CORRELATION BETWEEN THYROID HORMONES AND SERUM ALBUMIN IN CHILDREN WITH SEVERE ACUTE MALNUTRITION (SAM) AND MODERATE ACUTE MALNUTRITION (MAM): A RETROSPECTIVE OBSERVATIONAL STUDY

Abstract

Introduction:
Malnutrition in early childhood is a major global health problem, particularly in low- and middle-income countries (LMICs), where it contributes substantially to morbidity and mortality. Protein–energy malnutrition affects multiple organ systems, including the endocrine system, with significant alterations in thyroid hormone metabolism. Albumin, a major carrier protein for thyroid hormones, is often reduced in malnutrition, potentially influencing free hormone availability.

Aim:
To evaluate the correlation between serum albumin and thyroid hormone levels in children with moderate acute malnutrition (MAM) and severe acute malnutrition (SAM).

Materials and Methods:

This retrospective, observational (record-based) study was conducted in the Department of Pediatrics, Saveetha Medical College and Hospital, Tamil Nadu, India. Medical records of children aged 6–60 months diagnosed with MAM or SAM between June 2024 and December 2024 were reviewed. Anthropometric data, serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and albumin levels were extracted. Children with chronic systemic illnesses or conditions affecting thyroid function were excluded. Data analysis included descriptive statistics, independent samples t-test for group comparisons, and Pearson’s correlation for association between biochemical parameters. A p-value <0.05 was considered statistically significant.

Results:
Of the 100 children included, 43 had MAM and 57 had SAM. The mean age was comparable between groups (p = 0.369). Weight tended to be lower in SAM (8.73 ± 2.33 kg) than in MAM (9.59 ± 2.33 kg), but the difference was not statistically significant (p = 0.073). FT3 and FT4 levels were significantly higher in MAM (FT3: 3.63 ± 0.09 pg/mL; FT4: 1.82 ± 0.12 ng/dL) compared to SAM (FT3: 3.26 ± 0.13 pg/mL; FT4: 1.30 ± 0.19 ng/dL) (both p < 0.001). Serum albumin was also significantly higher in MAM (3.97 ± 0.29 g/dL) than SAM (3.06 ± 0.30 g/dL) (p < 0.001). TSH did not differ significantly between groups (p = 0.656). Strong positive correlations were observed between FT3 and albumin (r = 0.992, p < 0.001) and between FT4 and albumin (r = 0.990, p < 0.001).

Conclusion:
Serum albumin shows a strong positive correlation with FT3 and FT4 levels in children with acute malnutrition, suggesting that hypoalbuminemia may contribute to reduced thyroid hormone availability in SAM. Measuring both parameters may provide valuable insights into nutritional and endocrine status, enabling timely interventions to improve growth and metabolic outcomes.