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Kronik Karaciğer Hastalığı Nedeniyle Karaciğer Nakli Yapılan Çocuklarda Malnütrisyonun Değerlendirilmesinde Antropometrik Ölçümler ve Büyüme Faktörleri

Year 2022, , 257 - 269, 31.05.2022
https://doi.org/10.46237/amusbfd.950515

Abstract

Amaç: Kronik karaciğer hastalığı, özellikle insülin benzeri büyüme faktörü-1 (IGF-1) ve insülin benzeri büyüme faktörü bağlayıcı protein-3 (IGF-BP3) başta olmak üzere büyüme faktörü proteinlerinin yapı ve işlevindeki değişikliklerle birlikte çocuklarda büyüme geriliğine neden olur. Bu çalışmanın amacı, antropometrik parametreler (AP) ve büyüme faktörü proteinlerini kullanarak karaciğer nakli (LT) yapılan kronik karaciğer hastalığı olan çocuklarında beslenme durumunu değerlendirmektir.
Yöntem: Karaciğer nakli uygulanan 33 hasta ve 54 sağlıklı çocuk değerlendirildi. Hastaların AP'leri karaciğer nakli öncesi ve nakilden 1, 3, 6 ve 12 ay sonra değerlendirildi. Antropometrik parametreler, IGF-1/IGFBP-3 düzeyleri ve Child-Pugh skorları arasındaki ilişki analiz edildi.
Bulgular: Kronik karaciğer hastalığı olan çocuklarda, nakil öncesi boya göre ağırlık (WFH) dışındaki tüm antropometrik ölçümler kontrol grubuna göre daha düşüktü (p<0.05). Child-Pugh skoru ile triseps deri kıvrım kalınlığı (TSF) (r=-0.387, p=0.026) ve orta-üst kol çevresi (MUAC) Z-skoru (r=-0.448, p=0.009) arasında negatif bir ilişki vardı. IGF-I ve IGFBP-3 düzeyleri, nakil öncesi hasta grubunda ortalama 35.24±14.68 ng/ml ve 1.31±0.9 µg/ml olup, kontrol grubundan daha düşüktü (69.88±67.45 ng/ml ve 3.2±1µg/ml) (sırası ile p=0.001 ve p=0.000). 12 ay sonra, hasta grubunun yaşa göre boy Z skoru (HFA) (-0.7±1.46) kontrol grubundan daha düşük (0.08±0.9) (p=0.01) iken, TSF Z skoru (0.24±0.8) ve orta kol kas alanı (MAMA) (20.67±20.28) kontrol grubundan daha yüksekti (p=0.009, p=0.004). IGF-1 ve IGFBP-3 düzeyleri nakil öncesi dönemden daha yüksekti (p=0.000). IGF-1 ve IGFBP-3 seviyeleri ile AP arasında ilişki saptanmadı.
Sonuç: Kronik karaciğer hastalığı nedeniyle karaciğer nakli yapılan hastalarda malnütrisyon takibinde antropometrik parametreler IGF-1 ve IGFBP-3'e göre daha güvenilirdir.

