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.