Thyroid status in children with severe acute malnutrition

Abstract

Objectives: The objective of the study is to study thyroid hormone levels in children with severe acute malnutrition (SAM) and its correlation with serum total protein and albumin levels. Materials and Methods: A prospective cross-sectional study was carried out at Nutritional Rehabilitation Centre, Hubli, from Dec 2018 to Nov 2019. Inclusion criteria: All children in the age group of 6–59 months with SAM. Exclusion criteria: (i) Children suffering from metabolic disorders, tuberculosis, urinary tract infection, malabsorption syndrome (celiac disease), protein losing enteropathy, and nephrotic syndrome; (ii) Children with major congenital anomalies; and (iii) Children with chronic liver and kidney diseases. All enrolled children’s details of demography, clinical history, and examination were entered in a predesigned pro forma. Total triiodothyronine (TT3), total thyroxine (TT4), thyroid-stimulating hormone (TSH), and serum total protein and albumin were estimated. Data were analyzed using SPSS Version 16. Results: Total of 50 children fulfilled criteria during study period. Mean age of presentation was 18 ± 2.1 months with male-to-female ratio 0.8:1. The mean TT3 (ng/dl), TT4 (mcdg/l), and TSH (mIU/L) were 109.8 ± 50.6, 8.36 ± 3.7, and 2.5 ± 1.8, respectively. Mean total protein and albumin were 5.5 ± 1.4 g/dl and 2.97 ± 0.9 g/dl. Overall, 18 (36%) children had low total protein and 17 (34%) have low serum albumin. Low serum TT3, and TT4 levels were found in 11 (22%) and 14 (28%), respectively, and elevated TSH in 4 (8%) children. Low T3 was significantly associated with low albumin (P < 0.01). Conclusion: The impaired thyroid function and low serum T3 levels seen in SAM children were probably an adaptive change to malnutrition.