Hormonal changes in severely malnourished children.

Hormonal changes during the acute phase of protein-energy malnutrition (PEM) and at recovery have been examined in thirty-four severely malnourished subjects (twenty-four kwashiorkor and ten marasmus) all of whom were aged 3 years and below. It was observed that except for cortisol, the hormonal values were different between the marasmic and kwashiorkor children. Serum insulin levels were depressed and growth hormone (GH) elevated among the kwashiorkor children most especially among the kwashiorkor sub-groups II and III cases who had the greatest deficit in body weight. Although the GH values were also elevated in the marasmic patients, the levels were much lower than those for the kwashiorkor children. There was no statistically significant difference in the mean serum concentration of both cortisol and thyroxine among the different sub-groups of kwashiorkor and the marasmic subjects. The identical serum levels of cortisol in both the marasmic and kwashiorkor children may have been due to similar extent of exposure of infections. With improved dietary intake and some degree of anthropometric recovery, GH concentration fell steadily while insulin rose especially among the kwashiorkor cases. The reasons for these hormonal changes, their functions during the acute phase of PEM and at recovery are discussed.