Anthropometric, biochemical and clinical assessment of malnutrition among Egyptian children with chronic liver diseases: a single institutional cross-sectional study

Koofy, Nehal El; Moawad, Eman Mohamed Ibraheim; Fahmy, Mona; Mohamed, Mona Anwar; Mohamed, Hany Fathy Ahmed; Eid, Ehab Mohamed; Zaki, Moushira Erfan; El-Sayed, Rokaya

doi:10.1186/s12876-019-1145-3

Cited by 8 publications

(10 citation statements)

References 47 publications

(49 reference statements)

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“…In contrast, our study showed that MUAC was a more sensitive parameter than triceps SFT, as it correlated better with bilirubin. In agreement with our findings, El Koofi et al reported a slightly better correlation of MUAC‐Z than triceps SFT with bilirubin 20 . Our study showed greater sensitivity of MUAC and triceps SFT in detecting malnutrition, compared with WFA and LFA.…”

Section: Discussionsupporting

confidence: 92%

Body composition correlates with laboratory parameters and disease severity in infants with biliary atresia

Marderfeld

Waisbourd‐Zinman

Biran

et al. 2021

Pediatric Transplantation

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Aim Infants with biliary atresia (BA) generally have chronic malnutrition. However, the best anthropometric measure to assess malnutrition and its correlation with disease severity is unknown. We aimed to assess correlations of various anthropometric measurements, including air displacement plethysmography (ADP), with laboratory parameters and with the pediatric end‐stage liver disease (PELD) score in infants with BA. Methods Infants with BA were followed at a pediatric liver transplantation center during 2014–2018. Follow‐up comprised laboratory tests and nutritional assessment by a dietitian including dietary intake, weight, height, mid‐upper arm circumference (MUAC), and skin‐fold thickness. Fat‐free mass (FFM) and fat mass (FM) were measured by ADP. Results Forty‐three nutritional evaluations were performed in 28 infants with BA (13 boys, 44.4%). The median age was 20.7 weeks (IQR: 13–25.9). Based on the various anthropometry modalities, infants with BA were found to be malnourished on most of the visits; 63% had a MUAC‐Z score lower than −2 standard deviations. High serum bilirubin level predicted lower weight for age, length for age, and MUAC‐Z. Lower MUAC‐Z was associated with a higher PELD score. Neither FM mass nor FFM correlated with PELD or with serum bilirubin level. However, FM correlated with skin‐fold thickness‐Z and was low in most patients. Conclusions The majority of BA infants suffer from malnutrition as assessed by most anthropometrics modalities; low MUAC correlated best with disease severity and serum bilirubin level. Further studies are warranted to determine the contribution of FM measurement by ADP to the anthropometric assessment of infants with BA.

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Section: Discussionsupporting

confidence: 92%

Body composition correlates with laboratory parameters and disease severity in infants with biliary atresia

Marderfeld

Waisbourd‐Zinman

Biran

et al. 2021

Pediatric Transplantation

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“…3. Blood albumin level: Before the first surgery, the average blood albumin level in venous blood of all patients was 37.06 ± 0.51 g/L, which was significantly lower than the normal value (40-55 g/L) according to the nutrition status analysis of healthy children in the same age (6). This result indicated that the pre-operative nutrition status was generally poor.…”

Section: Resultsmentioning

confidence: 82%

“…The consensus also pointed out that during the treatment of children, the weight may not change with the changes in body composition at the same time, so the BMI index may not be accurate enough as the only nutritional evaluation index, and the degree of malnutrition may also be underestimated for newborns and small-month-old infants at the first administration to hospitals. Based on previous studies (6,22), for every 1 g/L decrease in serum albumin concentration, the mortality rate of hospitalized children increased by 137%, and the staying time in the ICU and ward were increased by 28 and 71%, respectively. The blood albumin level can be used as a mature independent indicator for the nutrition status evaluation of children with disease.…”

