Serum cortisol concentrations in children with protein energy malnutrition

ABSTRACT

We measured basal corisol level in 15 children with kwashiorkor, 15 children 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, maramic kwashiorkor, and maramus 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 rganism to adapt to decreased diatary protein and/or energy supply through breakdown of muscle protein to provide the liver with the necessary amino acids for gluconeogenesis and albumin synthesis: