Haliburton Beth, Mouzaki Marialena, Chiang Monping, Scaini Vikki, Marcon Margaret, Duan Wenming, Wilson David, Chiu Priscilla P L, Moraes Theo J
Department of Surgery, Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, 555 University Ave, M5G 1X8, Toronto, ON, Canada.
Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Ave, M5G 1X8, Toronto, ON, Canada.
J Pediatr Surg. 2017 Feb;52(2):252-256. doi: 10.1016/j.jpedsurg.2016.11.020. Epub 2016 Nov 14.
Malnutrition is common among congenital diaphragmatic hernia (CDH) survivors and may result from elevated respiratory effort. We evaluated body mass index (BMI), measured resting energy expenditure (mREE) and pulmonary function test (PFT) results in children and adolescents with CDH to determine if there is a correlation.
With ethics approval (REB# 1000035323), anthropometrics, indirect calorimetry (IC) results and PFTs were collected from patients 5-17years of age during CDH clinic visits between 2000 and 2016. Malnutrition was defined as BMI z-scores <-2.0; mREE (as percent predicted REE) was measured using IC; z-scores for forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) were normal if <-1.64.
GraphPad Prism 6, San Diego, CA.
RESULTS & DISCUSSION: Of 118 patients who attended clinic, 33 had reproducible PFTs, anthropometrics and IC results. Mean BMI z-score was -0.89±1.47 and 24% of patients were malnourished; mean FVC z-score (-1.32±1.39) was within normal range, whereas mean z-scores for FEV (-2.21±1.68) and FEV/FVC ratio (-1.78±0.73) were below normal. A correlation was noted between BMI and PFTs (FEV r=0.70, P<0.0001; FVC r=0.74 P<0.0001). Mean mREE was 112%±12% of expected and 67% of patients were hypermetabolic (mREE<110% predicted). IC results did not correlate with z-scores for either FEV (r=0.10, P=0.57); or FVC (r=0.28, P=0.12).
These preliminary results suggest that a correlation is present between BMI and lung function in CDH children and adolescents, whereas lung function does not seem to correlate with mREE.
II.
营养不良在先天性膈疝（CDH）幸存者中很常见，可能是由于呼吸功增加所致。我们评估了CDH患儿和青少年的体重指数（BMI）、测量的静息能量消耗（mREE）和肺功能测试（PFT）结果，以确定它们之间是否存在相关性。
经伦理批准（REB#1000035323），在2000年至2016年期间，收集了5至17岁CDH患者在门诊就诊时的人体测量学数据、间接测热法（IC）结果和PFT数据。营养不良定义为BMI z评分＜-2.0；使用IC测量mREE（作为预测REE的百分比）；如果1秒用力呼气量（FEV1）和用力肺活量（FVC）的z评分＜-1.64，则为正常。
使用加利福尼亚州圣地亚哥市GraphPad Prism 6软件。
在118名门诊患者中，33名患者的PFT、人体测量学和IC结果具有可重复性。平均BMI z评分为-0.89±1.47，24%的患者营养不良；平均FVC z评分（-1.32±1.39）在正常范围内，而FEV平均z评分（-2.21±1.68）和FEV/FVC比值平均z评分（-1.78±0.73）低于正常水平。BMI与PFT之间存在相关性（FEV，r=0.70，P＜0.0001；FVC，r=0.74，P＜0.0001）。平均mREE为预期值的112%±12%，67%的患者代谢亢进（mREE＜预测值的110%）。IC结果与FEV（r=0.10，P=0.57）或FVC（r=0.28，P=0.12）的z评分均无相关性。
这些初步结果表明，CDH患儿和青少年的BMI与肺功能之间存在相关性，而肺功能似乎与mREE无相关性。
II级。
