Whitehead R G, Coward W A, Lunn P G, Rutishauser I
Trans R Soc Trop Med Hyg. 1977;71(3):189-95. doi: 10.1016/0035-9203(77)90004-9.
The pattern of growth, biochemical and endocrine development, dietary intake and disease patterns of rural children in Uganda and The Gambia have been monitored during the first three years of life in order to gain a more complete understanding of the reasons why in Uganda kwashiorkor predominates, whereas in The Gambia it is marasmus. Evidence is produced which supports the view that the hormonal balance, particularly cortisol and insulin status, can have a profound influence on which organs of the body are preferentially affected by malnutrition and hence on the type of protein-energy malnutrition which is likely to emerge. There were, however, also important differences in protein and energy intake between the two countries.
为了更全面地了解为何在乌干达夸休可尔症较为普遍，而在冈比亚消瘦症更为常见，研究人员对乌干达和冈比亚农村儿童在出生后的头三年里的生长模式、生化和内分泌发育、饮食摄入以及疾病模式进行了监测。研究结果表明，激素平衡，尤其是皮质醇和胰岛素水平，会对身体哪些器官优先受到营养不良影响产生深远影响，进而影响可能出现的蛋白质 - 能量营养不良类型。然而，两国在蛋白质和能量摄入方面也存在重要差异。
