Body Composition Predicts Growth in Infants and Toddlers With Chronic Liver Disease

Abstract

This cross-sectional study was conducted on 15 infants and toddlers with chronic liver disease to validate arm anthropometry as an accurate measure of body composition (BC) compared to dual-energy x-ray absorptiometry and to predict growth from BC. The z score means of the anthropometric indicators were <-2 standard deviation, except for body fat index and subscapular skinfold, which were between -2 and +2 standard deviation. Fat mass was predicted by arm adiposity indicators and fat-free mass by arm muscle area. Bone mineral content explained 87% of variation in length. Two multiple regression models predicted length: 1 with fat mass plus fat-free mass; and the second with fat mass and bone mineral content. These observations suggest that arm anthropometry is a useful tool to estimate BC and the nutritional status in infants and toddlers with chronic liver disease. Length and head circumference can be predicted by fat mass, fat-free mass, and bone mineral content.

Higher Mortality in Pediatric Liver Transplant Candidates With Sarcopenia

“…The validity of these standard measurements is confounded by organomegaly, fluctuating ascites, and stunting of height progression, therefore not adequately reflecting malnutrition. ( 14 ) Measurement of PMSA allows for a novel assessment of nutritional status, unaffected by organomegaly and fluid overload. Practically, however, the correlation between PMSA z score and MAC z score supports the current use of MAC anthropometrics in clinical practice as a rapid and effective method to assess muscle bulk in the office setting.…”

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

“…Once digestion and absorption have been completed after a meal, the nutrients from the diet reach the liver through the portal vein, except for fats bound to lipoproteins that arrive through the systemic circulation (1). Damage to the specialized functions of the diseased liver severely disturbs the health and homeostasis of the body, which may be particularly critical in infants during the first growth spurt (17)(18)(19)(20)(21)(22) (Figure 1).…”

“…This early and serious condition has been related to impaired absorption of vitamin D and calcium, failure of the hepatic hydroxylation phase, lack of vitamin D stores, and systemic inflammation (27)(28)(29)(30). This bone disorder appears to be a significant predictor of linear growth retardation (19). Measuring fat-soluble vitamin A, D, and E levels in the serum of patients with CLDC is an alternative for estimating the nutritional status of these micronutrients, at least from the point of view of their serum levels (34)(35)(36).…”

Nutritive status peculiarities, assessment and correction in chronic liver diseases in children

“…Показ ник довжини тіла/зросту є ефективним у дов готривалій перспективі, оскільки змінюється зазвичай через кілька тижнів або навіть міся ців після виникнення порушення нутритивно го статусу. У зв'язку з такими особливостями показників маси та зросту NASPGHAN та ESPGHAN рекомендують визначати обвід середньої третини плеча (ОСТП) і товщину шкірної складки над трицепсом (ТШСТ), оскільки вони не залежать від наявності над лишкової води в організмі, органомегалії, а також дають змогу об'єктивно визначити нутритивний статус та відстежити його дина міку в короткотривалій перспективі [32,49,84]. Так, у дослідженні 91 дитини з ХЗП, середній вік яких становив 12 місяців, у 44% виявлено зменшення показника ОСТП, у 64% -показ ника ТШСТ; натомість зменшення показника відношення маси тіла до віку встановлено лише у 33% дітей [16].…”