Alterations in Thyroid Hormone Levels in Children with Protein-Energy Malnutrition

Background: Nutritional deficiencies are among the most significant public health challenges in India and other developing nations. Among those nutritional diseases, the Protein Energy Malnutrition (PEM) is the most prevalent one, affecting a large population especially children under five and is a major cause of morbidity and mortality. Aims and Objectives: To estimate serum total thyroxine (TT4), total tri-iodothyronine (TT3), thyroid stimulating hormones (TSH) in normal controls and children with PEM. To find out relationship between thyroid hormones and different grades of PEM. Methodology: Fifty children below 12 years of age suffering from different grades of protein energy malnutrition admitted in Pediatric ward, RIMS, Imphal, were selected as cases. Fifty healthy children, closely matched for age and gender, formed the control group. The study was carried out over a 24-month period, beginning in September 2016 and concluding in August 2018. Total thyroxine (TT4) and total trio-iodothyronine (TT3) were estimated by ELISA. Results: Serum thyroid hormones (TT3, TT4 and TSH) were significantly decreased in PEM when compared with controls. Among the different grades of PEM, total tri-iodothyronine (TT3) level was significantly low in Marasmic kwashiorkor children (0.61±0.14) whereas undernutrition group has the lowest value of Total Thyroxine (5.31±0.65) and TSH (1.60±0.81). Conclusion: A decrease in circulating thyroid hormone levels was linked to the severity of PEM. All the PEM cases should undergo a screening for thyroid hormone status which is essential for proper growth and health of the children.