Assessment of nutritional status of children with portal hypertension

Abstract

Introduction: Assessment of nutritional status of children with portal hypertension is an important prognostic factor which plays a significant role in the efficacy of their treatment. Aim: To assess the nutritional state of paediatric patients with portal hypertension through various methods of nutritional assessment and to investigate the usefulness of the techniques. Material and methods: The study group included 31 children with portal hypertension classified into 3 sub groups: patients with portal vein obstruction, biliary cirrhosis and post-hepatitic cirrhosis. The following anthropometrics data were measured: weight, body mass index (BMI), Cole's index and body mass rate (BMR). The body fat (BF) and fat-free mass (FFM) were measured by skin fold bioelectrical impedance assessment (BIA) and dual-energy X-ray absorptiometry (DEXA). The total body water percentage (TBW%) and extracellular fluid content were measured by bioelectrical impedance (BIA). Laboratory parameters such as albumins, cholesterol, vitamin levels (A, E and D), and trace elements (Fe, Zn) together with other biochemical markers were also assessed. The control group consisted of healthy children selected according to their age. Results and conclusions: Malnutrition, based on Cole's index and BMI < 10th percentile, was detected in 60% of children with biliary cirrhosis, 55.5% of those with post-hepatitic cirrhosis and 45.5% of those with portal vein obstruction, respectively. Fat-free mass, measured by different methods, remained stable in each group (r = 0.97). For BF, the correlation between anthropometry, BIA and DEXA was significantly lower. Total body water percentage was higher in children with biliary cirrhosis than in other groups (p < 0.05). Vitamin A concentration was decreased in each group (the lowest in children with biliary cirrhosis). No correlation between aminotransferase concentration and nutritional state was found.