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American Journal of Clinical Nutrition, Vol 43, 406-413, Copyright © 1986 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Thyroid hormone and carrier protein interrelationships in children recovering from kwashiorkor

WJ Kalk, KJ Hofman, AM Smit, M van Drimmelen, LA van der Walt and RE Moore

We have studied 15 infants with severe protein energy malnutrition (PEM) as a model of nutritional nonthyroidal illness. Changes in circulating thyroid hormones, binding proteins, and their interrelationships were assessed before and during recovery. Serum concentrations of total thyroxine and triiodothyronine and of thyroxine- binding proteins were extremely reduced, and increased progressively during 3 wk of refeeding. The T4:TBG molar ratio was initially 0.180 +/- 0.020, and increased progressively, parallel to the increases in TT4, to 0.344 +/- 0.038 after 21 days (p less than 0.025). The changes in free T4 estimates varied according to the methods used--FTI and analogue FT4 increased, dialysis FT4 fraction decreased. Serum TSH levels increased transiently during recovery. It is concluded 1) there is reduced binding of T4 and T3 to TBG in untreated PEM which takes 2-3 wk to recover; 2) there are methodological differences in evaluating free T4 levels in PEM; 3) increased TSH secretion appears to be an integral part of the recovery from PEM.


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C. D Capo-chichi, F. Feillet, J.-L. Gueant, K.'S. Amouzou, N. Zonon, A. Sanni, E. Lefebvre, K. Assimadi, and M. Vidailhet
Concentrations of riboflavin and related organic acids in children with protein-energy malnutrition
Am. J. Clinical Nutrition, April 1, 2000; 71(4): 978 - 986.
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Copyright © 1986 by The American Society for Nutrition