Body composition and phase angle as an indicator of nutritional status in children with juvenile idiopathic arthritis

Abstract

BackgroundJuvenile idiopathic arthritis (JIA) is the most common chronic, systemic autoimmune connective tissue disease diagnosed in children and adolescents. An important aspect of monitoring of children with JIA is a precise assessment of the nutritional status to identify children and adolescents at risk of malnutrition. The aim of the study was to assess the body composition and phase angle in children diagnosed with JIA in comparison to age and sex matched healthy children since there are scarce reports in paediatric patients.MethodsA total of 46 children and adolescents aged 4–18 years, with JIA were included in the cross-sectional study. Controls were selected from the group of healthy children and adolescents. Children with diagnosed JIA and healthy children were strictly matched for age and gender. In both groups BIA with phase angle calculation was performed.ResultsPhase angle score was significantly lower in the study group compared to control group (5.45 ± 0.64 vs. 5.85 ± 0.80, p = 0.010). Also lower percentage of body cell mass (50.63 ± 3.46 vs. 52.70 ± 4.06, p = 0.010) and muscle mass (46.02 ± 6.32 vs. 49.53 ± 6.67, p = 0.005) were revealed. In the analysis of subtypes of JIA we found significant differences between children and adolescents with polyarthritis compared to control group, while no significant differences were found between patients with oligoarthritis and control group.ConclusionsThe obtained results indicate a higher risk of malnutrition in children and adolescents with JIA compared to healthy peers, predominantly in patients with polyarthritis.

Body composition monitoring in children and adolescents: reproducibility and reference values

“…Body composition measurements are gaining interest in the scientific scene of chronic diseases [24][25][26] as well as childhood obesity [27,28]. Reliable tools for measuring the various compartments of the body are therefore essential in order to perform research in a standardized manner in the most optimal circumstances.…”

Adiposity Is Related to Inflammatory Disease Activity in Juvenile Idiopathic Arthritis

“…However, few studies have evaluated the association between adiposity and/or obesity and inflammatory activity in JIA. Given that most of these studies base their evaluation on anthropometric values and not DXA values [17,24,26,27,50], they may not suitably reflect patients' fat content. In fact, only one study addressed body composition analysis with DXA, although it was restricted to girls [27], and another used bioelectrical impedance analysis [17].…”

“…Given that most of these studies base their evaluation on anthropometric values and not DXA values [17,24,26,27,50], they may not suitably reflect patients' fat content. In fact, only one study addressed body composition analysis with DXA, although it was restricted to girls [27], and another used bioelectrical impedance analysis [17]. In our study, however, we used both anthropometric values and body composition by DXA, which is currently considered the gold standard for evaluating this parameter [51].…”

“…Delayed growth [7][8][9], reduced muscle and bone mass [10][11][12][13], and nutritional deficiency [14][15][16] are the most commonly reported long-term complications in the polyarticular [17], systemic [6,18,19], and oligoarticular [20] subtypes. Some of these abnormalities have been associated with more marked disease activity, reduced physical exercise [10], and more frequent use of glucocorticoids [8,21].…”

“…In contrast, the inclusion of biologics in therapy has improved disease control, growth, and body composition [2,6,7,19,[21][22][23]. Nevertheless, recent years have seen reports of overweight and obese children affected by the disease [17,[24][25][26][27]. The main potential causes of this phenomenon include greater calorie intake [28], reduced physical exercise, disability [19,29], inflammation of lower limb joints [4], disease subtype, treatments used [26], or a combination of all these factors [17].…”