Yavuz Sevgi, Kıyak Aysel, Er Ali, Korkmaz Orhan
Division of Pediatric Nephrology, Kanuni Sultan Suleyman Training and Research Hospital, 34303, Istanbul, Turkey.
Department of Radiology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Eur J Pediatr. 2015 Oct;174(10):1393-7. doi: 10.1007/s00431-015-2535-3. Epub 2015 Apr 29.
We aimed to evaluate anthropometric and bioimpedance analysis (BIA) indices of children with nutcracker syndrome (NCS). Eighteen patients and 20 age-gender matched controls were enrolled. Weight, height, body mass index (BMI), mid-arm circumference (MAC), waist circumference (WC), waist/hip ratio measurements, and BIA results were assessed. Laboratory parameters and Doppler sonographic findings were recorded. The weight, BMI, MAC, WC, body fat z scores, and waist/hip ratio were significantly lower in patients than in controls (p < 0.05). Serum creatinine (Scr), albumin, HDL cholesterol, and urine protein (Up) were significantly increased in NCS patients compared to controls (p < 0.05). On multivariate analysis, body fat z score was independently related to Up and the degree of superior mesenteric artery (SMA) angle (beta = -0.965, p = 0.018 and beta = 0.841, p = 0.04, respectively).
NCS might be considered in slim proteinuric patients with unproven etiology. Serial anthropometric measurements and BIA analysis would estimate the severity of entrapment in LRV. Long-term follow-up of Scr might be required in NCS.
• Nutcracker syndrome (NCS) is very rare and characterized by the compression of LRV between aorta and SMA. What is new: • Patients with NCS have a slimmer body feature with lower anthropometric and BIA indices. • Fat percentage indicates the degree of LRV entrapment and amount of proteinuria in NCS.
我们旨在评估胡桃夹综合征(NCS)患儿的人体测量学指标和生物电阻抗分析(BIA)指标。纳入了18例患者和20例年龄及性别匹配的对照。评估了体重、身高、体重指数(BMI)、上臂中部周长(MAC)、腰围(WC)、腰臀比测量值以及BIA结果。记录了实验室参数和多普勒超声检查结果。患者的体重、BMI、MAC、WC、体脂z评分和腰臀比均显著低于对照组(p < 0.05)。与对照组相比,NCS患者的血清肌酐(Scr)、白蛋白、高密度脂蛋白胆固醇和尿蛋白(Up)显著升高(p < 0.05)。多因素分析显示,体脂z评分与Up及肠系膜上动脉(SMA)夹角程度独立相关(β = -0.965,p = 0.018;β = 0.841,p = 0.04)。
病因不明的瘦型蛋白尿患者可能患有NCS。连续的人体测量和BIA分析可评估左肾静脉受压的严重程度。NCS患者可能需要对Scr进行长期随访。
• 胡桃夹综合征(NCS)非常罕见,其特征是左肾静脉在主动脉和SMA之间受压。新发现:• NCS患者身体更瘦,人体测量学指标和BIA指标更低。• 脂肪百分比表明NCS患者左肾静脉受压程度和蛋白尿水平。