References

  • 1. Sokol, R. J., Stall, C. (1990). Anthropometric evaluation of children with chronic liver disease. The American journal of clinical nutrition, 52(2), 203-208.
  • 2. Heubi, J. E., Heyman, M. B., Shulman, R. J. (2002). The impact of liver disease on growth and nutrition. Journal of pediatric gastroenterology and nutrition, 35 Suppl 1, S55-S59.
  • 3. Hurtado-López, E. F., Larrosa-Haro, A., Vásquez-Garibay, E. M., Macías-Rosales, R., Troyo-Sanromán, R., Bojórquez-Ramos, M. C. (2007). Liver function test results predict nutritional status evaluated by arm anthropometric indicators. Journal of pediatric gastroenterology and nutrition, 45(4), 451-457.
  • 4. Addo, O. Y., Himes, J. H., Zemel, B. S. (2017). Reference ranges for midupper arm circumference, upper arm muscle area, and upper arm fat area in US children and adolescents aged 1-20 y. The American journal of clinical nutrition, 105(1), 111-120.
  • 5. Jaswant, S., Nitish, M. (2014). Use of upper-arm anthropometry as measure of body-composition and nutritional assessment in children and adolescents (6-20 years) of Assam, Northeast India. Ethiopian journal of health sciences, 24(3), 243-252.
  • 7. Rosenbloom AL, Connor EL. (2007). Hypopituitarism and other disorders of the growth hormone-insulin-like growth factor-I axis.Lifshitz F (Ed.), Pediatric Endocrinology. 5th ed. (ss.65-90). New York: Informa Healthcare.
  • 7. Colakoğlu, O., Taşkiran, B., Colakoğlu, G., Kizildağ, S., Ari Ozcan, F., Unsal, B. (2007). Serum insulin like growth factor-1 (IGF-1) and insulin like growth factor binding protein-3 (IGFBP-3) levels in liver cirrhosis. The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 18(4), 245-249.
  • 8. Holt, R. I., Broide, E., Buchanan, C. R., Miell, J. P., Baker, A. J., Mowat, A. P., et al. (1997). Orthotopic liver transplantation reverses the adverse nutritional changes of end-stage liver disease in children. The American journal of clinical nutrition, 65(2), 534-542.
  • 9. Infante, D., Tormo, R., Castro de Kolster, C., Potau, N., Martínez, V., Broto, J., et al. (1998). Changes in growth, growth hormone, and insulin-like growth factor-I (IGF-I) after orthotopic liver transplantation. Pediatric surgery international, 13(5-6), 323-326.
  • 10. Sarna, S., Sipilä, I., Jalanko, H., Laine, J., Holmberg, C. (1994). Factors affecting growth after pediatric liver transplantation. Transplantation proceedings, 26(1), 161-164.
  • 11. Centers for Disease Control and Prevention (CDC). Epi-InfoTM 6 statistical analysis program Web site. http://www.cdc.gov/epiinfo/epi6/EI6dnjp.htm.
  • 12 Bundak R, Neyzi O. (2002). Büyüme. Neyzi O, Ertuğrul T (Ed.),Pediatri. 3. baskı. (ss:85-99). İstanbul: Nobel Tıp Kitabevi.
  • 13. McDowell, M. A., Fryar, C. D., Ogden, C. L., Flegal, K. M. (2008). Anthropometric reference data for children and adults: United States, 2003–2006. National health statistics reports, (10), 1-48.
  • 14. Urgancı, N., Çakır, D., Papatya, E., Polat, T. B. (2006). Anthropometric evaluation in chronic liver disease patients. TürkPediatriArşivi41(4), 214-220.
  • 15. Bartosh, S. M., Thomas, S. E., Sutton, M. M., Brady, L. M., Whitington, P. F. (1999). Linear growth after pediatric liver transplantation. The Journal of pediatrics, 135(5), 624-631.
  • 16. Codoner-Franch, P., Bernard, O., Alvarez, F. (1994). Long-term follow-up of growth in height after successful liver transplantation. The Journal of pediatrics, 124(3), 368-373.
  • 17. Renz, J. F., de Roos, M., Rosenthal, P., Mudge, C., Bacchetti, P., Watson, et al. (2001). Posttransplantation growth in pediatric liver recipients. Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 7(12), 1040-1055.
  • 18. Saito, T., Mizuta, K., Hishikawa, S., Kawano, Y., Sanada, Y., Fujiwara, T., et al. (2007). Growth curves of pediatric patients with biliary atresia following living donor liver transplantation: factors that influence post-transplantation growth. Pediatric transplantation, 11(7), 764-770.
  • 19. Shen, X. Y., Holt, R. I., Miell, J. P., Justice, S., Portmann, B., Postel-Vinay, M. C., et al. (1998). Cirrhotic liver expresses low levels of the full-length and truncated growth hormone receptors. The Journal of clinical endocrinology and metabolism, 83(7), 2532-2538.
  • 20. Møller, S., Juul, A., Becker, U., Henriksen, J. H. (2000). The acid-labile subunit of the ternary insulin-like growth factor complex in cirrhosis: relation to liver dysfunction. Journal of hepatology, 32(3), 441-446.
  • 21. Weber, M. M., Auernhammer, C. J., Lee, P. D., Engelhardt, D., Zachoval, R. (2002). Insulin-like growth factors and insulin-like growth factor binding proteins in adult patients with severe liver disease before and after orthotopic liver transplantation. Hormone research, 57(3-4), 105-112.
  • 22. Bassanello, M., De Palo, E. F., Lancerin, F., Vitale, A., Gatti, R., Montin, et al. (2004). Growth hormone/insulin-like growth factor 1 axis recovery after liver transplantation: a preliminary prospective study. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 10(5), 692-698.
  • 23. Sarna, S., Sipilä, I., Vihervuori, E., Koistinen, R., Holmberg, C. (1995). Growth delay after liver transplantation in childhood: studies of underlying mechanisms. Pediatric research, 38(3), 366-372.
  • 24. Caregaro, L., Alberino, F., Amodio, P., Merkel, C., Angeli, P., Plebani, M., et al (1997). Nutritional and prognostic significance of insulin-like growth factor 1 in patients with liver cirrhosis. Nutrition 13(3), 185-190.
  • 25. Holt, R. I., Crossey, P. A., Jones, J. S., Baker, A. J., Portmann, B., Miell, J. P. (1997). Hepatic growth hormone receptor, insulin-like growth factor I, and insulin-like growth factor-binding protein messenger RNA expression in pediatric liver disease. Hepatology, 26(6), 1600-1606.

