Malnutrition in Glasgow children

Iron deficiency in children undergoing adenoid-tonsillectomy

Following a preliminary study of peripheral blood values in 30 children undergoing tonsillectomy and adenoidectomy, a biochemical survey of the iron status of another 108 children also undergoing this operation was made utilizing an automated micro-method. It was shown that 8.4% of these children were frankly iron-deficient but there was no statistical relationship between the levels of serum iron and iron-binding capacity, the incidence of throat infections and the levels of the plasma immunoglobulins. Assessment of all children undergoing this operation for the presence of iron deficiency is advocated as a possible routine screening procedure.

Alkaline phosphatase in normal infants

Alkaline phosphatase was measured in plasma from children receiving vitamin D supplements in day nurseries in the London area, and from children exposed to sunlight in the West Indies. The distribution of values showed that there was no precise upper limit which could be used in the diagnosis of subclinical vitamin D deficiency.

A search for sub-clinical rickets in Glasgow children

Two random samples of Glasgow children aged 12 to 24 months were examined for clinical, biochemical and radiological evidence of subclinical rickets. No cases of florid rickets were discovered. One-third of the first sample studied (202 children) were estimated to be receiving less than 100 i.u. of vitamin D daily from all sources except sunshine. A poor dietary intake was most prevalent in the higher birth ranks and in social classes II and III (non-manual).

The mean serum alkaline phosphatase level was 20 K.A. units per 100 ml. (S.D. 8 units) and 11 per cent had levels of 25 K.A. units per 100 ml. or above. No reason, either dietary or clinical, was found which would account for these high levels.

Bone changes were observed in the wrist X-rays of about 9 per cent of children. They disappeared gradually with vitamin D therapy and there is some correlation with a raised alkaline phosphatase level and with tallness. They may be due to a relative insufficiency of vitamin D.

Serum alkaline phosphatase estimations and wrist radiography do not appear to be useful methods for estimating the prevalence of hypovitaminosis D in the community or as screening procedures in the detection of individual cases of subclinical rickets.