Section: Discussionmentioning

confidence: 91%

Study on the Effect of Bilateral Mandible Distraction Osteogenesis About the Nutrition Status of Infants With Pierre-Robin Sequence

et al. 2021

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Objective: By comparing and studying the changes of food intake, weight, body length, BMI, blood albumin level and other indicators of infants with Pierre-Robin Sequence (PRS) before and after Bilateral Mandible Distraction Osteogenesis operation, to explore the effect of distraction osteogenesis on PRS patients about the improvement of nutrition status.Methods: The children with PRS who admitted to the Oral and Maxillofacial Surgery Department of Guangzhou Women and Children's Medical Center from July 2015 to December 2020 were selected. All patients accepted bilateral mandible distraction osteogenesis surgery, and the pre- and post-operative indicators were recorded, such as food intake, weight, length, blood albumin level and others. BMI was calculated based on the indicators mentioned above, and comparative statistical analysis was performed.Results: 1. All patients were fed with whole milk before the first surgery, and the average calorie per kg was 91.8 kcal/kg, significantly lower than the standard (100–150 kcal/kg), suggesting the overall nutritional intake of PRS patients is low; 2. t tests for independent samples were used to analyze the pre-operative and post-operative indicators. The WFA percentile increased from 14.16 ± 2.17 to 15.01 ± 1.85% (P = 0.0048), WFA z score increased from −2.40 ± 0.18 to −1.90 ± 0.14 after the surgery (P = 0.0010), LFA percentile increased from 20.04 ± 3.48 to 33.67 ± 4.29% (P = 0.0098), LFA z score increased from −2.09 ± 0.19 to −1.42 ± 0.23 (P = 0.0009), BMI z score increased from −1.95 ± 0.22 to −1.39 ± 0.16 (P = 0.0408), ALB raised from 37.06 ± 0.51 to 42.85 ± 0.30 g/L (P < 0.001), which indicating that the physique of patients improved after the distraction osteogenesis surgery, mainly was reflected by the lifting of weight and length growth curves; the body shape also improved, indicating that the patients' nutrition status after the surgery is also improved.Conclusion: Bilateral mandible distraction osteogenesis surgery has a positive effect on the nutrition status of children with PRS. This effect is mainly reflected by the improvements of the body physical indicators after surgery.

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“…Osteodystrophy associated with CCLD has a multicausal etiology, including malabsorption of vitamin D, poor bone accretion of calcium, and systemic chronic inflammation with increased expression of IL-4 ( 28 – 31 ). In addition to decreased cell mass ( 31 ), decreased availability of energy, and impaired fat absorption ( 32 ), these factors seem to be related to the linear growth and head circumference growth retardation that is almost universally present in these patients, particularly in those with biliary atresia ( 2 , 20 , 31 , 33 ).…”

Section: Pathophysiology Of Secondary Malnutrition In Infants With Ccldmentioning

confidence: 99%

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

Larrosa‐Haro

Caro-Sabido²

2021

Front. Nutr.

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We aimed to conduct an updated review on the pathophysiology, diagnosis, and nutritional intervention of CCLD and secondary malnutrition in infants. Protein-energy malnutrition, impaired linear growth, fat-soluble vitamin deficiencies, and hepatic osteodystrophy can occur in up to 80% of cases. The proposed pathophysiological mechanisms include insufficient energy intake, lipid- and fat-soluble vitamin malabsorption, increased energy expenditure, altered intermediate metabolism, hormonal dysregulation, and systemic inflammation. The current approach to diagnosis is the identification of the deviation of growth parameters, body composition, and serum concentration of micronutrients, which determines the type and magnitude of malnutrition. Currently, liver transplantation is the best therapeutic alternative for the reversal of nutritional impairment. Early and effective portoenteroanatomosis can extend survival in patients with biliary atresia. Medical and dietary interventions in some storage and metabolic diseases can improve liver damage and thus the nutritional status. A proportion of patients with biliary atresia have fat-soluble vitamin deficiencies despite receiving these vitamins in a water-soluble form. With aggressive enteral nutrition, it may be possible to increase fat stores and preserve muscle mass and growth. The nutritional issues identified in the pre- and post-transplantation stages include muscle mass loss, bone demineralization, growth retardation, and obesity, which seems to correspond to the natural history of CCLD. Due to the implications for the growth and development of infants with CCLD with this complex malnutrition syndrome, innovative projects are required, such as the generation of prediction and risk models, biomarkers of growth and body composition, and effective strategies for nutritional prevention and intervention.

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Anthropometric, biochemical and clinical assessment of malnutrition among Egyptian children with chronic liver diseases: a single institutional cross-sectional study

Cited by 8 publications

References 47 publications

Body composition correlates with laboratory parameters and disease severity in infants with biliary atresia

Body composition correlates with laboratory parameters and disease severity in infants with biliary atresia

Study on the Effect of Bilateral Mandible Distraction Osteogenesis About the Nutrition Status of Infants With Pierre-Robin Sequence

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

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