Cross-sectional study of blood biochemical profile in malnourished children admitted in pediatrics indoor in a tertiary care hospital with respect to severity of malnutrition
DOI:
https://doi.org/10.18203/2349-3291.ijcp20263808Keywords:
Malnutrition, Severe acute malnutrition, Moderate acute malnutrition, Blood biochemical profileAbstract
Background: Malnutrition encompasses both undernutrition and overnutrition. In India, undernutrition is widely prevalent among under-five children in resource limited rural and tribal dominated areas of Bankura district of West Bengal, where the study was conducted. In undernourished state, there is alteration in blood glucose, electrolytes, liver function tests, renal function tests, lipid profile etc. These metabolic and biochemical markers are very important for feeding and fluid management of malnourished children.
Methods: The present study will provide an overview of blood biochemical changes in malnourished children aged 6 months to 60 months and admitted in Paediatric indoor of Bankura Sammilani Medical College. This prospective study included 105 children aged 6 months to 5 years, admitted with undernutrition and was categorized as per WHO classification according to its severity into moderate acute malnutrition (MAM) numbering 65 and severe acute malnutrition (SAM) numbering 40. Initial blood sugar, serum Na+, K+, liver function tests (ALT, AST, albumin, alkaline phosphatase), urea, creatinine, lipid profile were estimated as per standard protocol after taking consent from the parents of children included and were correlated with respect to severity of malnutrition.
Results: Significant difference in mean serum values of ALT, alkaline phosphatase, albumin, urea, sodium, potassium, cholesterol and triglyceride was observed between MAM and SAM groups. However, differences in mean values of blood glucose, AST, HDL and creatinine were not significant. Changes in blood biochemical parameters were also observed in phenotypic variants of malnutrition, namely marasmus and kwashiorkor.
Conclusions: Levels blood biochemical parameters vary with severity of malnutrition.
References
Bhutia DT. Protein energy malnutrition in India: the plight of Our Under Five children. J Family Med Prim Care. 2014;3(1):63-7.
Malnutrition. World Health Organization (WHO). Available at: https://www.who.int/health-topics/malnutrition#tab=tab 1 & 2. Accessed on 17 May 2026.
Zachary JM, Adama MK, Mehta-Gupta Das P, Mehta A, Akelo V, Oluoch OB, et al. Contribution of malnutrition to infant and child deaths in Sub-Saharan Africa and South Asia. BMJ Glob Health. 2024;9:e017262.
Malnutrition in Children-UNICEF Data. Available at: https://data.unicef.org›Nutrition›Malnutrition. Accessed on 4 May 2026.
Aguilar F. Interpreting nutrition through assessment techniques. Clin Nutr Hosp Diet. 2023;43(4):01-02.
The DHS Program>Publications>National, State and Union Territory, and District Fact Sheets-2015-16 National Family Health Survey (NFHS-4) (English) Available at: https://dhsprogram.com/publications/publication-OF31-Other-Fact-Sheets.cfm. Accessed on 8 May 2026.
Guideline-IRIS Home-World Health Organization (WHO). Guideline: Assessing and Managing Children at Primary Health-Care Facilities to Prevent Overweight and Obesity in the Context of the Double Burden of Malnutrition. Updates for the Integrated Management of Childhood Illness (IMCI). 2017. Definitions and Key terms, Table 1 World Health Organization (WHO) classification of nutritional status of infants and children. Available at: https://iris.who.int/bitstream/handle/10665/259133/9789241550123-eng.pdf. Accessed on 8 May 2026.
Wellcome Trust Working Party. Classification of infantile malnutrition. Lancet. 1970;2:302-3.
Pandey VK, Aggarwal P, Kakkar R. Modified BG Prasad Socio-economic Classification, Update-2019. Indian J Comm Health. 2019;31(1):123-5.
Chowdhury MRK, Rahman MS, Khan MMH, Mondal MNI, Rahman MM, Billah B. Risk factors for child malnutrition in Bangladesh: A multilevel analysis of a nationwide population-based survey. J Pediat. 2016;172:194-201.e1.
Khokar A, Singh S, Talwar R, Rasania SK, Badhan SR, Mehraet M. A study of malnutrition among children aged 6 months to 2 years from a resettlement colony of Delhi. Ind J Med Sci. 2003;57(7):286-9.
Lakshmi M, Sreenivas SK, Pavitra NA. Study of biochemical and nutritional indicators in severe acute malnutrition: A prospective observational study. Indian J Child Health. 2016;3(4):314-6.
