DOI: 10.36347/sjams.2018.v06i05.053

Pages: 2145-2149

The main objective of the study was estimation of serum T3, T4 and TSH levels in severely malnourished children admitted in nutrition rehabilitation centre of Teritary level care hospital, and find out any co-relation with serum protein and serum albumin levels. In NRC, during study period, 164 children were admitted. A total of 40 severely malnourished children and 20 children with grade I and II PEM were included. Serum levels of T3, T4 and TSH, and total protein and albumin were estimated in both groups. The mean serum T3 levels were significantly lower in severely malnourished children, whereas T4 and TSH levels were in normal range. As the severity of PEM increased, there was progressive decrease in mean T3 levels; the levels of T3 were significantly low only in grade IV PEM. In spite of low T3, none of children were clinically hypothyroid. The low T3 in malnutrition is attributed to impaired thyroid secretion rate, low thyro-binding protein, and impaired T4 mono-deiodination in liver due to reduced activity of 5’deiodinase system. Cortico-steroid which is elevated in acute PEM, also inhibits T3 generation from T4 by inhibiting 5’deiodinase system.