International Journal of Research in Medical Sciences | October 2017 | Vol 5 | Issue 10 Page 4486 International Journal of Research in Medical Sciences Sah SP et al. Int J Res Med Sci. 2017 Oct;5(10):4486-4489 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Effect of PEM on thyroid status, serum total protein and A/G ratio in pre-school going children Sumesh Prasad Sah 1 *, Manisha Arora 1 , Sudeep Kumar 1 , Jyoti Batra 2 , Imran Mustafa 1 , Lalendra Yadav 3 INTRODUCTION According to World Health Organization (WHO), Protein Energy Malnutrition (PEM) refers to “an imbalance between the supply of protein and energy and the body's demand for them to ensure optimal growth and function. The term protein-energy malnutrition (PEM) applies to a group of related disorders that include marasmus, kwashiorkor, and intermediate states of marasmus- kwashiorkar. 1 Marasmus is a form of starvation that occurs during childhood. Marasmus occurs most commonly during the first year of life and is found in most developing countries. A common cause is early cessation of breast feeding with lack of food intake. 2 Kwashiorkor is caused due to nutritional imbalance, consisting in protein deficiency and adequate or high carbohydrate intake. The disease occurs mainly in children 6 months to 3 years of age. It usually follows weaning when the infant is fed the poor and limited foods of the area (corn, other grains and vegetables). 3 In children with PEM, there are marked changes in secretion and metabolism of thyroid hormones and in the structure of thyroid gland. This results in reduction of activity of the gland and hence decreases in T3 and T4 level. In children with PEM, concentrations of all three thyroid hormone binding proteins are extremely low, and the serum T4 and T3 levels decline abruptly, often into 1 Department of Biochemistry, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India 2 Department of Biochemistry, Santosh Medical College, Ghaziabad, NCR, Uttar Pradesh, India 3 Department of Pharmacology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India Received: 31 July 2017 Accepted: 28 August 2017 *Correspondence: Dr. Sumesh Prasad Sah, E-mail: sumesh.sah@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Objective: The objective of the study was to evaluate and compare serum total protein, serum albumin and thyroid hormones in children with Protein Energy Malnutrition (PEM) and in healthy controls. Methods: Present study was a cross sectional hospital based case control study, total 75 children of age group 1-5 years were included in this study. Triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) was estimated by electro-chemiluminescence immunoassay method, serum total protein by biuret method, albumin by BCG method and plasma hemoglobin by CMG method. Result: In malnourished children, there is significant decrease in serum total protein (4.76 gm %), albumin (2.24 gm %) and Hb (10.57 gm %) as compared to normal healthy children. Serum T3 (0.51 ng/ml), and T4 (3.93 μg/ml) levels were significantly decreased and non-significant changes in TSH (4.26 μUI/ml) levels in children with PEM was observed as compared to healthy controls. Conclusion: The reduction in protein is due to decreased intake of proteins and reduced biosynthesis. The decreased in T3 and T4 levels in malnourished children is probably due to a decrease in circulating plasma proteins. Keywords: PEM, T3, T4, Thyroid stimulating hormone, Total proteins DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20174582