Pediatric sarcopenia: exploring a new concept in children with chronic liver disease

Merli, Manuela

doi:10.1016/j.jped.2019.08.001

Cited by 10 publications

(10 citation statements)

References 16 publications

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“…Only 2 studies included in our review assessed both muscle mass and muscle function ( 36 , 42 ), as recommended by EWGSOP, yielding inadequate values of SO prevalence. The assessment of muscle function is crucial for the assessment of sarcopenia, since muscle strength is not linearly related to muscle mass ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

“…Whereas only one study warranted reference values regarding CT-derived parameters of muscle mass in children ( 29 ). Assessment of muscle function should always be performed, since muscle strength is not linearly related to muscle mass ( 30 ). In older children and adolescents, strength and performance tests utilized in adults such as handgrip test, chair stand test, Timed Up and Go test, 6-min walk test, stair climb power test, and 400-m walk test can be used ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

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Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Zembura

Matusik

2022

Front. Endocrinol.

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Sarcopenic obesity (SO) is defined as co-occurrence of increased fat mass and sarcopenia and may predict adverse health outcomes in the pediatric population. However, the prevalence of SO and its association with adverse health outcomes have not been well defined in children and adolescents. We systematically reviewed data on the SO definition, prevalence, and adverse outcomes in the pediatric population. A total of 18 articles retrieved from PubMed or Web of Science databases were included. Overall, there was a wide heterogeneity in the methods and thresholds used to define SO. The prevalence of SO ranged from 5.66% to 69.7% in girls, with a range between 7.2% and 81.3% in boys. Of the 8 studies that evaluated outcomes related to SO, all showed a significant association of SO with cardiometabolic outcomes, non-alcoholic fatty liver disease (NAFLD) severity, inflammation, and mental health. In conclusion, this review found that SO is highly prevalent in children and adolescents and is associated with various adverse health outcomes. Findings of this review highlight the need for the development of a consensus regarding definition, standardized evaluation methods, and age and gender thresholds for SO for different ethnicities in the pediatric population. Further studies are needed to understand the relationship between obesity and sarcopenia and SO impact on adverse health outcomes in children and adolescents.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Zembura

Matusik

2022

Front. Endocrinol.

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“…Furthermore, age-, ethnicity-, and gender-specific reference values are infrequently established for children. 5 Here, we look to provide a broad overview of sarcopenia, focusing on the emerging literature describing its prevalence and impact in children with chronic liver disease.…”

Section: Introductionmentioning

confidence: 99%

Perspectives on Sarcopenia as a Predictor for Outcomes in Pediatric Patients with Chronic Liver Disease

Chen¹,

Ayers²,

Squires³

et al. 2022

HMER

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Sarcopenia, a pathologic deficiency of muscle mass and function, has emerged as an important secondary feature of many chronic disease states. For adults with end stage liver disease, there are multiple mechanisms which contribute to sarcopenia and its presence has proven to be an important predictor of morbidity and mortality. In children, there are only a limited number of reports which investigate the role of sarcopenia in liver disease. These studies, which are discussed and summarized in this review, report small, single-center analyses with dissimilar study cohorts and varying clinical definitions. Still, children meeting the study entry criteria have sarcopenia with a reported prevalence of 24–70%. When assessed, sarcopenia appears to be associated with more severe disease but is independent of the Pediatric End-Stage Liver Disease (PELD) score and does not correlate with age, gender, or traditional anthropometric measures such as weight, height, weight-for-height, or body mass index (BMI). While individual studies may identify sarcopenia as a statistically significant risk factor for certain post-transplant outcomes such as longer ICU stay, longer duration of intubation, repeat operation, development of serious infection, longer hospital stay, death, or long-term growth failure, such associations are not consistently replicated across studies. Finally, although various methods of muscle mass quantification are utilized, the most reported is the total psoas muscle surface area (tPMSA) on computed tomography. This method, along with others such as skeletal muscle area and skeletal muscle index, have had normative values recently defined and these collective efforts should enable researchers a common basis of comparison when delineating sarcopenia, and its impact, across various study populations in future investigations – including in children with liver disease.

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“…Sarcopenia is a clinical condition characterized by the reduction of muscle mass and function and has been shown to play a relevant role in malnutrition (3,4). Sarcopenia typically affects older or adult patients with chronic diseases, but it has recently been recognized in the pediatric literature with a growing interest, especially in CLD (5)(6)(7). Overall, knowledge on sarcopenia is limited by the lack of uniform definitions and similarities of principles with malnutrition, which could lead to the co-occurrence of both clinical conditions with overlapping risk in children with growth failure, neurodevelopmental delay, and postoperative outcome (8,9).…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes

Veraldi

Pietrobattista²,

Soglia³

et al. 2022

Front. Pediatr.

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Sarcopenia is a clinical condition characterized by a reduction in muscle mass, which typically affects adult patients; however, it has recently been recognized in pediatric literature. Few studies in children with chronic liver disease (CLD) undergoing liver transplantation (LT) have investigated the role of sarcopenia, with controversial results. The aim of our study was to assess the prevalence and impact of sarcopenia among children with CLD who are candidates for LT. We conducted a retrospective, single-center study at Bambino Gesù Children's Hospital (Rome, Italy) from July 2016 to July 2021, evaluating all children (0–16 years old) with CLD listed for LT with an abdomen computed tomography imaging available before LT. The total psoas muscle surface area (t-PMSA) was defined as the sum of left and right psoas muscle surface area measured at L4–L5 on axial images. The t-PMSA z-score was calculated according to reference data, and sarcopenia was defined as a t-PMSA z-score of ≤−2 (1–16 years) or a psoas muscle index [PMI; PMI = t-PMSA/(100 × BSA)] of <50th percentile of the population examined (<1 year). Clinical, laboratory, and LT outcome data were collected from all the patients with CLD. 27 out 48 (56%) of the patients aged 1–16 years were sarcopenic. No differences were noted in anthropometrics, nutritional support, liver function tests, model for ESLD (MELD), or pediatric ESLD (PELD) scores between patients with and without sarcopenia. The former showed a higher prevalence of respiratory complications (66.7% vs. 42.1%) and need for inotropes (40.7% vs. 10.8%) after LT. Among patients aged 0–1 years (n: 36), those with reduced muscle mass (50%) had a longer hospitalization time (44 vs. 24 days) and higher incidences of multi-organ failure syndrome (38.9% vs. 0%) and intensive care unit-related infections (61.1% vs. 27.8%) compared to those with greater muscle mass. t-PMSA and PMI were statistically significant predictors of LT outcomes. Sarcopenia is a reliable index of frailty in children with CLD, as its presence is associated with the risk of a more challenging LT. Future studies will have to investigate the functional aspects of sarcopenia and conceive preventive measures of muscle wasting in CLD patients.

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Pediatric sarcopenia: exploring a new concept in children with chronic liver disease

Cited by 10 publications

References 16 publications

Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Perspectives on Sarcopenia as a Predictor for Outcomes in Pediatric Patients with Chronic Liver Disease

Sarcopenia in children with chronic liver disease: Prevalence and impact on liver transplant outcomes

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