Causes of inadequate protein-energy status in thalassemic children.

Height-for-age, weight-for-age, triceps skinfold thickness (TST), mid upper arm circumference (MUAC), and mid upper arm muscle circumference (UAMC) were determined in 47 thalassemic children, ages ranging from 4- 5 years. Their mean (± SEM) height-for-age, weight-for age, TST, MUAC, and UAMC were 90.51± 0.98, 79.91± 2.33, 88.01± 1.26, 83.02± 1.37 and 80.09± 1.59% of standard values. Based on height-forage of less than 95% of standard values and weight-for-age, TST, MUAC, and UAMC of less than 90% of standard values, the prevalences of protein-energy malnutrition (PEM) in these thalassemic children were 72.3,74.5,53.7,75.6 and 82.9%, respectively. The causes of their inadequate protein-energy status were due to: (a) chronic hypoxia evidenced by the significantly positive correlations between haemoglobin levels and height-for-age (r=0.65, P<0.001), weight-for-age (r=0.58, P<0.001), MUAC (r=0.67, P<0.001) and UAMC (r=0.63, P<0.001); (b) zinc deficiency evidenced by significantly positive correlations between plasma zinc levels and height-for-age (r=0.26, P<0.05), MUAC (r=0.41, P<0.005), and UAMC (r=0.41, P<0.005) and significantly negative correlation between urinary zinc levels and UAMC (r=0.34, P<0.02); and (c) low energy intake, ie 65% of the mean recommended energy intake.