Дефицит массы тела у детей: особенности клинических проявлений и показателей пищевого статуса

Abstract

Objective. To assess body composition and actual nutrition in underweight children. Patients and methods. This study included 455 underweight children aged 3 months to 17 years 11 months (mean age: 7.1 [2.7; 13.1] years), of whom 251 (55.2%) were boys. Physical development was assessed according to the WHO criteria. Body composition was assessed in 243 children by bioelectrical impedance analysis using a portable analyzer “InBody S10” and a stationary analyzer “InBody 520” (Biospace Co. Ltd., Korea). Actual nutrition was measured in 214 patients. Results. Mild underweight was observed in 188 (41.3%) children, moderate and severe underweight – in 135 (29.7%) and 132 (29%) patients, respectively. Stunting was observed in 118 (25.9%) children, and severe stunting (Z-score < -3) was found in 71 (60.2%) children. In 53.5% of cases, severe malnutrition was diagnosed in patients with a Z-score of < -3. Manifestation of underweight in 82.7% of cases was noted before the age of 3 years. Deficiencies of body fat was registered in 213 (87.7%) children, muscle mass – in 183 (76.6%), body cell mass – in 152 (67%), protein – in 150 (63.3%), minerals – in 159 (67.1%), total body water – in 151 (62.1%). Low values of phase angle (<4.4) were recorded in 69 (45%) children. Analysis of the actual nutrition revealed a hypocaloric diet in 77.1% of cases, with isolated protein deficiency in 2 (0.9%) patients and protein-energy malnutrition in 31.8% of cases. Conclusion. As the duration of malnutrition increases in underweight children, the prevalence of severe forms of underweight and stunting increases. Key words: children, underweight, nutritional status, anthropometry, bioelectrical impedance analysis, actual nutrition