Anthropometric Measurements and Growth Factors in the Evaluation of Malnutrition in Children with Liver Transplantation due to Chronic Liver Disease

Year 2022, , 257 - 269, 31.05.2022
https://doi.org/10.46237/amusbfd.950515

Abstract

Objective: Chronic liver disease (CLD) causes growth retardation in children, together with the changes in the structure and function of growth factor proteins, especially the insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGF-BP3). The aim of this study was to evaluate nutritional status of children with CLD undergone liver transplantation (LT) by using anthropometric parameters (AP), and growth factor proteins.
Method: Thirty-three patients undergone LT and 54 healthy children were evaluated. The AP of the patients were determined before and 1, 3, 6, and 12 months after LT. Relationship between AP, IGF-1/IGFBP-3 levels and Child-Pugh scores were analyzed.
Results: In children with CLD, all anthropometric measurements except weight for height (WFH) before transplantation were lower than the control group (p<0.05). There was a negative correlation between Child-Pugh score and triceps skinfold thickness (TSF) (r=-0.387, p=0.026) and mid-upper arm circumference (MUAC) Z-score (r=-0.448, p=0.009). IGF-I and IGFBP-3 levels were 35.24±14.68 ng/ml and 1.31±0.9 µg/ml in the pre-transplant patient group and were lower than the control group (69.88±67.45 ng/ml and 3.2±1 µg/ml) (respectively p=0.001 and p=0.000). After 12 months, the patient group's height-for-age (HFA) Z score (-0.7±1.46) was lower than the control group (0.08±0.9) (p=0.01), while TSF Z score (0.24±0.8) and mid- arm muscle area (MAMA) (20.67±20.28) was higher than the control group (p=0.009, p=0.004). IGF-1 and IGFBP-3 levels were higher than before transplantation (p=0.000). No correlation was found between IGF-1 and IGFBP-3 levels and AP.
Conclusion: AP are more reliable for the follow-up of malnutrition in patients undergone LT due to CLD, when compared to IGF-1 and IGFBP-3.