Gebre A, Reddy PS, Mulugeta A, Sedik Y, Kahssay M. Prevalence of Malnutrition and Associated Factors among Under- Five Children in Pastoral Communities of Afar Regional State, Northest Ethiopia: A Community based Cross-Sectional Study. J Nutrit Metabol. 2019;9187609:13.
National Family Health Survey-5. 2019-21, India Fact Sheet. Available at: https://dhsprogram.com/pubs/pdf/OF43/India_National_Fact_Sheet.pdf. Accessed on 4 May 20256.
Prabhat A, Malla S. Influence of socio-economic status on grades of malnutrition. Int J Home Sci. 2015;1(1):52-5.
Chatterjee K, Sinha RK, Kundu AK, Shankar D, Gope R, Nair N, Tripathy PK. Social determinants of inequities in under-nutrition (weight-for-age) among under-5 children: a cross-sectional study in Gumla district of Jharkhand, India. Int J Equity Health. 2016;15(1):104.
Das S, Bose K. Prevalence of thinness using new international cut-off points among Santal tribal children and adolescents of Purulia District, West Bengal, India. Sri Lanka J Child Health. 2011;40(3):105-10.
Chakraborty S, Gupta SB, Chaturvedi B, Chakraborty S.K. A study of protein energy malnutrition (PEM) in children (0 to 6 years) in a rural population of Jhansi district (U.P.). Indian J Community Med. 2006;31(4):291-2.
Benjamin AI, Zachariah P. Nutritional status and feeding practices in under-3 years old children in the rural community in Ludhiana, Punjab. Health Populat Perspect Issues. 1993;16(1-2):3-21.
Khan MD N, Islam MM. Effect of exclusive breastfeeding on selected adverse health and nutritional outcomes: a nationally representative study. BMC Public Health. 2017;17:889.
Lodha R, Agarwala A. Nutrition. Undernutrition. Eds. Paul VK, Bagga A. Ghai Essential Pediatrics: 10th Ed. CBS Publishers and distributors Pvt. Ltd., New Delhi. 2023;85-87.
Kumar R, Singh J, Joshi K, Singh HP, Bijesh S. Hospitalized Children with Severe Acute Malnutrition in Rewa District. Indian Pediatr. 2013;51:125-7.
Coulthard MG. Oedema in kwashiorkor is caused by hypoalbuminaemia. Paediatr Int Child Health. 2015;35(2):83-9.
Verma GK, Yadav YS, Yadav RK, Sharma IK, Bharat K, Yadav KK. Study of lipid profile levels in malnourished and healthy children: a case control study. Int J Pediat Res. 2018;5(4):156-61.
Treatment of hypoglycaemia in children with severe malnutrition-World Health Organisation (WHO). Avaible at: https://www.who.int/tools/elena/interventions/hypoglycaemia-sam. Accessed on 08 May 2026.
Chowdhury MSI, Rahman AZ, Haque M, Nahar N, Taher A. Serum Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) Levels in Different Grades of Protein Energy Malnutrition. J Bangladesh Society Physiol. 2008;2:17-9.
Nagata JM, McDonald CM. Nutrition, Food Security and Health, Undernutrition. Eds Kliegman RM, St Geme III JW, Blum NJ, Schuh AM, Tasker RC, Mack CL, et al. Nelson Textbook of Pediatrics, 22nd Ed. Elsevier Inc., Philadelphia. 2025;421-31.
Whitehead RG, Coward WA, Lunn PG. Serum-albumin concentration and the onset of kwashiorkor. Lancet. 1973;1(7794):63-6.
Hari P, Bagga A, Mahajan P, Lakshmy R. Effect of malnutrition on serum creatinine and cystatin C levels. Pediatr Nephrol. 2007;22(10):1757-61.
Syed Tariq A, Naik SA, Wasim Rafiq A, Saleem R. Demographic, clinical profile of severe acute malnutrition and our experience of nutrition rehabilitation centre at children hospital Srinagar Kashmir. Int J Contemp Pediatr. 2015;2:233-7.
Mittal SK, Saxena S, Mundkur N, Srivastava G, Gupta S. Acute diarrhea in malnourished children. Clinical, biochemical and bacteriological profile. Indian Pediatr. 1980;17(3):247-54.
Elizabeth KE. Triple burden of malnutrition. Nutrition and Child Development, 4th Ed. Paras Medical Publisher, Hyderabad. 2010;163-217.
Gabriela RSV, Haroldo SF, Ana LS, Jairo C, Telma MMTF. Dyslipidaemia and Undernutrition in Children from Impoverished Areas of Maceió, State of Alagoas, Brazil. Int J Environ Res Public Health. 2010;7:4139-51.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ebna Rushad, Maitreyi Basu, Toshibananda Bag

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.