Serum Albumin and Selected Antioxidants Status in Children with Protein Energy Malnutrition in Sokoto, Nigeria.

ABSTRACT

Aims: To assess the serum albumin and selected antioxidant status in 51 children with protein energy malnutrition (PEM) in Sokoto, Nigeria. Study Design: A cross-sectional study was performed comparing two groups of children, one with confirmed case of PEM and the other apparently healthy children; both groups were gender, age and socioeconomically matched. Place and Duration of Study Departments of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto and Chemical Pathology, Faculty of Medical Laboratory Sciences, Usmanu Danfodiyo University, Sokoto, between April, 2014 and September, 2015. Methodology: We included fifty (51) children (of both sexes, aged range 6-60 months) with confirmed cases of protein energy malnutrition were included in this study. The modified Wellcome classification was used to classify the protein energy malnourished children into underweight (14), marasmus (17), kwashiorkor (10) and marasmic-kwashiorkor (10). Fifty (50) gender- age-and socioeconomically-matched apparently healthy children were used as controls. The subject selection, anthropometric parameters and clinical examinations were performed by the consultant paediatricians in the clinic. Standard procedures were used for the analyses of biochemical parameters. Results: Our results showed that, mean mid-upper arm circumference (MUAC), weight, body mass index (BMI), were significantly (P<0.001) lower in the malnourished group compared with the control group. With the exception of MUAC which decreased significantly (p<0.001) with increasing severity of malnutrition, the mean weight, and BMI were not significantly (p>0.05) different among the different classes of PEM. Serum Albumin, α-tocopherol, copper and zinc were significantly (P<0.001) lower in the malnourished group compared with the control group. Serum Albumin, α-tocopherol, copper and zinc decreased significantly (P<0.001) with increasing severity of malnutrition. Conclusion: Our results showed that serum albumin, α-tocopherol, copper and zinc were significantly lower in the malnourished group than the control group (p<0.001). The decrease in the serum albumin, α-tocopherol, copper and zinc progressed with the increasing severity of malnutrition among the children. These findings suggest an altered protein and antioxidant status in protein energy malnutrition. In addition to providing proteins and calories, adequate supplementations of zinc, copper and α-tocopherol should be provided. These should be part of nutritional rehabilitation of malnourished children in order to achieve optimal results of management and avoid clinical complications associated with zinc, copper and vitamin E deficiencies.