Micronutrient Profiles in Severe Acute Malnutrition: Analyzing Vitamin B12, Zinc, Copper, Selenium, Manganese, Molybdenum, and Cobalt Levels: Micronutrient Profiles in Severe Acute Malnutrition

Ubedullah Bahalkani; Mumtaz Ali Bharo; Kamran Ali; Bakhtiar Ahmed Bhanbhro; Asif Ali Khuhro; Faiza Kamran Ali

doi:10.54393/pjhs.v5i12.2423

Authors

Ubedullah Bahalkani Department of Paediatrics, Khairpur Medical College, KhairpurMirs, Pakistan
Mumtaz Ali Bharo Department of Paediatrics, Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan
Kamran Ali Department of Paediatrics, Khairpur Medical College, KhairpurMirs, Pakistan
Bakhtiar Ahmed Bhanbhro Department of Paediatrics, Pir Ahmed Shah Jillani, Institute of Medical Science, Gambat, Pakistan
Asif Ali Khuhro Department of Paediatrics, Pir Ahmed Shah Jillani, Institute of Medical Science, Gambat, Pakistan
Faiza Kamran Ali Department of Gynecology, Rural Health Center, Atta Muhammad Hami, Khairpur, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i12.2423

Keywords:

Severe Acute Malnutrition, Micronutrient Deficiencies, Pediatric Malnutrition, Nutritional Interventions, Growth Recovery

Abstract

Severe Acute Malnutrition (SAM) is a critical public health issue affecting millions of people globally. Objective: To evaluate the status of micronutrients and their relationship with malnutrition severity. Methods: A cross-sectional study was conducted over six months from November 2023 to April 2024 at Pead’s Department Of Khairpur Medical College, KhairpurMirs. The study included 384 participants diagnosed with SAM. Micronutrient levels were assessed using quantitative colorimetry. Statistical analyses were descriptive, independent t-tests, Pearson and Spearman correlation analyses to evaluate micronutrient deficiencies. Results: The mean age of the children was 24.5 months, with a male predominance of 54.7%. Micronutrient levels showed significant variation between children with mild and severe malnutrition: p = 0.03), zinc (62.7 vs. 55.8 µg/dl, p = 0.01), vitamin B12 (312.4 vs. 278.6 pg/ml, p = 0.02), copper (97.3 vs. 89.2 µg/dl, p = 0.03), and selenium (45.7 vs. 40.2 µg/l, p < 0.05). Positive correlations between micronutrient levels and anthropometric variables were found by correlation analysis. Logistic regression indicated that deficiencies in Vitamin B12 (OR: 1.45, p = 0.02), Zinc (OR: 1.62, p = 0.01), and Copper (OR: 1.35, p = 0.03) were significant predictors of severe malnutrition. Conclusions: The findings emphasized that the need for targeted nutritional interventions addressing Vitamin B12, Zinc, and Copper deficiencies to improve health outcomes in malnourished children. Further research was essential to evaluate the impact of supplementation strategies on growth and recovery

References

Yaikhomba T, Poswal L, Goyal S. Assessment of iron, folate and vitamin B12 status in severe acute malnutrition. The Indian Journal of Pediatrics. 2015 Jun;82: 511-4. doi: 10.1007/s12098-014-1600-7.

Verma GK, Chand R, Khan IA, Kumar A, Yadav RK. Association of developmental milestones with vitamin B12 and folate status among hospitalized severe acute malnutrition children at a tertiary care center in North India. MGM Journal of Medical Sciences. 2023 Apr;10(2): 235-40. doi: 10.4103/mgmj.MGMJ_34_23.

Dos Santos ME, da Silva KG, da Silva Souza AP, da Silva AB, da Silva RF, da Silva EH et al. Relationship between vitamin B12 levels and motor development: a systematic review. Clinical Nutrition ESPEN. 2024 Jun.doi: 10.1016/j.clnesp.2024.06.026.

Chen Y, Liu X, Li B, Li J, Meng L, Ye C et al. Explorative case control study on the associations of serum vitamin D3, folic acid and vitamin B12 levels on Kawasaki disease and coronary artery lesions. Frontiers in Nutrition. 2024 Jun;11: 1402316. doi: 10.3389/fnut.2024.1402316.

