Protein energy malnutrition (PEM) is a common health problem in developing countries. The mild form of PEM results in growth retardation while severe forms result in the syndromes of marasmus and kwashiorkor. Mild PEM was described as a condition in which specific or , non specific clinical signs , as well as non specific laboratory indices are present without any of the classical manifestations of nutritional deficiency.
Objective of this work was to assess serum transferrin and fibronectin as a biochemical markers for early detection of PEM. We studied 42 children: 30 patients had PEM (15 cases were mild to moderate PEM and 15 cases were severe PEM) with their age ranged between 4-36 months and the remaining 12 children were age and sex matched healthy children as controls. All studied children were subjected to: full history taking, thorough clinical examination including anthropometric measurements [weight, hight,body mass,index (BMI), and mid arm circumference (MAC)] as well as estimation of serum albumin, serum transferrin, fibronectin, Hb and urine analysis. Results revealed significant reduction in all anthropometric measurements in both mild to moderate and severe PEM patients as compared to control group . Serum albumin was significantly lowered in severe PEM as compared to control and still within normal level in mild to moderate PEM patients.
Serum transferrin and fibronectin were significantly lowered in mild to moderate PEM as compared to controls and more reduction in severe form of PEM as compared to controls . Serum fibronectin and transferrin correlated positively with BMI (P <0.05) and serum albumin (P <0.001) in both mild to moderate and severe PEM . In conclusion serum fibronectin and transferrin are markedly reduced in patients with mild to moderate PEM and correlated positively with BMI and serum albumin. This represents an evidence for the role of serum fibronectin and transferrin as biochemical markers for early detection of PEM.