Journal of Postgraduate Medicine
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Year : 1983  |  Volume : 29  |  Issue : 4  |  Page : 230-2  

Serum glycoprotein levels in protein-calorie malnutrition.

KK Goyal, CK Chahar, PC Khatri, AA Chaudhary, HC Mathur 
 

Correspondence Address:
K K Goyal





How to cite this article:
Goyal K K, Chahar C K, Khatri P C, Chaudhary A A, Mathur H C. Serum glycoprotein levels in protein-calorie malnutrition. J Postgrad Med 1983;29:230-2


How to cite this URL:
Goyal K K, Chahar C K, Khatri P C, Chaudhary A A, Mathur H C. Serum glycoprotein levels in protein-calorie malnutrition. J Postgrad Med [serial online] 1983 [cited 2023 Jun 9 ];29:230-2
Available from: https://www.jpgmonline.com/text.asp?1983/29/4/230/5513


Full Text



 INTRODUCTION



Malnutrition is directly and indirectly responsible for more child fatalities, than all other causes combined. In India, it contributes each day to deaths of approximately 6600 children of five years of age or below.[2]

Changes in various fractions of serum proteins in malnutrition have been reported by different workers; however, there are only a few published studies related to the influence of nutritional disorders on serum glycoproteins.[1], [4], [10] The serum glycoprotein levels are relatively stable in health but are altered by infections and metabolic or neoplastic diseases.[9] The present study was aimed to find out the levels of serum glycoproteins in various types of protein-energy malnutrition.

 MATERIAL AND METHODS



The present study was conducted on 50 patients of protein-energy malnutrition (PEM) of 6 months to 5 years of age. Twenty, age-matched, healthy controls were also included in the study. The diagnosis of P.E.M. was made on the basis of detailed history, clinical examination, anthropometric measurements and laboratory investigations.[8] The patients having signs of Vitamin A deficiency on clinical examination, were not included in the study since Vitamin A is known to alter serum glycoprotein levels grossly. The patients were classified into 4 groups, according to the Nutrition Sub-Committee of Indian Academy of Pediatrics.[5]

Serum glycoproteins were estimated by the method of Winzler[13] as described by Varley.[11]

 OBSERVATIONS



[Table1] shows the mean, range and standard deviation of glycoprotein levels in controls, underweight, marasmus, marasmic kwashiorkor and kwashiorkor children.

[Table 2] shows the comparison of serum glycoproteins in non-oedematous (Marasmus and underweight) and oedematous (Kwashiorkor and marasmic kwarshiorkor) malnutrition.

 DISCUSSION



In the present study, the levels of serum glycoprotein were 56.26 mg/dl with a range of 30.57-96.60 mg/dl in healthy controls. A wide range of serum glycoprotein levels varying from 3.38 0.27 to 136.5 23.92 mg/dl have been reported in the literature.[1], [3], [10], [12], [13] The reasons for these vast differences may be many, like variation in temperature, dilution of sera, speed of addition of perchloric acid, the amount of time spent at each step and sampling of different populations.[7] Hence it is important to determine normal values at each laboratory.

The mean levels of serum glycoproteins in 3 groups of PEM namely marasmus, marasmic kwashiorkor and kwashiorkor were 90.55, 116.59 and 110.96 mg/dl, respectively [Table 1]. The rise in the mean values of serum glycoproteins was statistically significant (p < 0.001) when compared with the controls. A similar rise in serum glycoprotein levels had also been reported by other workers in these types of PEM .[4], [6], [10] However, contrary to the above observations, Fayad et all reported no significant change in serum glycoproteins in cases of marasmus.

The factors governing the serum glycoproteins in normal persons are ill-understood. Some endogenous, humoral, endocrinal and hepatic factors may play a role. Therefore, a plausible explanation for raised serum glycoproteins in these types of PEM could be recurrent gastro-intestinal and respiratory infections, disturbed liver functions, humoral disturbances, excessive tissue catabolism and progressive muscle wasting.[10] In the underweight group of PEM, mean serum glycoproteins were slightly higher than in the controls but the rise was not statistically significant [Table 1]. It may further suggest that less marked metabolic derangement and fewer episodes of inter-current infections encountered in this group may be responsible for it.

When the mean serum glycoprotein levels in non-oedematous and oedematous groups were compared, a highly significant difference (p < 0.001) was noted [Table 2]. The probable reason for the above alteration could be excessive tissue catabolism, more marked hepatic dysfunction and higher incidence of intercurrent infections encountered in the oedematous group of PEM. Similar observations have also been reported by Singh et al.[10]

Multiple factors such as food deprivation, protein deficiency and infections that influence glycoprotein levels complicate the identification of causative factors in the clinical situation studied by us. Therefore, large scale studies are required in clinical and experimental malnutrition to know the isolated effect of PEM on serum glycoproteins.

References

1Fayad, I. M., Metwalli, O. M., Shukri, A. S. and Ismail, S. M.: Serum mucoproteins in protein-calorie deficiency. Gaz. Egypt Paediat. Assoc., 17: 139, 1969, Quoted by Patwardhan et al (1971).[6]
2Gulick, F.: Nutrition data reported by State Nutrition Surveys in India, 1963-1965; A summary note AID/India Staff Research Memorandum and accompanying tables, March, 1969. Quoted by Berg, A. D.: Nutrition as a national priority. Amer. J. Clin. Nutr., 23: 1396-1408, 1970.
3Lockey, E., Anderson, A. J. and MacLagan, N. F.: Urine and serum mucoproteins in cancer and other diseases. Brit. J. Cancer, 10: 209-221, 1956.
4Meghrabi, R. H. and Waslien, C. I.: The bound carbohydrate of fractionated serum proteins in protein-calorie malnutrition. Amer. J. Clin. Nutr., 29: 146-158, 1976.
5Nutrition Sub-Committee of the Indian Academy of Pediatrics (1971-72): Reports. Indian Paediatrics, 9: 360, 1972.
6Patwhardhan, V. N., Meghrabi, R. H., Mousa, W., Gabr, M. K. and Maraghy, S.: Serum glycoproteins in protein-calorie deficiency diseases. Amer. J. Clin. Nutr., 24: 906-912, 1971.
7Rai, B., Jain, M. S. and Jolly, S. S.: Role of serum mucoprotein estimation in hepatic disorders. Ind. J. Med. Sci., 26: 836-840, 1972.
8Shah, P. M.: "Early Detection and Prevention of Protein-Calorie Malnutrition." 1st Edition, Popular Prakashan (P) Ltd. Bombay, 1974, pp. 14-32.
9Shetlar, M. R.: Serum glycoproteins their origin and significance. Ann, N.Y. Acad. Sci., 94: 44-54, 1961.
10Singh, S. D., Bhargava, A., Chhapparwal, B. C., Mehta, S. and Dabke, A. T.: Serum mucoprotein (tyrosine) in protein-calorie malnutrition. Indian Paediatrics, 9: 257-260, 1972.
11Varley, H.: "Practical Clinical Biochemistry." 4th Edition, William Heinemann Medical Books Ltd., 199, pp. 270-274.
12Vij, S. C., Raman, B. N. and Maitrya, B. B.: Serum mucoprotein in hepatic disorders. Ind. Med. Gazz., 15: 63-64, 1975.
13Winzler, R.. J.: Determination of serum glycoproteins. In, "Methods of Biochemical Analysis." Vol, 2, Interscience Publishers, New York, 1955, pp. 279-311.

 
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