Sokol R J, Stall C
Department of Pediatrics, University of Colorado School of Medicine, Denver 80262.
Am J Clin Nutr. 1990 Aug;52(2):203-8. doi: 10.1093/ajcn/52.2.203.
To characterize type and age distribution of malnutrition and to determine the usefulness of anthropometric indices in children with chronic liver disease (CLD), 56 children (aged 1 mo-10 y) with CLD underwent anthropometric evaluation when they were clinically stable. Mean-height Z score was depressed, whereas mean-weight Z score was closer to normal and mean-weight/height Z score was normal in patients with extrahepatic biliary atresia, idiopathic neonatal hepatitis, and other liver disorders. Patients with arteriohepatic dysplasia showed more severe depression of all three variables. In all patients, triceps skinfold (TSF) thickness Z scores were significantly more depressed than were weight/height Z scores. Depressions of midarm-circumference and midarm-muscle-area Z scores were intermediate. Mean-head-circumference Z score was depressed in children aged less than 24 mo. We conclude that acute (wasting) and chronic (stunting) malnutrition are common in childhood CLD and that weight/height values underestimate the degree of acute malnutrition compared with TSF thickness, most likely because of the inflated patient weight caused by organomegaly.
为了描述营养不良的类型和年龄分布,并确定人体测量指标在慢性肝病(CLD)患儿中的实用性,56例年龄在1个月至10岁的CLD患儿在临床稳定时接受了人体测量评估。肝外胆道闭锁、特发性新生儿肝炎和其他肝脏疾病患儿的平均身高Z评分降低,而平均体重Z评分更接近正常,平均体重/身高Z评分正常。动脉肝发育不良患儿的所有三个变量均出现更严重的降低。在所有患儿中,三头肌皮褶(TSF)厚度Z评分比体重/身高Z评分显著降低更多。上臂围和上臂肌肉面积Z评分的降低程度居中。24个月以下儿童的平均头围Z评分降低。我们得出结论,急性(消瘦)和慢性(发育迟缓)营养不良在儿童CLD中很常见,与TSF厚度相比,体重/身高值低估了急性营养不良的程度,这很可能是由于器官肿大导致患儿体重增加。