Evaluation of Anthropometric and Biochemical Status in Children with Nutritional Deficiency

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Abstract

Objective: To evaluate the anthropometric and biochemical status of children with nutritional deficiency. Methods: We have conducted a prospective study on 226 children admitted in Pediatric Clinic I, divided into two groups: one group of 49 children with nutritional deficiency (body-mass-index < -2SD) and one control group (177 children). We have followed demographic data, anthropometric indices evaluated as standard deviations (weight, height, middle upper-arm circumference, tricipital skinfold), biochemical proteic status (Insulin-like Growth Factor 1 IGF-1, albumin, total proteins). We also followed parameters of general nutritional biochemistry. Results: The mean age for underweight children was 5.8 years, lower than in the control group. The weight of the nutritional-deficient group was significantly lower than in the control group, unlike the height (p <0.001). We have also found significant differences in body-mass-index, middle upper-arm circumference and tricipital skinfold, all of them with low SDs in children with nutritional deficiency. Regarding the biochemical markers, we have found significantly higher values of transaminases (p <0.001) and lower IGF-1 (p = 0.02) and total proteins (p = 0.013) in nutritional-deficient group. Most IGF-1 values were in normal range in both groups, but with a higher percent of low values in nutritional deficient children (37.5% vs 14.2%, p = 0.0046). There were no significant differences in height, albumin, cholesterol, triglyceride and glucose levels between the two groups. Conclusions: The anthropometric measurements are the most precise methods in evaluating the nutritional status. Among the studied biochemical markers, IGF-1, total proteins and transaminases are correlated with nutritional deficiencies

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  • 1. Friedrich N Schneider HJ Haring R et al. Improved prediction of allcause mortality by a combination of serum total testosterone and insulinlike growth factor I in adult men. Steroids. 2012;77(1-2):52-8.

  • 2. Gude MF Frystyk J Flyvbjerg A et al. The production and regulation of IGF and IGFBPs in human adipose tissue cultures. Growth Horm IGF Res Off J Growth Horm Res Soc Int IGF Res Soc. 2012;22(6):200-5.

  • 3. Hoffman DJ Sawaya AL Verreschi I Tucker KL Roberts SB. Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from São Paulo Brazil. Am J Clin Nutr. 2000;72(3):702-7.

  • 4. Sawaya AL Martins PA Grillo LP Florencio TT. Long-term Effects of Early Malnutrition on Body Weight Regulation. Nutr Rev. 2004;62:S127-S133.

  • 5. Agarwal E Ferguson M Banks M et al. Malnutrition and poor food intake are associated with prolonged hospital stay frequent readmissions and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010. Clin Nutr Edinb Scotl. Epub 2012 Dec 5.

  • 6. Lim SL Ong KCB Chan YH et al. Malnutrition and its impact on cost of hospitalization length of stay readmission and 3-year mortality. Clin Nutr Edinb Scotl. 2012;31(3):345-50.

  • 7. Chang CY Trehan I Wang RJ et al. Children successfully treated for moderate acute malnutrition remain at risk for malnutrition and death in the subsequent year after recovery. J Nutr. 2013;143(2):215-20.

  • 8. WHO | WHO Child Growth Standards: Methods and development [Internet]. WHO. [cited 2013 Jun 9]. Available from: http://www.who.int/ childgrowth/standards/technical_report/en/index.html

  • 9. Mihaela Ioana C Maria Despina B Alina G Oana M. Compoziţia corporală la copiii cu boală malignă. Rev Rom Pediatr. 2012;LXI(1):42-9.

  • 10. BodyMeasures_09.pdf [Internet]. [cited 2013 Jun 7]. Available from: http:// www.cdc.gov/nchs/data/nhanes/nhanes_09_10/BodyMeasures_09.pdf

  • 11. Sicotte M Ledoux M Zunzunegui M-V Aboubacrine SA Nguyen V-K. Reliability of anthropometric measures in a longitudinal cohort of patients initiating ART in West Africa. BMC Med Res Methodol. 2010 22;10(1):102.

  • 12. Crespi CM Alfonso VH Whaley SE Wang MC. Validity of child anthropometric measurements in the Special Supplemental Nutrition Program for Women Infants and Children. Pediatr Res. 2012;71(3):286-92.

  • 13. Ulijaszek SJ Kerr DA. Anthropometric measurement error and the assessment of nutritional status. Br J Nutr. 1999;82(3):165-77.

