Effects of Malnutrition on Left Ventricular Mass in a North-Malagasy Children Population

Abstract

BackgroundMalnutrition among children population of less developed countries is a major health problem. Inadequate food intake and infectious diseases are combined to increase further the prevalence. Malnourishment brings to muscle cells loss with development of cardiac complications, like arrhythmias, cardiomyopathy and sudden death. In developed countries, malnutrition has generally a different etiology, like chronic diseases. The aim of our study was to investigate the correlation between malnutrition and left ventricular mass in an African children population.Methods313 children were studied, in the region of Antsiranana, Madagascar, with age ranging from 4 to 16 years old (mean 7,8 ± 3 years). A clinical and echocardiographic evaluation was performed with annotation of anthropometric and left ventricle parameters. Malnutrition was defined as a body mass index (BMI) value age- and sex-specific of 16, 17 and 18,5 at the age of 18, or under the 15th percentile. Left ventricle mass was indexed by height2.7 (LVMI).ResultsWe identified a very high prevalence of children malnutrition: 124 children, according to BMI values, and 100 children under the 15th percentile. LVMI values have shown to be increased in proportion to BMI percentiles ranging from 29,8 ± 10,8 g/m2.7 in the malnutrition group to 45 ± 15,1 g/m2.7 in >95th percentile group. LVMI values in children < 15th BMI percentile were significantly lower compared to normal nutritional status (29,8 ± 10,8 g/m2,7 vs. 32,9 ± 12,1 g/m2,7, p = 0.02). Also with BMI values evaluation, malnourished children showed statistically lower values of LVMI (29,3 ± 10,1 g/m2,7 vs. 33,6 ± 12,5 g/m2,7, p = 0.001).ConclusionIn African children population, the malnourishment status is correlated with cardiac muscle mass decrease, which appears to be reduced in proportion to the decrease in body size.

Impact of Ethnicity on the Prevalence of Early Repolarization Pattern in Children: Comparison Between Caucasian and African Populations

“…An additional finding of this study was that Malagasy children showed a significant longer QT/QTc interval compared to the Caucasians. As we previously reported [23], malnutrition was common among Malagasy children included in this study. It is possible that malnutrition might cause some changes in the cardiac repolarization, leading to a prolongation of the QT interval [24].…”

Assessment of Myocardial Function in Kenyan Children With Severe, Acute Malnutrition

“…As demonstrated previously, 18 , 31 , 32 , 33 we found evidence of reduced myocardial mass. However, when adjusted for BSA, 34 few significant differences relative to reference values were evident. Similarly, the prevalence of abnormal cardiac function indices, when stratified by BSA, was proportionate to published cutoff levels.…”

Association Between Food Insecurity and Key Metabolic Risk Factors for Diet-Sensitive Non-Communicable Diseases in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

“…All twenty-two included studies were cross-sectional by design, and each of the studies focused on the different geographic settings, distributed across four regions of the sub-Saharan Africa (see Figure 2). A large proportion of the studies (n = 10 studies) was conducted in urban settings, [24][25][26][27][28][29][30][31][32][33] and four studies were conducted in rural settings only. [34][35][36][37] One study was conducted in a periurban 38 and one study in a semi-rural setting.…”

“…[40][41][42][43][44][45] Overall, the studies selected for inclusion (n = 22 studies) involved a total of 26 609 participants, 12 453 (46.8%) participants were males, and one study recruited only women of reproductive age living in informal settlements in Accra, Ghana 29 . The distribution of the rest of the studies by countries was as follows: 4 from Ethiopia, 25,27,40,41 ; 1 Nigeria, 24 ; 1 Madagascar, 26 ; 3 Ghana, 29,38,39 ; 1 Zambia, 37 ; 2 Tanzania, 28,35 ; 1 Malawi, 34 ; 1 Cameroon, 33 ; 2 Sudan, 30,31 ; 1 Burkina Faso, 42 ; 1 Kenya, 32 ; 1 Botswana, 45 and 3 studies from South Africa 36,43,44 . Figure 2 shows the study distribution from the four regions of sub-Saharan Africa, with only 1 study from Central Africa 33 and…”

“…32,37,40 Another subset (n = 9 studies) measured food insecurity at an individual level using the Minimum Adequate Diet criterion, 24,25,27,31,33,36,37,42,43 the Minimum Dietary Diversity criterion (n = 5 studies), 28,29,38,39,45 and the last subset (n = 4 studies) used more than one tool to gauge food insecurity. 30,37,44,45 While studies on children ≤ 5 years used the Minimum Meal Frequency criterion, 30 the Weight-for-height criterion, 34 and the Quetelet index 26 to ascertain food insecurity. See Table 1…”