry , Antioxidants/metabolism , Case-Control Studies , Glutathione Peroxidase , Hospitals, Pediatric , Infant Nutrition Disorders/enzymology , Kwashiorkor/enzymology , Morbidity , Nutrition Assessment , Nutritional Requirements , Nutritional Status , Nutritional Support/standardsABSTRACT
The enzyme glycoxalase I (glyox I) is involved in metabolic detoxification, and requires glutathione (GSH) as a cofactor. Given the low concentration of whole blood GSH in children with oedematous malnutrition, it is possible that the function of this pathway may be compromised in these children. Glyox I activity was therfore assayed in erythocytes taken from 133 severely malnourished children and 21 age-matched controls. The mean values (ñSEM) for the marasmic group (marasmus: 105 ñ 4/u/gm Hb) and the group with kwashiorkor (Kwash: 103 ñ 4/u/gm Hb) were not significantly different from controls (cont: 104 ñ 2u/gm HB)>. In the group with marasmic-kwashiorkor (M-K: 88 ñ 4u/g Hb) Glyox I activity was significantly lower in controls (p < 0.005), as well as in children with marasmus (p < 0.005), and kwashiorkor (p < 0.05). Enzyme activity was lower than normal in 45 per cent of the MK group. Seven children died subsequent to admission; in five cases Glyox I activities were exceedingly low. There was a weak positive correlation between Glyox I activity and whole blood levels of GSH (r=0.215). We conclude that Glyox I activity is relatively unaffected in malnutrition, except in those with M-K and especially those who do not survive the acutely malnourished state