الفهرس | Only 14 pages are availabe for public view |
Abstract The aim of this study was to evaluate growth and nutritional status of children with CLD & to measure the level of IGF-1 and to identify the relation between its level to both the degree of malnutrition and the degree of hepatic dysfunction. This study included 50 Egyptian children (25 males and 25 females) recruited from the outpatient clinic of pediatric hepatology and from pediatric hepatology department of Pediatric Hospital, Cairo University. Their mean age was 2.05 years (ranged from 0.6 -5.75 years). Laboratory results were compared to 50 age and sex-matched children (control group). Anthropometric measurements, liver functions tests, serum level of IGF-1 & 25 (OH) D were performed to all subjects. Our results revealed that 54% of the patients were short, while malnutrition was identified in 70% of patients by TUAA, 62% by MUAC, 56% by TSFT, 56% by SSFT, 52% by MUAFA, 46% by MUAMA, 42% by Wt, 30% by Wt/Ht, and 22% by AFI. Moreover, MUAC was the most affected anthropometric parameter followed by TUAA, TSFT, MUAFA, Wt, MUAMA, SSFT, AFI, Wt/Ht respectively. Also, results showed that TSFT, SSFT and AFI z scores were significantly lower in Child Pugh C compared to Child Pugh B and A, and were significantly lower in Child Pugh B compared to Child Pugh A. In addition, Wt, Wt /Ht, MUAC, TUAA, MUAMA, and MUAFA z scores were significantly lower in Child Pugh C compared to Child Pugh A. Moreover, TUAA, MUAC, MUAMA, TSFT, SSFT, MUAFA and AFI z scores were significantly depressed in cholestatic group when compared to non cholestatic group, and were significantly depressed in children aged < 2 years old when compared to children aged ≥ 2 years old. Concerning serum IGF-1 & 25 (OH) D levels, both were significantly lower in patients compared to controls, and were significantly lower in Child Pugh C compared to Child Pugh B and A, and were significantly lower in Child Pugh B compared to Child Pugh A. Also, no significant correlation was found between any of the anthropometric parameters and serum IGF-1. It was concluded that growth retardation and malnutrition are common complications in children with CLD particularly when the liver disease is cholestatic, its onset is in infancy and with progression of liver disease severity. Moreover, it was concluded that the best anthropometric parameters, that can identify malnutrition in these patients, were TUAA, MUAC and TSFT. Also, in CLD patients, IGF-I level was reflecting the degree of liver dysfunction rather than the degree of malnutrition. |