Godswill AG, Somtochukwu IV, Ikechukwu AO, Kate EC. Health benefits of micronutrients (vitamins and minerals) and their associated deficiency diseases: A systematic review. International Journal of Food Sciences. 2020 Jan 7;3(1):1-32. DOI:10.47604/ijf.1024.

Peroni DG, Hufnagl K, Comberiati P, Roth-Walter F. Lack of iron, zinc, and vitamins as a contributor to the etiology of atopic diseases. Frontiers in Nutrition. 2023 Jan 9;9:1032481. doi: 10.3389/fnut.2022.1032481.

Alflah YM, Alrashidi MA. Severe acute malnutrition and its consequences among malnourished children. Journal of Clinical Pediatrics Research. 2023;2(1):1-5. doi: 10.2147/JMDH.S428873

Kumar M, Kumar D, Sharma A, Bhadauria S, Thakur A, Bhatia A. Micronutrients throughout the Life Cycle: Needs and Functions in Health and Disease. Current Nutrition & Food Science. 2024 Jan; 20(1): 62-84. doi: 10.2174/1573401319666230420094603.

Collins S, Dent N, Binns P, Bahwere P, Sadler K, Hallam A. Management of severe acute malnutrition in children. The Lancet. 2006 Dec;368(9551): 1992-2000. doi: 10.1016/S0140-6736(06)69443-9.

Vishwakarma B and David A. Underlying risk determinants of acute and moderate malnutrition in children and its preventive management. Pharmaceutical and Biosciences Journal. 2021 Aug: 01-11. doi: 10.20510/10.20510/pbj/9/i4/1640.

Kamath L, Ratageri VH, Kanthi AS, Fattepur SR, Desai RH. Status of vitamin B12, zinc, copper, selenium, manganese, molybdenum and cobalt in severe acute Malnutrition. Indian Journal of Pediatrics. 2023 Oct;90(10):988-93.

Saleem J, Zakar R, Bukhari GM, Fatima A, Fischer F. Developmental delay and its predictors among children under five years of age with uncomplicated severe acute malnutrition: a cross-sectional study in rural Pakistan. BioMed Central Public Health. 2021 Dec;21: 1-0. doi: 10.1186/s12889-021-11445-w.

Gavhi F, Kuonza L, Musekiwa A, Motaze NV. Factors associated with mortality in children under five years old hospitalized for Severe Acute Malnutrition in Limpopo province, South Africa, 2014-2018: A cross-sectional analytic study. PLOS One. 2020 May;15(5): e0232838. doi: 10.1371/journal.pone.0232838.

Atiq A, Shah D, Sharma S, Meena RK, Kapoor S, Gupta P. Prevalence and Predictors of Vitamin B12 Deficiency in Children with Severe Acute Malnutrition, and its Association with Development. Indian Journal of Pediatrics. 2023 Nov: 1-7. doi: 10.1007/s12098-023-04909-x.

Arfi N, Khatoon K, Alim F. Zinc malnutrition in children and its consequences on health. Microbial biofertilizers and micronutrient availability: the role of zinc in agriculture and human health. 2022:35-67. DOI:10.1007/978-3-030-76609-2_2

Bahati YL, Delanghe J, Balaluka GB, Philippé J. Exploration of the relationship between anemia and iron and zinc deficiencies in children under 5 years of age living in the malaria endemic area of South Kivu/Democratic Republic of Congo. Annals of Hematology. 2022 Jun;101(6):1181-9. doi: 10.1007/s00277-022-04816-9.

Berger MM, Pantet O, Schneider A, Ben-Hamouda N. Micronutrient deficiencies in medical and surgical inpatients. Journal of clinical medicine. 2019 Jun; 8(7): 931. doi: 10.3390/jcm8070931.

Joshi S, Tabassum N, Mobeen A, Bora J. Micronutrients. In: Food Fortification. Boca Raton: CRC Press; 2024. 33-54. doi: 10.1201/9781003160663-3.

Adhaulia A, Maurya M, Tiwari AD. Developmental delay in children with severe acute malnutrition and its association with vitamin B12 deficiency. Indian Journal of Child Health. 2019; 6(10): 548-51. doi:10.18203/2349-3291.ijcp20194721.

Kurmi A, Jayswal DK, Saikia D, Lal N. Current Perspective on Malnutrition and Human Health. InNano-Biofortification for Human and Environmental Health 2023 Aug 11 (pp. 155-177). Cham: Springer International Publishing. DOI:10.1007/978-3-031-35147-1_9.