BACKGROUND Malnutrition is a common problem among children with chronic liver diseases (CLD). We aimed to assess the nutritional status of children with CLD and to correlate the anthropometric indices with the severity of liver disease, liver function tests, insulin growth factor-1 (IGF-1) and 25-hydroxy vitamin D (25- OH D). METHODS A total of 69 patients with CLD and 50 healthy controls (6 months - 6 years) were included in the study. Nutritional status was assessed by anthropometric indices expressed in standard deviation score (Z score), biochemical, hematological and clinical parameters. RESULTS We found 52.2% of CLD patients underweight by weight for age (W/A); 50.2% were stunted by height for age/ length for age (HAZ or LAZ); and 39% exhibited wasting by weight/height or (length) for age (W/HZ or W/LZ) z scores analysis. The mean values of z scores for all anthropometric parameters were significantly correlated with unconjugated and conjugated bilirubin and INR (p < 0.05), except HAZ or LAZ. Also, a significant correlation to albumin was found, except for W/HZ or (W/LZ) (p = 0.157). The z scores < - 2 SD based on W/ H versus arm indicators showed significant differences in MUAC, UAA and AMA (p < 0.001). We found no correlation between anthropometric z-scores and the mean IGF-1 and (25- OH D) values (p > 0.05). Malnutrition was directly correlated with the severity of hepatic dysfunction, particularly, Child-Pugh C cases. The mean IGF-1 and (25- OH D) values were significantly correlated with the severity of liver disease (p < 0.001). CONCLUSIONS Our results identified anthropometric arm indicators and MUAC/A measurements as an effective applied methods for assessing nutritional status in CLD children. Moreover, Integrating comprehensive clinical assessment, anthropometric measurements and objective biochemical analyses is essential for evaluation, follow-up and management of CLD children with variable degree of malnutrition.

中文翻译：

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埃及慢性肝病儿童营养不良的人体测量、生化和临床评估：一项单一机构横断面研究。

背景技术营养不良是患有慢性肝病（CLD）的儿童中的一个常见问题。我们的目的是评估 CLD 儿童的营养状况，并将人体测量指标与肝病严重程度、肝功能测试、胰岛素生长因子-1 (IGF-1) 和 25-羟基维生素 D (25- OH D) 相关联。方法 本研究共纳入 69 名 CLD 患者和 50 名健康对照者（6 个月至 6 岁）。营养状况通过以标准差评分（Z 评分）、生化、血液学和临床参数表示的人体测量指数进行评估。结果 我们发现 52.2% 的 CLD 患者按年龄体重计算体重不足 (W/A)；50.2% 的儿童因年龄身高/年龄身长（HAZ 或 LAZ）而发育迟缓；39% 的人表现出体重/身高或年龄（W/HZ 或 W/LZ）z 分数分析的（长度）消瘦。除 HAZ 或 LAZ 外，所有人体测量参数的 z 得分平均值与非结合胆红素和结合胆红素以及 INR 显着相关 (p < 0.05)。此外，除 W/HZ 或 (W/LZ) 外，还发现与白蛋白存在显着相关性 (p = 0.157)。基于 W/H 与手臂指标的 z 分数 < - 2 SD 显示 MUAC、UAA 和 AMA 存在显着差异 (p < 0.001)。我们发现人体测量 z 分数与平均 IGF-1 和 (25-OH D) 值之间没有相关性 (p > 0.05)。营养不良与肝功能障碍的严重程度直接相关，尤其是 Child-Pugh C 病例。平均 IGF-1 和 (25-OH D) 值与肝病的严重程度显着相关 (p < 0.001)。结论 我们的结果表明，人体测量手臂指标和 MUAC/A 测量是评估 CLD 儿童营养状况的有效应用方法。此外，综合临床评估、人体测量和客观生化分析对于不同程度营养不良的慢性肺病儿童的评估、随访和管理至关重要。