Di Gioia Giuseppe, Creta Antonio, Fittipaldi Mario, Giorgino Riccardo, Quintarelli Fabio, Satriano Umberto, Cruciani Alessandro, Antinolfi Vincenzo, Di Berardino Stefano, Costanzo Davide, Bettini Ranieri, Mangiameli Giuseppe, Caricato Marco, Mottini Giovanni
Department of Medicine and Surgery, Cardiology Unit, Università Campus Bio-Medico di Roma, Rome, Italy.
Paediatric Cardiothoracic Surgery, Starship Greenlane Paediatric and Congenital Heart Service, Auckland, New Zealand.
PLoS One. 2016 May 3;11(5):e0154523. doi: 10.1371/journal.pone.0154523. eCollection 2016.
Malnutrition among children population of less developed countries is a major health problem. Inadequate food intake and infectious diseases are combined to increase further the prevalence. Malnourishment brings to muscle cells loss with development of cardiac complications, like arrhythmias, cardiomyopathy and sudden death. In developed countries, malnutrition has generally a different etiology, like chronic diseases. The aim of our study was to investigate the correlation between malnutrition and left ventricular mass in an African children population.
313 children were studied, in the region of Antsiranana, Madagascar, with age ranging from 4 to 16 years old (mean 7,8 ± 3 years). A clinical and echocardiographic evaluation was performed with annotation of anthropometric and left ventricle parameters. Malnutrition was defined as a body mass index (BMI) value age- and sex-specific of 16, 17 and 18,5 at the age of 18, or under the 15th percentile. Left ventricle mass was indexed by height2.7 (LVMI).
We identified a very high prevalence of children malnutrition: 124 children, according to BMI values, and 100 children under the 15th percentile. LVMI values have shown to be increased in proportion to BMI percentiles ranging from 29,8 ± 10,8 g/m2.7 in the malnutrition group to 45 ± 15,1 g/m2.7 in >95th percentile group. LVMI values in children < 15th BMI percentile were significantly lower compared to normal nutritional status (29,8 ± 10,8 g/m2,7 vs. 32,9 ± 12,1 g/m2,7, p = 0.02). Also with BMI values evaluation, malnourished children showed statistically lower values of LVMI (29,3 ± 10,1 g/m2,7 vs. 33,6 ± 12,5 g/m2,7, p = 0.001).
In African children population, the malnourishment status is correlated with cardiac muscle mass decrease, which appears to be reduced in proportion to the decrease in body size.
欠发达国家儿童群体中的营养不良是一个主要的健康问题。食物摄入不足和传染病共同作用,进一步增加了患病率。营养不良会导致肌肉细胞流失,并引发心脏并发症,如心律失常、心肌病和猝死。在发达国家,营养不良通常有不同的病因,如慢性疾病。我们研究的目的是调查非洲儿童群体中营养不良与左心室质量之间的相关性。
对马达加斯加安齐拉纳纳地区的313名儿童进行了研究,年龄在4至16岁之间(平均7.8±3岁)。进行了临床和超声心动图评估,并记录了人体测量和左心室参数。营养不良的定义为18岁时特定年龄和性别的体重指数(BMI)值分别为16、17和18.5,或低于第15百分位数。左心室质量通过身高的2.7次方进行指数化(左心室质量指数,LVMI)。
我们发现儿童营养不良的患病率非常高:根据BMI值,有124名儿童,100名儿童低于第15百分位数。LVMI值显示随着BMI百分位数的增加而增加,从营养不良组的29.8±10.8 g/m2.7到>第95百分位数组的45±15.1 g/m2.7。BMI百分位数<15的儿童的LVMI值与正常营养状况相比显著更低(29.8±10.8 g/m2.7 vs. 32.9±12.1 g/m2.7,p = 0.02)。同样通过BMI值评估,营养不良的儿童LVMI值在统计学上更低(29.3±10.1 g/m2.7 vs. 33.6±12.5 g/m2.7,p = 0.001)。
在非洲儿童群体中,营养不良状态与心肌质量减少相关,心肌质量减少似乎与体型减小成比例。