Studies on skin and urinary mucopolysaccharides in malnourished/vitamin A deficient children.

In protein-calorie malnourished children, with or without associated vitamin A deficiency, skin content of acid mucopolysaccharides (MPS) and urinary excretion of MPS and amino sugars were studied. MPS content of skin in both malnourished groups was increased 3-6-fold. This increase was essentially in the non-sulphated component. In normal skin, non-sulphate MPS accounted for 68% of the MPS content, whereas in the malnourished group with vitamin A deficiency it constituted 93%. Urinary excretion of MPS (24h) was significantly reduced by 50-70% in malnourished groups. This returned to normal levels in the malnourished/vitamin A deficient group when vitamin A injections were administered. Excretion of amino sugars (24 h) in the malnourished groups was also decreased by 50-70%. In normal children 55% of the total amino sugars was dialysable whereas in the malnourished it was increased to 60%. The excretion of protein-bound and dialysable amino sugars was increased to normal level only in the group given supplements of vitamin A in addition of protein and calories.

Urinary excretion of arylsulfatases in malnourished/vitamin A deficient children.

Serum vitamin A (retinol) levels were generally low in all malnourished children (6-15 microgram/100 ml) compared with control children (50 microgram/100 ml). A significant increase in vitamin A after appropriate therapy was observed in all malnourished groups. Dietary supplements of proteins and calories even without extra vitamin A supplements increased serum vitamin A levels in cases of kwashiorkor indicating active mobilization of liver vitamin A. Total urinary arylsulfatase A activity excreted in 24-h or within 8-h in the morning (6 a.m. to 2 p.m.) was significantly reduced in cases of malnutrition with or without mild vitamin A deficiency symptoms. The excretion of arylsulfatase B was not altered. In cases of severe vitamin A deficiency coupled with malnutrition increased excretion of both arylsulfatases A and B was evident. These results on urinary arylsulfatases excretory pattern have been obtained either in samples collected for 24-h or specifically for 8-h (morning) and it is suggested that this test on urinary arylsulfatases may prove useful for detection of acute vitamin A deficiency with malnutrition in field studies. A ratio of arylsulfatases A/B of 2.0 or less seems to indicate mild malnutrition, the normal ratio being 3.4. Furthermore a low ratio coupled with increased excretion of both arylsulfatases A and B may be considered specific for acute vitamin A deficiency.