Abstract
SummaryBackground & aimsThe use of handgrip strength (HGS) as a proxy of nutritional status in sick children has not been studied. This study created HGS centile charts in healthy children and explored the utility of HGS z-scores as markers of body composition and screening of malnutrition risk in sick children.MethodsData from 535 healthy children aged 5–16 years were used for the development of HGS centiles adjusted either for age or height. In 595 sick children, relationships between HGS z-scores with body composition, malnutrition risk (Paediatric Yorkhill Malnutrition Score-PYMS), length of hospital stay (LOS) and biomarkers of disease severity were explored. The use of HGS z-score to identify sick children in need of further dietetic assessment was investigated.ResultsChildren scoring at high malnutrition risk with PYMS had lower HGS z-scores for age (by 0.51 SD, p < 0.001) and height (by 0.46 SD, p = 0.001) than those who scored low. A HGS z-score at cut-offs of ˗0.81 SD and ˗1.2 SD for age and height, respectively, was predictive of need for dietetic intervention in sick children with sensitivity of 79% and 70% and specificity of 56% and 69%, respectively. HGS z-scores were predictive of fat free mass (FFM) in sick and healthy (all p < 0.001) children, while fat mass was not. HGS z-scores were inversely related with plasma CRP (rho, age: ˗0.21; height: ˗0.23, both p = 0.001). HGS was not predictive of LOS.ConclusionHGS is predictive of FFM, could compliment assessment of malnutrition risk, and may help identify children for further dietetic intervention on admission to hospital.
Highlights
Handgrip strength (HGS) is a quantitative measure of muscle function
535 healthy and 595 sick children were included in the study. 343 (58%), 105 (17%) and 147 (25%) of the sick children were from the medical inpatient, surgical inpatient, and gastroenterology outpatient wards, respectively (Table 1, Fig. 1)
The current study aimed to develop centile charts of handgrip strength (HGS) in healthy children (Fig. 2) and subsequently evaluate their use as nutritional status indices in a large cohort of sick children
Summary
Handgrip strength (HGS) is a quantitative measure of muscle function. It is non-invasive, inexpensive, and fast to obtain making it suitable to use at the bedside in routine clinical practice. Whether HGS could be used as a screening method of malnutrition risk in sick children admitted to hospital has not yet been studied. In 595 sick children, relationships between HGS z-scores with body composition, malnutrition risk (Paediatric Yorkhill Malnutrition Score-PYMS), length of hospital stay (LOS) and biomarkers of disease severity were explored. The use of HGS z-score to identify sick children in need of further dietetic assessment was investigated. A HGS z-score at cut-offs of À0.81 SD and À1.2 SD for age and height, respectively, was predictive of need for dietetic intervention in sick children with sensitivity of 79% and 70% and specificity of 56% and 69%, respectively. Conclusion: HGS is predictive of FFM, could compliment assessment of malnutrition risk, and may help identify children for further dietetic intervention on admission to hospital.
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