The effect of protein-calorie malnutrition on the composition of the human femur.

I. A femur was analysed from each of the following malnourished children: five Turkish (4-7.5 months; marasmic), eight Jamaican (9-13 months; two marasmic, one marasmic with kwashiorkor, three with kwashiorkor, two ‘malnourished’) and two Ugandan (I: and 12 months; marasmic and with kwashiorkor respectively). These were matched with appropriate controls. Dry weight, fat, total nitrogen, collagen N, calcium and phosphorus were determined, and values are presented for them in the bone, with and without epiphyses, and in the epiphyses and cortex. 2. The femurs of the Turkish children (4-7.5 months) showed greater deficits in length, Ca and P than did those of the Jamaican and Ugandan children (9-13 months). In both agegroups, regardless of the clinical condition, there was significantly less dry fat-free bone tissue than in control bones of similar ages. The concentration of fat in the bones was variable, but in the Turkish bones it was higher than in the controls. 3. When the epiphyses were excluded, the femurs of the Jamaican and Ugandan children with kwashiorkor contained a lower concentration of total N per IOO g fat-free solids than did those of children with marasmus. 4. The epiphyses of the malnourished children aged 4-7‘5 months contained lower concentrations of total N, collagen N, Ca and P than those of controls. In the older age-group the only significant difference was a lower level of Ca. 5. The cortex of all the malnourished children had a similar composition to that of the controls.