Oedema in kwashiorkor is caused by hypoalbuminaemia

Coulthard, Malcolm

doi:10.1179/2046905514y.0000000154

Cited by 46 publications

(44 citation statements)

References 44 publications

(49 reference statements)

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“…Muscles wasting in the marasmic subjects results in significant reduction in MUAC as the proteins of the somatic compartments and subcutaneous fats are catabolized as an attuned response that serves provide the body with amino acids as alternative source of energy during calorie deprivation with the resultant atrophy of muscle mass reflected by reduced mid upper arm circumference (MUAC) values. Albumin on the other hand is significantly lower in the kwashiorkor than in the marasmic children which may be due to relative protein deficiency in the former, a similar finding was reported by studies of Reeds & Laditan; Malcolm [31,32]. Protein deficiency results in low albumin and marginal weight loss, the true weight loss often masked by fluid retention, [33,34,35].…”

Section: Discussionsupporting

confidence: 68%

Albumin and Serum Vitamin A Status of Malnourished Children

Richard¹,

Ekong²

2018

EJCBS

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Malnutrition remains a major health problem in the third world countries, and is a key factor to the high death rate among children below five years old. This study aimed to determine serum vitamin A, mid-upper arm circumference (MUAC), and albumin levels of malnourished children and their well-fed counterparts. A total of one hundred (100) children comprising of fifty (50) malnourished children under the age of five years and fifty (50) well-fed age-matched children were recruited into this study. Mid upper arm circumference (MUAC) measurement was used to categorize the children into malnourished and the well-fed groups. The malnourished were further classified into kwashiorkor and marasmic cohorts. Serum vitamin A and albumin levels were determined by colorimetric methods. Data were analyzed using SPSS version 20.0 statistical package, differences between and variations among groups were determined by Student's t-test and ANOVA respectively while the association between variables by Pearson's correlation. Differences were considered statistically significant at p≤0.05. Serum vitamin A, MUAC and albumin levels of the well-fed group were significantly higher (p<0.05) than those of the malnourished. Comparing the well-fed, the kwashiorkor and the marasmic groups, the mean serum vitamin A, MUAC and albumin of the well-fed were significantly higher (p=0.001) than those of the kwashiorkor and marasmic groups. Mean albumin level of the kwashiorkor was significantly lower (p<0.05) than that of marasmic group. Mean MUAC of the kwashiorkor subjects was significantly higher (p<0.05) than that of the marasmic subjects. Serum vitamin A was not significantly different (p=0.724) between the kwashiorkor and the marasmic groups. In the marasmic subjects mean serum vitamin A correlates negatively with albumin (r= -0.517, p=0.011). In the kwashiorkor subjects, serum vitamin A correlates negatively with albumin (r=-0.080, p=0.690). In the well-fed children, serum vitamin A correlates positively with albumin (r=0.340, p=0.016). Conclusion: malnourished children with kwashiorkor and marasmus have lower albumin, serum vitamin A and MUAC compared with the well-fed children.

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Section: Discussionsupporting

confidence: 68%

Albumin and Serum Vitamin A Status of Malnourished Children

Richard¹,

Ekong²

2018

EJCBS

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“…Accordingly, signs of suppressed secretion and enhanced autophagy have been identified in protein calorie-restricted humans. Most notably, hypoalbuminemia is a hallmark of the severe, edematous form of undernutrition known as kwashiorkor (72). Likewise, dozens of studies have reported low plasma levels of complement proteins, in particular C3, in undernourished children (73).…”

Section: R E V I E W S E R I E S : N U C L E a R R E C E P T O R Smentioning

confidence: 99%

Nutrient-sensing nuclear receptors PPARα and FXR control liver energy balance

Preidis¹,

Kim²,

Moore³

2017

Journal of Clinical Investigation

156

124

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The nuclear receptors PPARα (encoded by NR1C1) and farnesoid X receptor (FXR, encoded by NR1H4) are activated in the liver in the fasted and fed state, respectively. PPARα activation induces fatty acid oxidation, while FXR controls bile acid homeostasis, but both nuclear receptors also regulate numerous other metabolic pathways relevant to liver energy balance. Here we review evidence that they function coordinately to control key nutrient pathways, including fatty acid oxidation and gluconeogenesis in the fasted state and lipogenesis and glycolysis in the fed state. We have also recently reported that these receptors have mutually antagonistic impacts on autophagy, which is induced by PPARα but suppressed by FXR. Secretion of multiple blood proteins is a major drain on liver energy and nutrient resources, and we present preliminary evidence that the liver secretome may be directly suppressed by PPARα, but induced by FXR. Finally, previous studies demonstrated a striking deficiency in bile acid levels in malnourished mice that is consistent with results in malnourished children. We present evidence that hepatic targets of PPARα and FXR are dysregulated in chronic undernutrition. We conclude that PPARα and FXR function coordinately to integrate liver energy balance.

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“…It was interesting that conditions such as malnourishment and renal disease predispose patients to a significantly higher incidence of skin grafting use. In malnourishment, a lack of proteins may lead to a decrease in colloid osmotic pressure which in turn leads to diffusion of fluid in the interstitium, thus increasing edema [6] . Similarly in renal disease, there is urinary protein loss leading to decrease of plasma albumin and subsequently lowering the plasma oncotic pressure leading to an imbalance of the Starling forces [7] .…”

mentioning

confidence: 99%