ABSTRACT
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.
Subject(s)
Liver Diseases/complications , Malnutrition/diagnosis , Nutrition Assessment , Age Factors , Arm/anatomy & histology , Body Height , Body Weight , Carrier Proteins/blood , Case-Control Studies , Child , Child, Preschool , Chronic Disease , Cross-Sectional Studies , Egypt , Female , Growth Disorders/blood , Growth Disorders/diagnosis , Head/anatomy & histology , Humans , Infant , Insulin-Like Growth Factor I/analysis , Liver Diseases/blood , Liver Function Tests , Male , Malnutrition/blood , Malnutrition/etiology , Serum Albumin/analysis , Severity of Illness Index , Skinfold Thickness , Thinness/blood , Thinness/diagnosis , Vitamin D/analogs & derivatives , Vitamin D/blood , Wasting Syndrome/blood , Wasting Syndrome/diagnosisABSTRACT
The fat mass and obesity-associated (FTO) gene is recognized as the strongest predictor of obesity related traits such as insulin sensitivity and plasma glucose. The aim of this study was to investigate the association of the FTO rs17817449 genetic variant (G > T) polymorphism with risk of insulin resistance (IR) among Egyptian women. The variants in FTO rs17817449 were genotyped in 301 Egyptian women comprising two study groups, 150 women with IR and 151 healthy controls. The polymorphism of FTO rs17817449 was tested for association with IR. The frequencies of the FTO genotypes differed significantly between IR patients and healthy controls. Results revealed a significant association of TT genotype (OR, 2.33; 95% CI, 1.38-3.92; p = .001) and T-allele (OR, 1.55; 95% CI, 1.11-1.72; p .007) with IR. BMI, waist circumference, waist to hip and, body fat % were the highest in homozygotes TT genotype and the lowest in GG homozygotes in IR women but not observed in control subjects. Moreover, other abnormal metabolic risk parameters were significantly higher in TT carriers compared to GT and GG carriers in IR group. Association between FTO SNP (rs17817449) and IR was observed under recessive model. CONCLUSION: The present study suggests that FTO rs17817449 may have an important role in development of IR in Egyptian women.
