Hormonal changes during the acute phase of
protein-energy malnutrition (PEM) and at recovery have been examined in thirty-four severely malnourished subjects (twenty-four
kwashiorkor and ten
marasmus) all of whom were aged 3 years and below. It was observed that except for
cortisol, the hormonal values were different between the marasmic and
kwashiorkor children. Serum
insulin levels were depressed and
growth hormone (GH) elevated among the
kwashiorkor children most especially among the
kwashiorkor sub-groups II and III cases who had the greatest deficit in
body weight. Although the GH values were also elevated in the marasmic patients, the levels were much lower than those for the
kwashiorkor children. There was no statistically significant difference in the mean serum concentration of both
cortisol and
thyroxine among the different sub-groups of
kwashiorkor and the marasmic subjects. The identical serum levels of
cortisol in both the marasmic and
kwashiorkor children may have been due to similar extent of exposure of
infections. With improved dietary intake and some degree of anthropometric recovery, GH concentration fell steadily while
insulin rose especially among the
kwashiorkor cases. The reasons for these hormonal changes, their functions during the acute phase of PEM and at recovery are discussed.