Please enter verification code
Albumin and Serum Vitamin A Status of Malnourished Children
European Journal of Clinical and Biomedical Sciences
Volume 4, Issue 1, February 2018, Pages: 6-11
Received: Nov. 26, 2017; Accepted: Dec. 14, 2017; Published: Mar. 23, 2018
Views 1941      Downloads 138
Egbe Edmund Richard, Department of Medical Laboratory Science, University of Calabar, Calabar, Nigeria
Eworo Raymond Ekong, Department of Medical Laboratory Science, University of Calabar, Calabar, Nigeria
Article Tools
Follow on us
Malnutrition remains a major health problem in the third world countries, and is a key factor to the high death rate among children below five years old. This study aimed to determine serum vitamin A, mid-upper arm circumference (MUAC), and albumin levels of malnourished children and their well-fed counterparts. A total of one hundred (100) children comprising of fifty (50) malnourished children under the age of five years and fifty (50) well-fed age-matched children were recruited into this study. Mid upper arm circumference (MUAC) measurement was used to categorize the children into malnourished and the well-fed groups. The malnourished were further classified into kwashiorkor and marasmic cohorts. Serum vitamin A and albumin levels were determined by colorimetric methods. Data were analyzed using SPSS version 20.0 statistical package, differences between and variations among groups were determined by Student’s t-test and ANOVA respectively while the association between variables by Pearson’s correlation. Differences were considered statistically significant at p≤0.05. Serum vitamin A, MUAC and albumin levels of the well-fed group were significantly higher (p<0.05) than those of the malnourished. Comparing the well-fed, the kwashiorkor and the marasmic groups, the mean serum vitamin A, MUAC and albumin of the well-fed were significantly higher (p=0.001) than those of the kwashiorkor and marasmic groups. Mean albumin level of the kwashiorkor was significantly lower (p<0.05) than that of marasmic group. Mean MUAC of the kwashiorkor subjects was significantly higher (p<0.05) than that of the marasmic subjects. Serum vitamin A was not significantly different (p=0.724) between the kwashiorkor and the marasmic groups. In the marasmic subjects mean serum vitamin A correlates negatively with albumin (r= -0.517, p=0.011). In the kwashiorkor subjects, serum vitamin A correlates negatively with albumin (r=-0.080, p=0.690). In the well-fed children, serum vitamin A correlates positively with albumin (r=0.340, p=0.016). Conclusion: malnourished children with kwashiorkor and marasmus have lower albumin, serum vitamin A and MUAC compared with the well-fed children.
Albumin, Vitamin A, MUAC, Malnutrition, Children
To cite this article
Egbe Edmund Richard, Eworo Raymond Ekong, Albumin and Serum Vitamin A Status of Malnourished Children, European Journal of Clinical and Biomedical Sciences. Vol. 4, No. 1, 2018, pp. 6-11. doi: 10.11648/j.ejcbs.20180401.12
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Millennium Development Goals, “Current progress in Nigeria”, United Nations Development Programme-Nigeria; 2012.
Wilson E. D. and Fisher K. H, “Principles of nutrition 3rd ed. John Wiley and son incorporate”, Oxford, 1994; 216-224.
Allen, L. H., Rosado, J. L., Casteline, J. E, “Lack of haemoglobin response to iron supplementation in anemic Mexican preschoolers with multiple micronutrient deficiencies”, American Journal of Clinical Nutrition, 2000; 17: 1485-1494.
World Health Organization. “World health report, Geneva”, (2002).
Rice A. L, Sacco L, Hyder A, Black R. E, “Manutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries,” Bulletin of World Health Organization, 2007; 78: 1207-21.
Kara A. Bresnahan and Sherry A. Tanumihardjo, “Undernutrition, the acute phase response to infection and its effects on micronutrient status indicators”, Advances in Nutrition, 2014; vol. 5: 702-711, doi:10.3945/an.114.006361.
Fuchs G. J, Ausayakhun S, Ruckphaopunt S, Tansuhaj A, Suskind R. M, “Relationship between vitamin A deficiency, malnutrition, and conjunctival impression cytology”, American Journal of Clinical Nutrition, 1994; 60: 293–8.
Requejo JH, Bryce J, Barros AJ, Berman P, Bhutta Z, Chopra M, Daelmans B, de Francisco A, Lawn J, Maliqi B, Mason E, Newby H, Presern C, Starrs A, Victora CG, “Countdown to 2015 and beyond: fulfilling the health agenda for women and children”, Lancet, 2015; 385 (9966): 466-76.
Barber, E. W., Roles, OA, “Vitamin A status of children in Srilanka,” American Journal of clinical nutrition”, 2000; 32: 84-91.
Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., De Onis, M., Ezzati, M., Mathers, C., Rivera, J, “Maternal and child undernutrition: global and regional exposures and health consequences”, Lancet, 2008; 371: 243-260.
West, K. P. Jr, “Extent of vitamin A deficiency among preschool children and women of reproductive age", Journal of Nutrition, 2002; 132 (9 Suppl): 2857S-2866S.
United Nations international Children’s Education Fund (UNICEF). “Strategizing Micronutrient deficiency control in Nigeria—from Policy to Workplan” Lagos: UNICEF.
Ajenifuja B, “Paediatrics Health Care in Nigeria: Yesterday, Today and Tomorrow” Nigerian Journal of Paediatrics, 2011; 38 (4): 146-158.
Duffy, E. & Gibney, MJ, “Use of a food-consumption database with packaging information to estimate exposure to food-packaging migrants: expoxidized soybean oil and styrene monomer. Food Additives Contamination”, 2007; 24 (2): 216-25.
Ojofeitimi, EO, “Malnutrition and approaches to improving the nutritional status of children in low income settings.
