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The thyroid functional parameters of 102 children with protein-calorie malnutrition (PCM) classified as undernourished, marasmic, kwashiorkor and marasmic-kwashiorkor were studied by measuring the serum T4, T3, T3 percentage uptake (T3%UT), free thyroxine index (FTI), and (in a few subjects) TSH. Total plasma proteins, albumin and globulin were also estimated. T4 was increased markedly in the undernourished children and significantly decreased in kwashiorkor and marasmic-kwashiorkor groups. There was a consistent and significant fall in T3 levels of all PCM children. From normal values, the fall in T3 levels was progressive in the order of undernourished, marasmic, kwashiorkor and the marasmic-kwashiorkor states. The T3%UT was increased above normal in the marasmic, kwashiorkor and marasmic-kwashiorkor conditions. The FTI decreased somewhat in marasmus and kwashiorkor groups and was very low in marasmic-kwashiorkor. Total protein and albumin levels were above normal in the undernourished but became markedly depressed in the marasmic-kwashiorkor children. The changes in the levels of both T4 and T3 in our observations are well correlated with the levels of plasma proteins in the undernourished, marasmic and kwashiorkor states but not in the marasmic-kwashiorkor group.

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Thyroid status was estimated serially by measuring triiodothyronine (T3), thyroxine (T4) and thyrotrophin (hTSH) in 20 patients suffering from meningococcal meningitis, typhoid fever and other acute febrile illnesses. Significantly low T3 and only slightly increased T4 were observed in all the patients. hTSH was normal in all of these. A significant reciprocal relationship was found between the degree of fever and fall in T3 concentrations. T3 tended to rise in patients who recovered but in those who deteriorated or died, T3 remained persistently low.

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1. Skinfold thicknesses, arm circumferences, heights, weights and serum cholesterol levels were determined in ninety-one university students, 207 soldiers and 102 out-patients, all male subjects. Some of these measurements were used to determine the amount of body fat, Quetelet's index and mid-arm muscle circumference2. Quetelet's indices and body-fat values obtained were similar to previously reported values for lean or moderately built males3. Serum cholesterol levels were generally low, with means ranging from 3·98 mmol/1 for 18- to 29-year-old students to 5·19 mmol/l for 40- to 69-year-old out-patients4. The mean values for triceps skinfold thickness, the amount of body fat and serum cholesterol levels for healthy adults obtained in this study are probably normal for northern Nigerian populations5. There was a significant correlation between the amount of body fat and values for triceps and subscapular skinfold thicknesses, Quetelet's index and body-weight for all adults. The correlation between muscle circumference and the amount of body fat was significant for all subjects except adult soldiers.

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