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Myopenia and Reduced Subcutaneous Adiposity in Children With Liver Disease Are Associated With Adverse Outcomes
Author(s) -
Ooi Poh Hwa,
Mazurak Vera C.,
Bhargava Ravi,
DunichandHoedl Abha,
Ayala Romero Rocio,
Gilmour Susan M.,
Yap Jason YK,
Mager Diana R.
Publication year - 2021
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1963
Subject(s) - medicine , sarcopenia , adipose tissue , liver disease , magnetic resonance imaging , body mass index , lumbar , gross motor skill , anthropometry , parenteral nutrition , gastroenterology , pediatrics , surgery , radiology , motor skill , psychiatry
Background Sarcopenia is defined as reduced skeletal muscle mass (SMM) or myopenia and altered muscle function and physical performance. It is unknown whether myopenia in children with end‐stage liver disease (ESLD) adversely impacts clinical outcomes. We hypothesized that myopenia was prevalent in children with ESLD and related to suboptimal nutrition intake contributing to gross motor and growth delay, increased hospitalization, and medical complications. Methods This retrospective study evaluated abdominal imaging (computed tomography/magnetic resonance imaging) for SMM (total, psoas, paraspinal, abdominal wall muscle; cm 2 /height 2 ) and adipose tissue (total, visceral, subcutaneous adipose tissue [SAT], ) determinations at the third and fourth lumbar vertebrates during liver transplantation (LTx) assessment. ESLD children (n = 30) were age‐ and gender‐matched to healthy controls (n = 24). Myopenia was defined as SMM index z score <‐2 and low SAT was defined as SAT index z ‐score <‐1.5. Anthropometric, biochemical, and clinical data (hospitalization, complications, growth, neurodevelopment, energy/protein intake) were collected at LTx assessment, LTx, and post LTx (first hospitalization, 6 months, 12 months). Results Four distinct body composition phenotypes in children with ESLD were found: (1) myopenia with low SAT (17%;5 of 30), (2) myopenia (3%;1 of 30), (3) low SAT (20%;6 of 30), (4) normal muscle mass and SAT (60%;18 of 30). Myopenia with low SAT was prevalent in older (>2 years), male children and was associated with gross motor delay, reduced energy intake, and increased hospitalization and infections (total/viral/fungal). Conclusions Myopenia, accompanied by low SAT in children with ESLD, is associated with adverse clinical outcomes. Rehabilitation strategies aimed at combating myopenia in children are important.