Prentice AM, Nabwera H, Unger S, Moore SE, “Growth monitoring and the prognosis of mortality in low-income settings” American Journal of Clinical Nutrition, 2016; 03: 681–682.
Policy Project of Nigeria “Reproductive Health in Nigeria, Situation, Response, and Prospects” Key Issues Abuja policy Project, 2002.
Müller, O., & Krawinkel, M., “Malnutrition and health in developing countries”, CMAJ: Canadian Medical Association Journal, 2005; 173 (3), 279–286.
Nemer L, Gelband H, Jha P., “Commission on Macroeconomics and Health. The evidence base for interventions to reduce malnutrition in children under five and school-age children in low- and middle-income countries”, CMH working papers no WG5: 11. 2001, Geneva: World Health Organization.
Nnakwe, N., “The effect and causes of protein-energy malnutrition in Nigerian children”, Nutrition Research, 1995; 15: 785-794.
Myatt M., Khan, T., Collins, S., “A review of methods to detect severe malnutrition in the community for their admission into community based therapeutic feeding centers”, Food and Nutrition Bulletin, N0 3 supplement, the United Nation University, 2006; 1142-1144.
World Health Organization “Nutrition: challenges”, (2009;
Neeld, JB, Pearson, WN, “Macro and micro methods for the determination of serum vitamin A using TCA”, Journal of Nutrition, 1963; 79: 454-462.
Young, H., Borrel, A., Holland, D., Salama, P, “Public nutrition in complex emergencies” Lancet, 2004; 365: 1899-1909.
Doumas, B. T., Watson, W. A., Biggs, HG, “Albumin standard and measurement of serum albumin with Bromocresol green” Clinica Chimica Acta, 1971; 31: 87-96.
Reddy, V., Mohanram, M., Raghuramulu, N, “Serum retinol-binding protein and vitamin A levels in malnourished children”, Acta of paediatric scandal, 1979; 68 (1): 65-69.
Ikekpeazu E. J., Neboh, E. E., Maduka I. C., Ezedigbo, A. N & Odetunde, T, “Serum vitamin A levels in children with protein energy malnutrition”, Current Pediatric Research, 2010; 14 (1): 9-13.
Moriese, G. Raz, A., Mancini, G., Carbonara, A. O, “Regulation of retinol binding protein metabolism by vitamin A status in the human”, Journal of Biological Chemistry, 1997; 247: 2442-2450.
Ugwuja, E. I., Nwosu, K. O., Ugwu1, N. C. and Okonji, M, “Serum Zinc and Copper Levels in Malnourished Pre-School Age Children in Jos, North Central Nigeria”, Pakistan Journal of Nutrition, 2007; 6 (4): 349-354.
Nathalie Pascal, Emile Kou Santa Amouzou, Ambeliou Sanni, Fares Namour, Idrissia Abdelmouttaleb, Michel Vidailhet, and Jean-Louis Guéant, “Serum concentrations of sex hormone binding globulin are elevated in kwashiorkor and anorexia nervosa but not in marasmus”, American Journal of Clinical Nutrition, 2002; 76, 239-244.
Reeds P. J and Laditan, A. A, “Serum albumin and transferrin in protein-energy malnutrition, their use in the assessment of marginal undernutrition and the prognosis of severe undernutrition”, British Journal of Nutrition, 1976; 36 (2): 255-63.
Malcolm G. Coulthard, “Oedema in kwashiorkor is caused by hypoalbuminaemia” Paediatrics International Child Health, 2015; 35 (2): 83–89. doi:10.1179/2046905514Y.0000000154.
Olaf M. & Michael K, “Malnutrition and health in developing countries”, Canadian Medical Association Journal, 2005; 173, 3 doi: 10.1503/cmaj.050342.
Taiwo, O. O & Thomas, KD, “Plasma biochemical parameters in Nigerian children with protein energy malnutrition” East African Medical Journal, 1992; 69 (8): 428-32.
Mohammad Ali Kalantar Motamedi, Maryam Barzin, a Mohammadreza Ebrahimi, Reza Ebrahimi, and Alireza Khalaj, “Severe fatal protein malnutrition and liver failure in a morbidly obese patient after mini-gastric bypass surgery: Case report”, International Journal of Surgical Case Reports, 2017; 33: 71–74. doi: 10.1016/j.ijscr.2017.02.033.
Black R. “Micronutrient deficiency an underlying cause for morbidity and mortality” Bulletin of World Health Organization 2003; 81: 79.
Pujitha Wickramasinghe, “Micronutrients in childhood nutrition”, Sri Lanka Journal of Child Health, 2013; 42 (4): 157-165.
Diaz JR, de las Cagigas A, Rodriguez R, “Micronutrient deficiencies in developing and affluent countries [review]”, European Journal of Clinical Nutrition, 2003; 57: S70-2.
Donnen P, Brasseur D, Dramaix M, Vertongen F, Zihindula M, Muhamiriza M, Hennart, P, “Vitamin A supplementation but not deworming improves growth of malnourished preschool children in eastern Zaire”, Journal of Nutrition, 1998; 128: 1320–1327.
Vinicius J. B. Martins, Telma M. M. Toledo Florêncio, Luciane P. Grillo, Maria do Carmo P., Franco, Paula A. Martins, Ana Paula G. Clemente, Carla D. L. Santos, Maria de Fatima A., Vieira, and Ana Lydia Sawaya, “Long-Lasting Effects of Undernutrition”, International Journal of Environmental Research, 2011; 8 (6): 1817–1846.
Koletzko, B., Abiodun, P. O., Laryea, M. D., Bremer, H. J, “Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition”, European Journal of Pediatrics, 1986; 154: 109-115.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186