References

  • 1. Sokol, R. J., Stall, C. (1990). Anthropometric evaluation of children with chronic liver disease. The American journal of clinical nutrition, 52(2), 203-208.
  • 2. Heubi, J. E., Heyman, M. B., Shulman, R. J. (2002). The impact of liver disease on growth and nutrition. Journal of pediatric gastroenterology and nutrition, 35 Suppl 1, S55-S59.
  • 3. Hurtado-López, E. F., Larrosa-Haro, A., Vásquez-Garibay, E. M., Macías-Rosales, R., Troyo-Sanromán, R., Bojórquez-Ramos, M. C. (2007). Liver function test results predict nutritional status evaluated by arm anthropometric indicators. Journal of pediatric gastroenterology and nutrition, 45(4), 451-457.
  • 4. Addo, O. Y., Himes, J. H., Zemel, B. S. (2017). Reference ranges for midupper arm circumference, upper arm muscle area, and upper arm fat area in US children and adolescents aged 1-20 y. The American journal of clinical nutrition, 105(1), 111-120.
  • 5. Jaswant, S., Nitish, M. (2014). Use of upper-arm anthropometry as measure of body-composition and nutritional assessment in children and adolescents (6-20 years) of Assam, Northeast India. Ethiopian journal of health sciences, 24(3), 243-252.
  • 7. Rosenbloom AL, Connor EL. (2007). Hypopituitarism and other disorders of the growth hormone-insulin-like growth factor-I axis.Lifshitz F (Ed.), Pediatric Endocrinology. 5th ed. (ss.65-90). New York: Informa Healthcare.
  • 7. Colakoğlu, O., Taşkiran, B., Colakoğlu, G., Kizildağ, S., Ari Ozcan, F., Unsal, B. (2007). Serum insulin like growth factor-1 (IGF-1) and insulin like growth factor binding protein-3 (IGFBP-3) levels in liver cirrhosis. The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 18(4), 245-249.
  • 8. Holt, R. I., Broide, E., Buchanan, C. R., Miell, J. P., Baker, A. J., Mowat, A. P., et al. (1997). Orthotopic liver transplantation reverses the adverse nutritional changes of end-stage liver disease in children. The American journal of clinical nutrition, 65(2), 534-542.
  • 9. Infante, D., Tormo, R., Castro de Kolster, C., Potau, N., Martínez, V., Broto, J., et al. (1998). Changes in growth, growth hormone, and insulin-like growth factor-I (IGF-I) after orthotopic liver transplantation. Pediatric surgery international, 13(5-6), 323-326.
  • 10. Sarna, S., Sipilä, I., Jalanko, H., Laine, J., Holmberg, C. (1994). Factors affecting growth after pediatric liver transplantation. Transplantation proceedings, 26(1), 161-164.
  • 11. Centers for Disease Control and Prevention (CDC). Epi-InfoTM 6 statistical analysis program Web site. http://www.cdc.gov/epiinfo/epi6/EI6dnjp.htm.
  • 12 Bundak R, Neyzi O. (2002). Büyüme. Neyzi O, Ertuğrul T (Ed.),Pediatri. 3. baskı. (ss:85-99). İstanbul: Nobel Tıp Kitabevi.
  • 13. McDowell, M. A., Fryar, C. D., Ogden, C. L., Flegal, K. M. (2008). Anthropometric reference data for children and adults: United States, 2003–2006. National health statistics reports, (10), 1-48.
  • 14. Urgancı, N., Çakır, D., Papatya, E., Polat, T. B. (2006). Anthropometric evaluation in chronic liver disease patients. TürkPediatriArşivi41(4), 214-220.
  • 15. Bartosh, S. M., Thomas, S. E., Sutton, M. M., Brady, L. M., Whitington, P. F. (1999). Linear growth after pediatric liver transplantation. The Journal of pediatrics, 135(5), 624-631.
  • 16. Codoner-Franch, P., Bernard, O., Alvarez, F. (1994). Long-term follow-up of growth in height after successful liver transplantation. The Journal of pediatrics, 124(3), 368-373.
  • 17. Renz, J. F., de Roos, M., Rosenthal, P., Mudge, C., Bacchetti, P., Watson, et al. (2001). Posttransplantation growth in pediatric liver recipients. Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 7(12), 1040-1055.
  • 18. Saito, T., Mizuta, K., Hishikawa, S., Kawano, Y., Sanada, Y., Fujiwara, T., et al. (2007). Growth curves of pediatric patients with biliary atresia following living donor liver transplantation: factors that influence post-transplantation growth. Pediatric transplantation, 11(7), 764-770.
  • 19. Shen, X. Y., Holt, R. I., Miell, J. P., Justice, S., Portmann, B., Postel-Vinay, M. C., et al. (1998). Cirrhotic liver expresses low levels of the full-length and truncated growth hormone receptors. The Journal of clinical endocrinology and metabolism, 83(7), 2532-2538.
  • 20. Møller, S., Juul, A., Becker, U., Henriksen, J. H. (2000). The acid-labile subunit of the ternary insulin-like growth factor complex in cirrhosis: relation to liver dysfunction. Journal of hepatology, 32(3), 441-446.
  • 21. Weber, M. M., Auernhammer, C. J., Lee, P. D., Engelhardt, D., Zachoval, R. (2002). Insulin-like growth factors and insulin-like growth factor binding proteins in adult patients with severe liver disease before and after orthotopic liver transplantation. Hormone research, 57(3-4), 105-112.
  • 22. Bassanello, M., De Palo, E. F., Lancerin, F., Vitale, A., Gatti, R., Montin, et al. (2004). Growth hormone/insulin-like growth factor 1 axis recovery after liver transplantation: a preliminary prospective study. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 10(5), 692-698.
  • 23. Sarna, S., Sipilä, I., Vihervuori, E., Koistinen, R., Holmberg, C. (1995). Growth delay after liver transplantation in childhood: studies of underlying mechanisms. Pediatric research, 38(3), 366-372.
  • 24. Caregaro, L., Alberino, F., Amodio, P., Merkel, C., Angeli, P., Plebani, M., et al (1997). Nutritional and prognostic significance of insulin-like growth factor 1 in patients with liver cirrhosis. Nutrition 13(3), 185-190.
  • 25. Holt, R. I., Crossey, P. A., Jones, J. S., Baker, A. J., Portmann, B., Miell, J. P. (1997). Hepatic growth hormone receptor, insulin-like growth factor I, and insulin-like growth factor-binding protein messenger RNA expression in pediatric liver disease. Hepatology, 26(6), 1600-1606.
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Ferda Özbay Hoşnut 0000-0002-4549-7474

Figen Ozcay 0000-0002-5214-516X

Oğuz Canan 0000-0003-0614-4497

Asburce Olgac 0000-0002-4989-221X

Mehmet Haberal This is me 0000-0002-3462-7632

Publication Date May 31, 2022
Published in Issue Year 2022

Cite

APA Özbay Hoşnut, F., Ozcay, F., Canan, O., Olgac, A., et al. (2022). Kronik Karaciğer Hastalığı Nedeniyle Karaciğer Nakli Yapılan Çocuklarda Malnütrisyonun Değerlendirilmesinde Antropometrik Ölçümler ve Büyüme Faktörleri. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(2), 257-269. https://doi.org/10.46237/amusbfd.950515