  • 14. Stomfai S Ahrens W Bammann K et al. Intra- and inter-observer reliability in anthropometric measurements in children. Int J Obes. 2011;35(S1):S45-S51.

  • 15. Mei Z Grummer-Strawn LM Pietrobelli A et al. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr. 2002;75(6):978-85.

  • 16. Ashwell M Gunn P Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012;13(3):275-86.

  • 17. Bertoli S Cardinali S Veggiotti P et al. Evaluation of nutritional status in children with refractory epilepsy. Nutr J. 2006;5(1):14.

  • 18. Olack B Burke H Cosmas L et al. Nutritional Status of Under-fi ve Children Living in an Informal Urban Settlement in Nairobi Kenya. J Health Popul Nutr. 2011;29(4):357-63.

  • 19. Wamani H Astrom AN Peterson S Tumwine JK Tylleskar T. Boys are more stunted than girls in Sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC Pediatr. 2007;7:17.

  • 20. Kurz KM. Adolescent nutritional status in developing countries. Proc Nutr Soc. 1996;55(1B):321-31.

  • 21. Young VR Marchini JS Cortiella J. Assessment of protein nutritional status. J Nutr. 1990;120(S11):1496-502.

  • 22. Pass C MacRae VE Ahmed SF Farquharson C. Infl ammatory cytokines and the GH/IGF-I axis: novel actions on bone growth. Cell Biochem Funct. 2009;27(3):119-27.

  • 23. Gupta N Lustig RH Kohn MA McCracken M Vittinghoff E. Sex differences in statural growth impairment in Crohn’s disease: role of IGF-1. Infl amm Bowel Dis. 2011;17(11):2318-25.

  • 24. Andreassen M Frystyk J Faber J Kristensen LØ. GH activity and markers of infl ammation: a crossover study in healthy volunteers treated with GH and a GH receptor antagonist. Eur J Endocrinol. 2012;166(5):811-9.

  • 25. Thissen JP Ketelslegers JM Underwood LE. Nutritional regulation of the insulin-like growth factors. Endocr Rev. 1994;15(1):80-101.

  • 26. Livingstone C. The Insulin-Like Growth Factor System and Nutritional Assessment. Scientifi ca [Internet]. 2012 Jul 29 [cited 2013 Jun 8];2012. Available from: http://www.hindawi.com/journals/scientifi ca/2012/768731/abs/

  • 27. Walker WA Watkins JB. Nutrition in Pediatrics: Basic Science and Clinical Applications. PMPH-USA; 2003. p. 1128.

  • 28. Hanachi M Melchior JC Crenn P. Hypertransaminasemia in severely malnourished adult anorexia nervosa patients: Risk factors and evolution under enteral nutrition. Clin Nutr. 2013;32(3):391-5.

  • 29. Chowdhury MSI Rahman AZ Haque M Nahar N Taher A. Serum Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) Levels in Different Grades of Protein Energy Malnutrition. J Bangladesh Soc Physiol. 2007;2(0):17-9.

  • 30. Nwosu BU Stavre ZG Maranda L Cullen K Lee MM. Hepatic dysfunction is associated with vitamin D defi ciency and poor glycemic control in diabetes mellitus. J Pediatr Endocrinol Metab JPEM. 2012;25(1-2):181-6.

  • 31. Bouillanne O Hay P Liabaud B et al. Evidence that albumin is not a suitable marker of body composition-related nutritional status in elderly patients. Nutrition. 2011;27(2):165-9.

  • 32. Lark RK Williams CL Stadler D et al. Serum prealbumin and albumin concentrations do not refl ect nutritional state in children with cerebral palsy. J Pediatr. 2005;147(5):695-7.

  • 33. Bennett F Walker S Gaskin P Powell C. Fasting levels of serum glucose cholesterol and triglyceride at age eleven to twelve years in stunted and non-stunted Jamaican children. Acta Pædiatrica. 2002;91(9):903-8.

  • 34. Bandsma RHJ Spoelstra MN Mari A et al. Impaired Glucose Absorption in Children with Severe Malnutrition. J Pediatr. 2011;158(2):282-287.e1.

  • 35. Das BK Ramesh J Agarwal JK Mishra OP Bhatt RP. Blood sugar and serum insulin response in protein-energy malnutrition. J Trop Pediatr. 1998;44(3):139-41.

  • 36. Mishra SK Bastola SP Jha B. Biochemical nutritional indicators in children with protein energy malnutrition attending Kanti Children Hospital Kathmandu Nepal. Kathmandu Univ Med J KUMJ. 2009;7(26):129-34.

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