Ogunshina S O, Hussain M A
Am J Clin Nutr. 1980 Apr;33(4):794-800. doi: 10.1093/ajcn/33.4.794.
Weight, height, midarm circumference (AC), midarm muscle circumference (AMC), triceps skinfold thickness (TSF), and plasma thyroxine binding (TBPA) were measured in 73 children free from any clinical evidence of disease and in 15 severe protein-energy malnourished (PEM) (marasmus, marasmic kwashiorkor, and kwashiorkor) Nigerian preschool children. The children were divided into various groups according to both Wellcome and Waterlow's classification. All measurements made on them were then compared between the various groups within each classification. It was found that plasma TBPA values were not only able to distinguish various grades of PEM but was the only parameter studied which can distinguish mild PEM from normals when weight, height, TSF, AC, and AMC were not sensitive enough to do so. TBPA was also found to be significantly related to body weight, deficit in weight for age, AC, and AMC. Both marasmic and kwashiorkor groups had significantly lower TBPA levels than undernourished group. The marasmic children also had significantly lower body weight but higher TBPA levels than kwashiorkor, while the TBPA values for marasmic kwashiorkor children were in between the two. Considerable overlapping of individual TBPA values were found between normals and undernourished in Wellcome classification but very little overlapping was found between normals and mild PEM in Waterlow's classification.
对73名无任何疾病临床证据的儿童以及15名患有严重蛋白质 - 能量营养不良（PEM）（消瘦、消瘦型夸希奥科病和夸希奥科病）的尼日利亚学龄前儿童测量了体重、身高、上臂围（AC）、上臂肌肉围（AMC）、三头肌皮褶厚度（TSF）和血浆甲状腺素结合力（TBPA）。根据韦尔科姆和沃特洛的分类法将儿童分为不同组。然后对每组内不同组之间的所有测量值进行比较。结果发现，血浆TBPA值不仅能够区分不同程度的PEM，而且是所研究的唯一参数，当体重、身高、TSF、AC和AMC不够敏感时，它能够区分轻度PEM与正常儿童。还发现TBPA与体重、年龄别体重不足、AC和AMC显著相关。消瘦组和夸希奥科病组的TBPA水平均显著低于营养不良组。消瘦儿童的体重也显著低于夸希奥科病儿童，但TBPA水平高于夸希奥科病儿童，而消瘦型夸希奥科病儿童的TBPA值介于两者之间。在韦尔科姆分类中，正常儿童和营养不良儿童的个体TBPA值有相当大的重叠，但在沃特洛分类中，正常儿童和轻度PEM之间的重叠很少。
