Sarcopenia in children and adolescents with chronic liver disease

Rezende, Ionar Figueredo Bonfim; Conceição‐Machado, Maria Ester Pereira da; Souza, Viviane Sahade; Santos, Elisana M. dos; Silva, Luciana Rodrígues

doi:10.1016/j.jped.2019.02.005

Cited by 26 publications

(26 citation statements)

References 26 publications

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“…Few previous studies in children with chronic liver disease revealed lower psoas muscle area and skeletal muscle mass compared to matched healthy controls 15,17 . Moreover, children with sarcopenia had significantly lower weight velocity and height z ‐score compared to children without sarcopenia after LT 18 .…”

Section: Introductionmentioning

confidence: 84%

“…Few previous studies in children with chronic liver disease revealed lower psoas muscle area and skeletal muscle mass compared to matched healthy controls. 15,17 Moreover, children with sarcopenia had significantly lower weight velocity and height z-score compared to children without sarcopenia after LT. 18 Therefore, we aimed to determine the association between psoas muscle mass and waitlist mortality as well as post-LT outcomes in children with end-stage liver disease.…”

Section: Introductionmentioning

confidence: 98%

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Low psoas muscle index as an unfavorable factor in children with end‐stage liver disease undergoing liver transplantation

Jitwongwai

Lertudomphonwanit

Junhasavasdikul

et al. 2021

Pediatric Transplantation

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Sarcopenia is defined as an involuntary progressive and diffuse loss of muscle mass, strength, and physical performance which often found in elderly people and adults with chronic illness or malnutrition. [1][2][3] However, sarcopenia can also occur in children with chronic disease such as leukemia, inflammatory bowel disease, and end-stage renal disease. [4][5][6][7] The condition is also common in patients with cirrhosis and could contribute to poor prognosis both pre-and post-LT. 8,9 Pathogenesis of sarcopenia in cirrhosis is multi-factorial, mainly caused by malnutrition from poor energy intake, malabsorption, increased inflammatory cytokines, and side effects from various medications. [10][11][12] The European Working Group on Sarcopenia in Older People proposed a three-step criteria consisting of low

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 98%

Low psoas muscle index as an unfavorable factor in children with end‐stage liver disease undergoing liver transplantation

Jitwongwai

Lertudomphonwanit

Junhasavasdikul

et al. 2021

Pediatric Transplantation

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“…In liver-transplanted children, sarcopenia is associated with relevant clinical outcomes (growth retardation, length of hospitalization, and rate of readmission) [ 149 ]. The use of an internal comparison for the diagnosis of sarcopenia may cause different series to have different cutoffs, which hampers the generalization of results [ 150 , 151 ].…”

Section: Post-transplant Obesity With Fatty Liver and Mets Risk: The Malnutrition In Excess Paradoxmentioning

confidence: 99%

“…Although several valid malnutrition screening tools with which to identify nutritional risk are available, an increased risk of protein malnutrition may be masked by edema, and further work regarding tools with which to distinguish between protein–energy malnutrition (PEM), sarcopenia, and cachexia are required for the pediatric age group. Functional assessment of muscle sarcopenia in pediatric CCLD is not generally performed because appropriate muscle function tests have not been developed for early childhood, and a standardized assessment of muscle function for the diagnosis of sarcopenia in young pediatric patients is currently lacking [ 150 , 151 ].…”

Section: Post-transplant Obesity With Fatty Liver and Mets Risk: The Malnutrition In Excess Paradoxmentioning

confidence: 99%

“…Sarcopenia, evaluated by total psoas muscle area (tPMA) measurements from computed tomography (CT) imaging, was prevalent in patients with pediatric ESLD awaiting LT, highlighting the need for nutritional support before LT and/or after LT in the PICU [ 156 ]. Only one study [ 150 ] examined both muscle mass and muscle function in children with CLD, as recommended by the recent EWGSO consensus [ 157 ].…”

Section: Post-transplant Obesity With Fatty Liver and Mets Risk: The Malnutrition In Excess Paradoxmentioning

confidence: 99%

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Malnutrition in Pediatric Chronic Cholestatic Disease: An Up-to-Date Overview

et al. 2021

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Despite recent advances, the causes of and effective therapies for pediatric chronic cholestatic diseases remain elusive, and many patients progress to liver failure and need liver transplantation. Malnutrition is a common complication in these patients and is a well-recognized, tremendous challenge for the clinician. We undertook a narrative review of both recent and relevant older literature, published during the last 20 years, for studies linking nutrition to pediatric chronic cholestasis. The collected data confirm that malnutrition and failure to thrive are associated with increased risks of morbidity and mortality, and they also affect the outcomes of liver transplantation, including long-term survival. Malnutrition in children with chronic liver disease is multifactorial and with multiple potential nutritional deficiencies. To improve life expectancy and the quality of life, patients require careful assessments and appropriate management of their nutritional statuses by multidisciplinary teams, which can identify and/or prevent specific deficiencies and initiate appropriate interventions. Solutions available for the clinical management of these children in general, as well as those directed to specific etiologies, are summarized. We particularly focus on fat-soluble vitamin deficiency and malnutrition due to fat malabsorption. Supplemental feeding, including medium-chain triglycerides, essential fatty acids, branched-chain amino acids, and the extra calories needed to overcome the consequences of anorexia and high energy requirements, is reviewed. Future studies should address the need for further improving commercially available and nutritionally complete infant milk formulae for the dietary management of this fragile category of patients. The aid of a specialist dietitian, educational training regarding nutritional guidelines for stakeholders, and improving family nutritional health literacy appear essential.

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Body composition in pediatric patients

Zamberlan,

Mazzoni,

Bonfim

et al. 2023

Nut in Clin Prac

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Undernutrition is highly prevalent in children who are critically ill and is associated with increased morbidity and mortality, including a higher risk of infection due to transitory immunological disorders, inadequate wound healing, reduced gut function, longer dependency on mechanical ventilation, and longer hospital stays compared with eutrophic children who are critically ill. Nutrition care studies have proposed that early interventions targeting nutrition assessment can prevent or minimize the complications of undernutrition. Stress promotes an acute inflammatory response mediated by cytokines, resulting in increased basal metabolism and nitrogen excretion and leading to muscle loss and changes in body composition. Therefore, the inclusion of body composition assessment is important in the evaluation of these patients because, in addition to the nutrition aspect, body composition seems to predict clinical prognosis. Several techniques can be used to assess body composition, such as arm measurements, calf circumference, grip strength, bioelectrical impedance analysis, and imaging examinations, including computed tomography and dual‐energy x‐ray absorptiometry. This review of available evidence suggests that arm measurements seem to be well‐established in assessing body composition in children who are critically ill, and that bioelectrical impedance analysis with phase angle, handgrip strength, calf circumference and ultrasound seem to be promising in this evaluation. However, further robust studies based on scientific evidence are necessary.

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Sarcopenia in children and adolescents with chronic liver disease

Cited by 26 publications

References 26 publications

Low psoas muscle index as an unfavorable factor in children with end‐stage liver disease undergoing liver transplantation

Low psoas muscle index as an unfavorable factor in children with end‐stage liver disease undergoing liver transplantation

Malnutrition in Pediatric Chronic Cholestatic Disease: An Up-to-Date Overview

Body composition in pediatric patients

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