Nutritional evaluation of children with chronic cholestatic disease
Journal Title: Jornal de Pediatria - Year 2016, Vol 92, Issue 2
Abstract
Objective To evaluate the nutritional status of children with persistent cholestasis and to compare the anthropometric indices between children with and without liver cirrhosis and children with and without jaundice. Methods Children with persistent cholestasis, i.e. increased direct bilirrubin or changes in the canalicular enzyme gamma-glutamyl transferase (GGT), were included. The anthropometric measures were weight (W), height or length (H), arm circumference (AC), triceps skinfold thickness (TST), arm muscle circumference (AMC), and body mass index (BMI). Results Ninety-one children with cholestasis, with current median age of 12 months, were evaluated. W/age (A) and H/A indices below −2 Z-scores were observed in 33% and 30.8% of patients, respectively. Concerning the W/H index and BMI, only 12% and 16% of patients, respectively, were below −2 Z-scores. Regarding AC, 43.8% of 89 evaluated patients had some depletion. Observing the TST, 64% of patients had depletion, and 71.1% of the 45 evaluated patients had some degree of depletion regarding the ACM index. Conclusion Evaluation using weight in patients with chronic liver diseases may overestimate the nutritional status due to visceromegaly, subclinical edema, or ascites. Indices that correlate weight and height, such as W/H and BMI, may also not show depletion because of the chronic condition in which there are depletion of both weight and height. TST, AC, and ACM are parameters that better estimate nutritional status and should be part of the management of patients with liver diseases and cholestasis.
Authors and Affiliations
Alexandre Ferreira
Keywords
Related Articles
- EP ID EP553604
- DOI 10.1016/j.jped.2015.07.006
- Views 66
- Downloads 0
Variations in the number of births by day of the week, and morbidity and mortality in very-low-birth-weight infants
Objective To know the distribution of births of very low birth weight infants by day of the week, and whether this distribution affects the morbidity and mortality in this group of patients. Methods This was a retrospec...
Application of tactile/kinesthetic stimulation in preterm infants: a systematic review
Objective To verify the methods used by the clinical trials that assessed the effect of tactile/kinesthetic stimulation on weight gain in preterm infants and highlight the similarities and differences among such studies....
Ultra-processed food consumption among infants in primary health care in a city of the metropolitan region of São Paulo, Brazil
Objective To analyze the prevalence of ultra-processed food intake among children under one year of age and to identify associated factors. Methods A cross-sectional design was employed. We interviewed 198 mothers of ch...
Trends in breastfeeding indicators in a city of northeastern Brazil
Objective To investigate trends in breastfeeding indicators in the city of Feira de Santana, Brazil, and to identify population characteristics that might have influenced this trend. Methods Three methodologically compa...
Factors associated with objectively measured total sedentary time and screen time in children aged 9–11 years
Objective To identify factors associated with total sedentary time and screen time in children aged 9–11 years. Methods For seven consecutive days, 328 children (51.5% boys) used accelerometers to monitor total sedentar...