Abstract
Introduction: Anthropometric assessment of the nutritional status may be inaccurate in children with advanced chronic liver disease (CLD) due to liver and spleen enlargement, ascitis and distal edema. Arm anthropometrics may be a diagnostic alternative in these patients. Objective: To compare arm vs. conventional anthropometric indexes in the nutritional diagnosis of children and adolescents with CLD. Methods: Design. Cross-sectional. Setting. A referral pediatric hospital n = 79 Inclusion. Age 2-194 months, diagnosis of CLD. Variables: Liver function tests, pediatric end stage liver disease score (PELD); anthropometrical indexes: weight for height, height for age, mid arm circumference, tricipital skinfold; total, muscular and fat arm areas. Methods Conventional anthropometric technique and instruments, criteria of normality > or <2DE, NCHS reference pattern. Statistics Frequencies, %, chi-square, Fisher test, means, SD, Student t. Results: 54% females, mean age 72.6 months. Diagnosis: Biliary atresia 27.8%, idiopatic CLD 12.7%, Alagille syndrome 8.9%. Liver damage: Infants had higher PELD scores, 60% had esophageal varices, 58% liver fibrosis and 28% cirrhosis. Nutritional Status: 24 to 62% had growth impairment, being infants and preschooler the most affected groups. Weight for height <−2SD was identified in 8 to 20% age groups. Arm indexes identified cases <−2DE from 12 to 85%, being infants and preschoolers the most frequently affected. Arm indexes significantly identified more cases <−2DE in all age groups than weight for height. Conclusions: Growth impairment was identified in all age groups. Arm indexes identified more cases <−2 DE than weight for height and weight for age. Arm indexes may become a better anthropometric tool for the diagnosis of nutritional status in children with CLD and may predict better the degree of liver damage than indexes that weight and height indexes.
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