["Free" iron, transferrin and ferritin levels in serum and their relation with severe malnutrition]. / Hierro libre, transferrina y ferritina séricas en desnutrición aguda grave.

INTRODUCTION: "Free" serum iron has been associated with the development of edema in Kwashiorkor-type severe acute malnutrition. MATERIAL AND METHODS: A descriptive, cross sectional study was performed. Twenty-four children with edematous malnutrition, 22 with marasmus and 20 without malnutrition were compared. "Free" iron, transferrin, saturation index and attachment capacity of iron, ferritin, total protein, albumin, total iron, and C-reactive protein (CRP) were determined in serum. RESULTS: A significant difference was found between malnourished children with "free" serum iron and the control group in which "free" iron was not found. However, no significant differences were found in "free" serum iron levels between marasmatic and edematous children. Transferrin was negatively correlated with "free" iron (r=-0.519; p=0.000). Total proteins, albumin and transferrin were all significantly lower in children with edema than in those with marasmus. A low transferrin level and a high saturation index could be used to estimate the probability of edema in 67.5% of cases (p=0.001). CONCLUSIONS: Severe acute malnutrition was associated with the presence of "free" serum iron both in children with marasmus and in those with edema. "Free" iron does not explain the presence of edema but, as with severe hypoalbuminemia, the concurrence of a low transferrin level and a high saturation index may contribute to the etiology of edema.

Hierro libre, transferrina y ferritina séricas en desnutrición aguda grave / 'Free' iron, transferrin and ferritin Levels in serum and their relation with severe malnutrition

Introducción El hierro libre en suero se ha asociado con el desarrollo del edema en la desnutrición aguda grave tipo kwashiorkor. Materiales y métodos Estudio descriptivo, de corte, tipo cross-sectional, comparó 24 niños con desnutrición edematosa, 22 con marasmo y 20 sin desnutrición. Se determinó en suero: hierro libre, transferrina, índice de saturación y capacidad de fijación de hierro, ferritina, proteínas totales, albúmina, hierro total y proteína C reactiva (PCR). Resultados Se halló diferencia significativa entre los niños desnutridos que tuvieron hierro libre en suero y el grupo control en el cual no se detectó, sin embargo no hubo diferencia significativa en la concentración sérica de hierro libre entre marasmáticos y edematosos. La transferrina correlacionó negativamente con el hierro libre (r = -0,519; p = 0,000). Las proteínas totales, albúmina y transferrina fueron significativamente más bajas en los niños con edema que con marasmo. Una baja concentración de transferrina y un alto índice de saturación, podrían estimar la probabilidad del edema en un 67,5 % (p = 0,001). Conclusiones La desnutrición aguda grave se asoció con la presencia de hierro libre en suero tanto en los niños con marasmo como con edema. El hierro libre no explica la presencia de edema, pero la concomitancia de una baja concentración de transferrina y un alto índice de saturación podrían contribuir a su etiología, lo mismo que la hipoalbuminemia grave

Introduction 'Free' serum iron has been associated with the development of edema in Kwashiorkor-type severe acute malnutrition. Material and methods A descriptive, cross sectional study was performed. Twenty-four children with edematous malnutrition, 22 with marasmus and 20 without malnutrition were compared. 'Free' iron, transferrin, saturation index and attachment capacity of iron, ferritin, total protein, albumin, total iron, and C-reactive protein (CRP) were determined in serum. Results A significant difference was found between malnourished children with 'free' serum iron and the control group in which 'free' iron was not found. However, no significant differences were found in 'free' serum iron levels between marasmatic and edematous children. Transferrin was negatively correlated with 'free' iron (r = -0.519; p = 0.000). Total proteins, albumin and transferrin were all significantly lower in children with edema than in those with marasmus. A low transferrin level and a high saturation index could be used to estimate the probability of edema in 67.5 % of cases (p = 0.001). Conclusions Severe acute malnutrition was associated with the presence of 'free' serum iron both in children with marasmus and in those with edema. 'Free' iron does not explain the presence of edema but, as with severe hypoalbuminemia, the concurrence of a low transferrin level and a high saturation index may contribute to the etiology of edema

[Lipid peroxidation and plasma vitamin E concentration in hypercholesterolemic children from Medellin (Colombia)]. / Peroxidación lipídica y concentración de vitamina E plasmática en niños hipercolesterolémicos de Medellín (Colombia).

BACKGROUND: Serum lipid abnormalities in early childhood are risk factors for atherosclerosis. Lipid peroxidation might play an important role in this process, along with hypercholesterolemia. OBJECTIVE: To compare plasma concentrations of malondialdehyde (MDA) and vitamin E in two groups of children: one group with low density lipoproteins (LDL) concentrations > or = 130 mg/dL and another group with LDL concentrations < 130 mg/dL. METHODS: Cross-sectional study. Healthy schoolchildren from the city of Medellin selected by probabilistic sampling performed by staff at the Universidad de Antioquia in Colombia. SAMPLE: There were 134 subjects, aged 6 to 9 years old, divided into two groups: a group of 67 hypercholesterolemic children (LDL > or = 130 mg/dL) and a control group of 67 normocholesterolemic children (LDL < 130 mg/dL). RESULTS: Hypercholesterolemic children with a mean serum LDL concentration of 147.7 +/- 15.5 mg/dL and a total cholesterol concentration of 212 +/- 17 mg/dL had higher MDA plasma concentrations than the control group (0.18 +/- 0.1 6 microM; 0.08 +/- 0.06 microM, p < 0,0001, respectively). A negative correlation was observed between alpha-tocopherol/total lipids ratio and MDA values in children with hypercholesterolemia (r = -0.337 p < 0.01). CONCLUSION: Lipid peroxidation was higher in hypercholesterolemic children than in the control group and was even higher when there was a deficit in the alpha-tocopherol/total lipids ratio. Hypercholesterolemia and lipid peroxidation are co-existing risk factors that are established during school age.