Short Description About Protein Energy Malnutrition, Its Clinical And Biochemical Changes. Basics For 1st Year MBBS Students

1. Protein Energy Malnutrition
Shubham Gupta
1st MBBS
Dept. of Biochemistry

2. Learning Objectives
 Short description and Introduction
about Protein.
 What is Protein Energy Malnutrition?
 Description about Kwashiorkor?
 Description about Marasmus?
 Difference between Kwashiorkor and
Marasmus?
 Treatment.

3. Introduction
 Protein are the Polymers of Amino Acids.
 Proteins are regarded as “Body- Building
Foods”.
 Also as “Working horses” of the cell.
 10-15% of total body energy is derived from
protein.
 Functions of Protein :-
1. Cell structure and functions.
2. Enzymes, hormones, immunoglobulins,
transport carriers etc. are Proteins.
3. -Maintenance of osmotic pressure.
-Clotting of blood.
-Muscle contraction.

4. Protein Energy Malnutrition
 Deficiency of protein may lead to
Protein Energy Malnutrition(PEM) or
Protein Calorie Malnutrition(PCM).
 Forms of PEM or PCM :-
1. Kwashiorkor
2. Marasmus

5. Kwashiorkor
 Literally means : Sickness of deposed child,
i.e.- a disease the child gets when next baby
is born.
 Cause :- Low protein intake.
 Occurrence :- Pre-school children.
 Clinical symptoms :-
1. Moon face
2. Abdomen- protruding
3. Edema
4. Diarrhea
5. Apathy
6. Anemia

9.  Biochemical manifestation :-
1. Plasma Albumin concentration :- Decreased
(<2 g/dl, normal : 3-4.5 g/dl)
2. Serum Cortisol :- Decreased or may be normal
3. Serum K+ :- Decreased
4. Plasma retinol binding protein (RBP) :- reduced.
5. Edema – due to lack of plasma proteins.
6. Immunological response – very low.
 Treatment :-
- Ingestion of Protein-rich foods (3-4 g of
protein/kg body weight/day)

11. Marasmus
 Literally means : To waste.
 Cause :- Deficiency of Calories.
 Occurrence :- Weaned infants (<1 yr)
 Clinical symptoms :-
1. Old man’s like face.
2. Abdomen- Shrunken.
3. Edema – Absent.
4. Severe growth retardation.
5. Muscle wasting.

15.  Biochemical manifestations :-
1. Serum Albumin :- Decreased( 2-3 g/dl).
2. Serum Cortisol :- Increased
3. Serum K+ :- Normal
4. No edema +nt.
 Treatment :-
Ingestion High calorific diet.

17. Summary
 Deficiency of protein may lead to
Protein Energy Malnutrition(PEM) or
Protein Calorie Malnutrition(PCM).
 Kwashiorkor is caused due to Protein
deficiency while Marasmus is caused
due to calorie deficiency.
 Treatment of Kwashiorkor- Protein rich
diet and treatment of Marasmus-
Calorie rich diet.