Abstract
OBJECTIVES: To study the correlation of serum enzymes (alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, amylase) abnormalities in protein energy malnutrition and to assess their clinical significance. MATERIAL AND METHOD: 30 cases of PEM admitted to the pediatric wards of Government Medical College and Hospital, Nagpur were studied from 5 Jan 2011 to 15 August 2011. 30 age and sex matched controls were selected from children of normal weight for age attending OPD or wards. All the clinical details, along with the relevant clinical history were noted. Venous blood sample was collected for estimation of alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, and amylase. RESULTS AND OBSERVATIONS: Patients with PEM had reduced serum alkaline phosphatase. Amylase was found to be reduced in kwashiorkor while it remained unchanged in marasmus. Increase in aspartate aminotransferase, alanine aminotransferase was found in PEM. Serum amylase in kwashiorkor is lower than marasmus. DISCUSSION: In patients with PEM, we found higher levels of AST and ALT ,as there is increased tissue breakdown in PEM to metabolise the amino acids released by protein catabolism, the process of transamination is enhanced leading to increased activity of related enzymes AST and ALT. Reduced serum Alkaline phosphatase may be due to impairment of protein synthesis. Many of these alternations of enzymes may be due to metabolic readjustment resulting from protein deficiency.
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