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Utility of Subjective Global Nutritional Assessment Tool for the Assessment of Malnutrition in Pediatric Patients with Chronic Liver Disease

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주제분류소아과학

초록

Purpose: Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. Methods: This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. Results: A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), midupper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). Conclusion: In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.

Abstract

Purpose: Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. Methods: This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. Results: A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), midupper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). Conclusion: In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.

참고문헌 (14)

  1. Pawaria A, "38. Nutritional assessment in pediatric chronic liver diseases: subjective global nutritional assessment versus conventional anthropometry", J Clin Exp Hepatol, 8, pp.S120~ (2018)
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  8. Secker DJ, "Subjective Global Nutritional Assessment for children", Am J Clin Nutr, 85, pp.1083~1089 (2007)
  9. Acharya G, "Child-Turcotte-Pugh score, MELD score and MELD-Na score as predictors of short-term mortality among patients with end-stage liver disease in Northern India", Inflamm Intest Dis, 5, pp.1~10 (2020)
  10. El Koofy N, "Anthropometric, biochemical and clinical assessment of malnutrition among Egyptian children with chronic liver diseases : a single institutional cross-sectional study", BMC Gastroenterol, 19, pp.223~ (2019)
  11. Sudhakar P, "Nutritional status assessment by anthropometry in children with chronic liver disease aged 6 months to 12 years", Int J Contemp Pediatr, 6, pp.260~ (2019)
  12. da Silva FV, "Nutritional evaluation of children with chronic cholestatic disease", J Pediatr(Rio J), 92, pp.197~205 (2016)
  13. Schneider ACR, "Nutritional risk and malnutrition determination by anthropometry in cirrhotic children and adolescents", Arq Gastroenterol, 44, pp.345~349 (2007)[DOI]
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