الفهرس 
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Abstract
Protein-energy malnutrition is a disease caused by a complex of dietary, infective and environmental factors, forms result in growth
retardation, while severe deficiency cause the syndromes of nutritional
marasmus and KWO (Barltrop, 1992).i
In this work we planned to evaluate the biochemical changes in lipid metabolism in marasmic children before and after nutritional treatment.
The study included 30 children of both sex with the age ranging from 6-24 months and their weight ranging for 4.90 to 9.80 kg. All subjects were submitted to anthropometric measurements including body weight, height, midarm circumference, chest circumference and head circumference, the results revealed that body weight, midarm circumference and chest circumference were high significantly lower in marasmic children when compared to after treated group.
Samples were obtained from each case before and after one month of treatment, the biochemical tests for each subject included.
- Liver function tests (Albumin, T-protein, SGPT and SGOT).
- Kidney function tests (Serum urea and createnine).
- Lipid profiles ( T-lipid, triglycerides, T-cholesterol, HDL-C, LDL-
C and lipoprotein (a) [Lp (a)] .
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*SUMMARY AND CONCLUSION *
- Atherogenic ratios (T. cholesterol/High density lipoprotein and low density lipoprotein/high density.
In both liver function tests: (Albumin, T-protein, SGPT and SCOT and kidney function tests (serum area and createnine) the mean levels in
marasmic group were non significantly decreased from the corresponding
mean levels of after treated group.
While, the laboratory results of lipid profiles showed significant elevations of mean values of total lipid in marasmic children as compared to after treated group this may be due to insufficient caloric intake which leads to increase mobilization of fat from adipose tissues provide the body with the required calories intake the stimulated the effect of FFA from despot stores. The FFA are esterified by the liver to form triglycerides.
While, the results revealed high significant decrease levels of serum t-cholesterol in marasmic group when compared to after treated group, this may be due to decrease dietary essential nutrient needed for cholesterol formation as well as decreased LCAT activity and as the absorption dietary glucose is minimal in marasmus, that leads to reduce of lipogenesis in general and decreased cholesterol synthesis in particular.
Marasmic patients group had significantly lower HDL-C level than postmarasmic ones this could be due to reduced LCAT activity with its Co-factor apo A-1 level which lead to decreased HDL-C level.
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*SUMMARY AND CONCLUSION *
Marsmic patients had significantly lower LDL-C levels than after treated ones. This could be due to depressed ability of liver to assemble and hydrolyze VLDL to IDL and LDL-C due to reduced apo B level in
PEM.
Marasmic patients had significant lower lipoprotein (a) levels than
the after treat vat?, this could be due to reduced apo B level in
HI I
maragmus, whicii may be due to decreaced ammo gigic ill (110, 1111d111011
I MIto intestinal atrophy and mal-absorption w me_ are gtqueni gniingg in
PEM.
RECOMMENDATIONS
An increased attention was paid in recent years for atherosclerotic changes in coronary arteries originated during childhood. Even in children and young adults, the extent of lesions correlates positively with plasma LDL-c levels and negatively with HDL-C levels. thus, prevention of atherosclerosis should be started by the pediatrician. As the atherosclerosis is the major cause of CHD condition starts early in life and progresses
silently for decades.
In this study the association of PEM with changes of lipid, lipoprotein and apolipoproteins has been clarified that these changes seem to imply no more risk for these patients and are probably explained by the.