Hierro libre, transferrina y ferritina séricasen desnutrición aguda grave

Abstract

RESUMEN: Introducción: El hierro libre en suero se ha asociado con el desarrollo del edema en la desnutrición aguda grave tipo kwashiorkor. Materiales y métodos: Estudio descriptivo, de corte, tipo <i>cross-sectional, comparó 24 niños con desnutrición edematosa, 22 con marasmo y 20 sin desnutrición. Se determinó en suero: hierro libre, transferrina, índice de saturación y capacidad de fijación de hierro, ferritina, proteínas totales, albúmina, hierro total y proteína C reactiva (PCR). Resultados: Se halló diferencia significativa entre los niños desnutridos que tuvieron hierro libre en suero y el grupo control en el cual no se detectó, sin embargo no hubo diferencia significativa en la concentración sérica de hierro libre entre marasmáticos y edematosos. La transferrina correlacionó negativamente con el hierro libre (r = -­0,519; p = 0,000). Las proteínas totales, albúmina y transferrina fueron significativamente más bajas en los niños con edema que con marasmo. Una baja concentración de transferrina y un alto índice de saturación, podrían estimar la probabilidad del edema en un 67,5 % (p = 0,001). Conclusiones: La desnutrición aguda grave se asoció con la presencia de hierro libre en suero tanto en los niños con marasmo como con edema. El hierro libre no explica la presencia de edema, pero la concomitancia de una baja concentración de transferrina y un alto índice de saturación podrían contribuir a su etiología, lo mismo que la hipoalbuminemia grave.

ABSTRACT: Introduction: "Free" serum iron has been associated with the development of edema in Kwashiorkor-type severe acute malnutrition. Material and methods: A descriptive, cross sectional study was performed. Twenty-four children with edematous malnutrition, 22 with marasmus and 20 without malnutrition were compared. "Free" iron, transferrin, saturation index and attachment capacity of iron, ferritin, total protein, albumin, total iron, and C-reactive protein (CRP) were determined in serum. Results: A significant difference was found between malnourished children with "free" serum iron and the control group in which "free" iron was not found. However, no significant differences were found in "free" serum iron levels between marasmatic and edematous children. Transferrin was negatively correlated with "free" iron (r =­ -0.519; p = 0.000). Total proteins, albumin and transferrin were all significantly lower in children with edema than in those with marasmus. A low transferrin level and a high saturation index could be used to estimate the probability of edema in 67.5 % of cases (p = 0.001). Conclusions: Severe acute malnutrition was associated with the presence of "free" serum iron both in children with marasmus and in those with edema. "Free" iron does not explain the presence of edema but, as with severe hypoalbuminemia, the concurrence of a low transferrin level and a high saturation index may contribute to the etiology of edema structurally related compounds to INA displayed a significant antimicrobial and antioxidant activity. Therefore, INA, SA and structurally-related compounds can be used to increase the amounts of natural antioxidant or antimicrobial compounds in soybean, either to protect the plant directly against pathogens or as a natural source for subsequent isolation of isoflavonoids or bioactive extracts, which have potential application in functional foods or pharmaceutical and personal care products.