Yu Ronghua, Wang Yizhong, Xiao Yongmei, Mo Lili, Liu Aishu, Li Dan, Ge Ting, Yu Guangjun, Zhang Ting
Department of Gastroenterology, Hepatology, and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, People's Republic of China.
Department of Children's Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, People's Republic of China.
J Nutr Sci. 2017 Oct 30;6:e55. doi: 10.1017/jns.2017.56. eCollection 2017.
Nutritional status of 380 hospitalised children aged from 1 month to 5 years with liver disease was evaluated in a single paediatric centre. The total prevalence of stunting (height-for-age (HAZ) < -2), underweight (weight-for-age (WAZ) < -2) and wasting (weight-for-height < -2) was 9·8, 9·0 and 7·9 %, respectively. The overall nutritional risk (-2 ≤ < -1) of stunting, underweight and wasting was 11·8, 12·9 and 12·6 %. The prevalence of undernutrition was significantly higher in children with cholestasis than children without cholestasis (stunting, 17·5 %/4·4 %, < 0·001, and underweight, 14·9 %/4·9 %, < 0·001). HAZ and WAZ scores were significantly higher in children without cholestasis than children with cholestasis (0·58 (sd 1·59)/-0·68 (sd 1·99), < 0·001, and 0·37 (sd 1·35)/-0·47 (sd 1·75), < 0·001). Further multivariate logistic regression analysis strengthened the evidence that cholestasis was significantly associated with undernutrition of stunting (OR = 4·18, = 0·002) and underweight (OR = 3·26, = 0·008), and suggested that the prevalence of stunting caused by infection was lower than other aetiologies in hospitalised children with liver disease (OR = 0·10, = 0·002). We concluded that a high prevalence of malnutrition and risk of undernutrition presents in hospitalised young children with liver disease, especially in children with cholestasis. Nutrition assessment is recommended for hospitalised children with liver disease.
在一家儿科中心对380名年龄在1个月至5岁之间的住院肝病患儿的营养状况进行了评估。发育迟缓(年龄别身高(HAZ)<-2)、体重不足(年龄别体重(WAZ)<-2)和消瘦(身高别体重<-2)的总患病率分别为9.8%、9.0%和7.9%。发育迟缓、体重不足和消瘦的总体营养风险(-2≤<-1)分别为11.8%、12.9%和12.6%。胆汁淤积患儿的营养不良患病率显著高于无胆汁淤积患儿(发育迟缓,17.5%/4.4%,<0.001;体重不足,14.9%/4.9%,<0.001)。无胆汁淤积患儿的HAZ和WAZ评分显著高于胆汁淤积患儿(0.58(标准差1.59)/-0.68(标准差1.99),<0.001;0.37(标准差1.35)/-0.47(标准差1.75),<0.001)。进一步的多因素逻辑回归分析强化了以下证据:胆汁淤积与发育迟缓(比值比=4.18,=0.002)和体重不足(比值比=3.26,=0.008)的营养不良显著相关,并表明在住院肝病患儿中,感染导致的发育迟缓患病率低于其他病因(比值比=0.10,=0.002)。我们得出结论,住院肝病幼儿中营养不良的患病率很高且存在营养不足风险,尤其是胆汁淤积患儿。建议对住院肝病患儿进行营养评估。