SEVERE MALNUTRITION IS ASSOCIATED WITH DECREASED LEVELS OF PLASMA TRANSFERRIN RECEPTOR

Sixty children aged 1-3 years with protein malnutrition were involved in the present study. Measurements were made of plasma transferrin rec eptor (TfR), haemoglobin (Hb), ferritin, transferrin and Fe in compari son with twenty apparently healthy age- and sex-matched reference chil dren in Nigeria. Plasma TfR was measured by an immunofluorometric assa y. The mean plasma concentrations of both albumin (37 g/l) and transfe rrin (1.88 g/l) were within reference ranges in the 'healthy' children . The malnourished children had severe protein deficiency as indicated by their significantly lower mean plasma albumin (24.4-28.2 g/l; P < 0.0001) and transferrin (1.24-1.53 g/l; P < 0.0001) concentrations in comparison with the reference children. In the reference children, the traditional indicators of Fe nutrition (plasma Fe, transferrin Fe sat uration and Hb) were within the reference ranges, but ferritin values were raised, indicating acute or chronic infection and/or inflammation . The mean concentrations of plasma TfR (4.2-5.2 mg/l) in the malnouri shed group were significantly lower than the mean (6.1 mg/l) of the re ference children (P = 0.0009). In the children with severe malnutritio n, none of the indicators of Fe status except Hb (81.5-86.7 g/l; P < 0 .0001) showed Fe deficiency, including the serum concentration of TfR and the TfR:ferritin ratio, although the Fe status was lower than in t he reference children (for Fe P = 0.009; and ferritin P = 0.0004). In the absence of haemodilution, the low Hb values are a clear indication that the malnourished children were Fe deficient; none of the other i ndices was indicative of Fe deficiency. This is the first report of Tf R levels in malnourished and healthy African children.