Plasma albumin, parasitic infection and pubertal development in Egyptian boys.

Pubertal stage was assessed in 453 Egyptian boys aged from nine to 17 years. Weights and albumin concentrations were measured and parasites identified from stool samples. The mean age to reach each stage of puberty was significantly delayed in the presence of low albumin levels and parasites. The magnitude of the delay was greater for genital stage 2 than for later stages. Weight was also lower in children with reduced albumin concentration or parasites. Among children of the same age, weight and albumin were positively correlated (P less than 0.001), suggesting that albumin status is involved in the timing of puberty.

Antioxidant status in children with protein-energy malnutrition (PEM) living in Cairo, Egypt.

OBJECTIVES: Free radicals are implicated in many diseases. The rise in free radicals associated with antioxidant deficiency results in tissue damage. The pathogenesis of oedema and anaemia commonly found in children with protein-energy malnutrition (PEM) has been suggested to be caused by an imbalance between the production of toxic radicals and their safe disposal. The aim of this study was to evaluate antioxidant status in children with PEM. DESIGN: A total of 68 children (age range: 3 months to 3 years) living in Cairo, Egypt were recruited. Forty-six of these subjects had different degrees of PEM; they were admitted at the Abo-Elrish Hospital, Cairo. Of these, 26 children had kwashiorkor (KWO) and twenty had marasmus (MAR). Twenty-two age and sex matched healthy well-nourished children were recruited from the local community, and used as controls. METHODS: The antioxidant status of the study population was determined by measuring copper-zinc superoxide dismutase (Cu-Zn, SOD) in red blood cells, glutathione peroxidase (GPX) in whole blood, and ceruloplasmin in plasma. In addition, the plasma levels of trace-elements involving antioxidant activities, such as copper (Cu), zinc (Zn), and selenium (Se) were determined, along with a select group of vitamins. The latter included vitamin A (retinol), vitamin E (alpha-tocopherol) and vitamin C (ascorbic acid). RESULTS: The mean whole blood GPX activity along with plasma levels of vitamins A, E and C as well as ceruloplasmin, Cu and Se were all lower in children with either KWO or MAR than their corresponding control subjects. The erythrocyte SOD activity, on the other hand, was increased while the plasma Zn concentrations were either increased or not changed in the malnourished children. It was of interest that while haemoglobin concentrations were decreased, the plasma free iron (Fe) levels were significantly increased in children with KWO. CONCLUSIONS: The significant increase in red cell SOD activity associated with the decrease in plasma ceruloplasmin, antioxidant vitamins and the whole blood GPX activity in PEM children suggest that these children are potentially susceptible to high oxidative stress. An elevated plasma Fe concentrations, especially with KWO may augment the harmful effect of free radicals with a clinical consequence of oedema.

Some aspects on liver enzymes in protein-energy malnutrition.

Liver enzymes alkaline phosphatase and transaminases (GPT & GOT) were studied in cases of protein-depleted rats. Alkaline phosphatase activities were determined with and without Mg addition to the incumedia, since it is the essential metal for this enzyme. The liver transaminases were also determined before and after pyridoxine injection, which is the coenzyme for this group. Both liver alkaline phosphatase and transaminases activities were increased on protein depletion. The study indicates that the increased activities of liver alkaline phosphatase in protein-depleted animals is suggestive of increased enzyme protein synthesis. On the contrary, high activities of liver transaminases are suggestive to be a result of some regulation mechanisms between the enzyme protein and its coenzyme.

Sexual maturation and growth pattern in Egyptian boys.

The mean ages of attainment of successive stages of puberty were estimated in a cross-sectional sample of 453 Egyptian schoolboys from a semi-urban area of Cairo, ranging in age from 9 to 17 years. The stages of puberty were as defined by Tanner (1962). The mean age of onset of puberty (stage 2) was 11.1 years, assessed either by genitalia or by pubic hair. Stage 5 occurred at 16.2 years, again both for genitalia and pubic hair. The time interval between these ages, 5.1 years, was 2 years longer than for British or Chinese boys. There was a highly significant effect of social class on the mean ages of attainment, and the heights and weights of the boys were also related to social class, the class 1 boys being taller and heavier than Tanner's British boys.

Effect of low-protein diet and its duration on hair composition.

The effect of feeding a low-protein diet (1%) and its duration (4, 8, 12 and 16 weeks) on the protein content and amino-acid pattern of hair were studied. These changes were compared with control groups fed an adequate protein diet (16%). Protein content of hair was diminished in the protein-deficient rats after four weeks followed by a gradual decrease till the end of the experiment. Sulphur-containing amino acids, cystine and cysteine, were significantly reduced in the hair of the protein-deficient rats when compared with the normal controls. The amino-acid pattern showed significant differences from controls by the end of the whole experimental period.

Effect of low-protein diet and its duration on hair composition.

The effect of feeding rats a low-protein diet (1%) and its duration (4, 8, 12 and 16 weeks) on the protein content and the amino acids pattern of hair were studied. These variations were compared with control group fed an adequate protein diet (16%). Protein content of hair was diminished in the protein deficient rats after four weeks followed by a gradual decrease till the end of the experiment. Sulphur-containing amino acids cystine and cysteine were significantly reduced in the hair of the protein deficient rats when compared with the controls. The amino acids patterns showed significant differences from controls by the end of the whole experimental period.

Response of the reproductive system of male rats to protein and zinc deficiency during puberty.

Male weanling rats were fed four diets providing high or low levels of protein and/or zinc. One group on each diet was sacrificed every 2 weeks to measure the weights of the reproductive organs, plasma levels of follicle-stimulating hormone and luteinizing hormone, and the plasma and testicular concentrations of testosterone, dihydrotestosterone and zinc. The results demonstrate that hypogonadal states are produced in response to protein deficiency and zinc deficiency but the mechanisms involved are different. The specific effects of zinc deficiency are not observed in protein-deficient animals.

Etiology of rickets in Egyptian children.

Factors associated with the rickets found in children attending the Outpatients Department of Cairo Children's Hospital have been studied. All the children studied were small for their age with the rachitic children being significantly smaller than the controls. The clinical diagnosis of the disease was confirmed in 54 children by X-ray and plasma biochemistry. The best indicator of the disease was the enlarged epiphysis of the wrist and to a lesser extent that of the ankles. Some of the factors predisposing to rickets were assessed in the rachitic children and in age-matched controls. There was no difference in the nutrient intake of these two groups of children although intakes of energy, calcium and vitamin D, but not of protein, were lower than recommended dietary allowances. Although more of the rachitic children came from urban areas than the controls there were no significant differences in the environments to account for the occurrence of the disease. Factors contributing to the development of rickets are discussed with particular regard to aspects such as low body weight, low maternal vitamin D status and low calcium intakes which cause a high rate of utilization and metabolism of vitamin D.