Laboratory indicators of nutritional status in children with cerebral palsy

Abstract

Children with cerebral palsy are at high risk of developing nutritional disorders: malnutrition, osteopenia, micronutrient deficiency. This is facilitated by motor disorders, restriction of actual nutrition, the presence of concomitant drug therapy, and metabolic features.Purpose. The study aims at evaluation of laboratory markers of nutritional status in children with cerebral palsy.Material and methods: for a comprehensive assessment of nutritional status disorders, a cross-sectional analytical study of 175 children with cerebral palsy was carried out. Laboratory studies included the determination in blood of: total protein, glucose, ALT, AST, total and direct bilirubin, cholesterol, creatinine, urea, vitamins A, E, B12, folic acid, magnesium, phosphorus, calcium, serum iron, zinc, total iron-binding ability, ferritin, 25-OH vitamin D, parathyroid hormone.Results. Only in 5 (3%) children all the studied laboratory parameters were within the reference values. The most frequently observed in children with cerebral palsy were: 25-OH vitamin D insufficiency/deficiency in 68% of children, a decrease in folic acid levels in 32%, an increase in vitamin B12 in 32%, a decrease in cholesterol in 26% and creatinine in 16.6%, a decrease in phosphorus in 14.5%, serum iron in 12.4% and an increase in magnesium in 10.3%.Conclusion. The detected deficiency of some indicators is most likely associated with an unbalanced actual diet of patients with cerebral palsy, although the reduced intake of certain vitamins and microelements was not always reflected in their blood concentrations (vitamin A, E, magnesium, calcium). The levels of zinc, vitamin B12 and A did not decrease in any of the examined children, which casts doubt on the recommendations of ESPGHAN experts in terms of prescribing them to all children with cerebral palsy in routine clinical practice.

Evaluation of micronutrient status in pediatric palliative care clinic: a single-center cross-sectional study

“…In the same study, Carman et al reported that children with CP exhibited low levels of zinc, vitamin A, phosphorus, and manganese [22]. In another study conducted on patients with CP, 14.5% of patients exhibited phosphorus de ciency [23]. In accordance with the ndings of previous studies, our investigation revealed hypophosphatemia in 18.3% of patients.…”

“…The vitamin B12 de ciency observed in our patient was lower than that observed in other studies (1.1%) [8, 23,32]. In addition, along with iron parameters, vitamin B12 was the only vitamin that did not correlate with age.…”

“…In a separate study, elevated vitamin B12 levels were observed in 32% of the patients with CP [23]. Elevated vitamin B12 levels were found to be 4.…”

“…In studies conducted on children with CP, magnesium levels were lower than those in the control group [23,31]. Hypomagnesemia was reported in 45% and hypermagnesemia in 12% of patients with a history of chronic disease [20].…”

“…previous study revealed that 67.5% of children with CP had inadequate daily dietary folate intake[36]. Folic acid de ciency has also been reported in 32% of patients with CP[23]. İspiroğlu et al reported a folate de ciency of 10% in their study of patients who could not feed themselves due to neurological disease[32].…”