The relation between thyroid homeostasis and the biochemical parameters of subclinical
protein malnutrition has been analyzed in schoolchildren in a rural area in the south of Italy, known to be moderately
iodine-deficient. The sera of 32 children (15 males and 17 females aged 6 to 11 years) have been analyzed. These children were divided into two groups, according to thyroid function: (1) 16 euthyroid children (mean
thyrotropin [TSH] 2.38 +/- .35 mU/L; 6 with
goiter) and (2) 16 subclinical hypothyroid children (mean TSH 7.32 +/- 1.68 mU/L; 6 with
goiter).
Retinol circulating complex (RCC) components were determined in serum by high-performance liquid chromatography (HPLC) and radial immunodiffusion and the essential and nonessential
amino acid levels by ion exchange chromatography. Reduced
retinol binding protein (RBP) and
transthyretin (TTR) levels were recorded in the sera of 11 of 32 (34%) and in 5 of 32 (16%) patients, respectively. The linear regression analysis revealed that RBP and TSH levels were inversely correlated (r = -0.514; p < 0.0026). The RBP levels were subnormal in 2 of 16 euthyroid and in 9 of 16 hypothyroid patients (Fisher test p < 0.023), and the mean RBP levels were significantly reduced in the hypothyroid patients when compared with those of the euthyroid group (p < 0.0026). The
retinol/RBP ratio was also significantly different between euthyroid and hypothyroid children (0.75 vs. 0.95; p < 0.0002). The mean
essential amino acid levels, with the exception of
methionine, were all in the normal range. The selected
amino acid ratios confirmed that the patients were exposed to mild
protein malnutrition. These results provide evidence that even mild
protein-energy malnutrition may have detrimental effects on thyroid homeostasis in
iodine-deficient areas.