Biochemical and anthropometric correlates of bio-electrical impedance parameters in severely malnourished children: A cross-sectional study

Tsinuel Girma; Anne-Louise Hother Nielsen; Pernille Kæstel; Alemseged Abdissa; Kim F. Michaelsen; Henrik Friis; Jonathan C Wells

doi:10.1016/j.clnu.2017.02.017

Biochemical and anthropometric correlates of bio-electrical impedance parameters in severely malnourished children: A cross-sectional study

Tsinuel Girma, Anne-Louise Hother Nielsen, Pernille Kæstel, Alemseged Abdissa, Kim F. Michaelsen, Henrik Friis, Jonathan C Wells

Ernæring og Sundhed hos børn og voksne

7 Citationer (Scopus)

Abstract

Introduction: Despite expanding use of bio-impedance (BI), little is known about its pathophysiologic significance and biological correlates Objective: Determine correlations of BI parameters with anthropometry and biomarkers of electrolyte homeostasis, inflammation and liver function in children with severe acute malnutrition (SAM). Methods: We studied Ethiopian children with SAM (mid-arm circumference <11·0 cm or weight-for-height <70% of the NCHS growth reference median and/or nutritional oedema) at hospitalization. Impedance (Z, Ohm), resistance (R, Ohm), reactance (Xc, Ohm) and phase angle (PA, degree) were measured at 50 kHz. R and Xc were height-indexed. Anthropometric Z-scores were calculated. Serum phosphate, Ca, Na, K, Mg, alkaline phosphatase, bilirubin, α1-acid glycoprotein, albumin and haemoglobin were measured. Healthy children were used for BI comparison. Correlates of BI were established using forward selection after comparing models using likelihood ratio test. Results: The sample comprised 55 children with SAM (age 36 ± 24 months; 60% males; 72.7% oedematous) and 80 healthy control children (age 28 ± 15 months; 47.5% males). Oedematous children had the lowest BI parameters compared with reference and non-oedematous children. Similarly, they had lower serum albumin, K and alkaline phosphatase levels than non-oedematous children. Oedema was independent negative correlate of R, Xc and PA. Serum albumin level and weight-for-height Z-score were positive correlates of R, whereas serum calcium and Cl levels were positive correlates of Xc. MUAC correlated positively with PA. Conclusion: Nutritional oedema explained the divergence of BI parameters from normality. Soft tissue mass, serum albumin, Ca and Cl accounted for variability of BI parameters in children with SAM.

Originalsprog	Engelsk
Tidsskrift	Clinical Nutrition
Vol/bind	37
Udgave nummer	2
Sider (fra-til)	701-705
Antal sider	5
ISSN	0261-5614
DOI	https://doi.org/10.1016/j.clnu.2017.02.017
Status	Udgivet - apr. 2018

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10.1016/j.clnu.2017.02.017

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title = "Biochemical and anthropometric correlates of bio-electrical impedance parameters in severely malnourished children: A cross-sectional study",

abstract = "Introduction: Despite expanding use of bio-impedance (BI), little is known about its pathophysiologic significance and biological correlates Objective: Determine correlations of BI parameters with anthropometry and biomarkers of electrolyte homeostasis, inflammation and liver function in children with severe acute malnutrition (SAM). Methods: We studied Ethiopian children with SAM (mid-arm circumference <11·0 cm or weight-for-height <70% of the NCHS growth reference median and/or nutritional oedema) at hospitalization. Impedance (Z, Ohm), resistance (R, Ohm), reactance (Xc, Ohm) and phase angle (PA, degree) were measured at 50 kHz. R and Xc were height-indexed. Anthropometric Z-scores were calculated. Serum phosphate, Ca, Na, K, Mg, alkaline phosphatase, bilirubin, α1-acid glycoprotein, albumin and haemoglobin were measured. Healthy children were used for BI comparison. Correlates of BI were established using forward selection after comparing models using likelihood ratio test. Results: The sample comprised 55 children with SAM (age 36 ± 24 months; 60% males; 72.7% oedematous) and 80 healthy control children (age 28 ± 15 months; 47.5% males). Oedematous children had the lowest BI parameters compared with reference and non-oedematous children. Similarly, they had lower serum albumin, K and alkaline phosphatase levels than non-oedematous children. Oedema was independent negative correlate of R, Xc and PA. Serum albumin level and weight-for-height Z-score were positive correlates of R, whereas serum calcium and Cl levels were positive correlates of Xc. MUAC correlated positively with PA. Conclusion: Nutritional oedema explained the divergence of BI parameters from normality. Soft tissue mass, serum albumin, Ca and Cl accounted for variability of BI parameters in children with SAM.",

keywords = "Correlates, Bio-electrical impedance, Severe acute malnutrition, Biochemical",

author = "Tsinuel Girma and Nielsen, {Anne-Louise Hother} and Pernille K{\ae}stel and Alemseged Abdissa and Michaelsen, {Kim F.} and Henrik Friis and Wells, {Jonathan C}",

note = "CURIS 2018 NEXS 100",

year = "2018",

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doi = "10.1016/j.clnu.2017.02.017",

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pages = "701--705",

journal = "Clinical Nutrition",

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TY - JOUR

T1 - Biochemical and anthropometric correlates of bio-electrical impedance parameters in severely malnourished children

T2 - A cross-sectional study

AU - Girma, Tsinuel

AU - Nielsen, Anne-Louise Hother

AU - Kæstel, Pernille

AU - Abdissa, Alemseged

AU - Michaelsen, Kim F.

AU - Friis, Henrik

AU - Wells, Jonathan C

N1 - CURIS 2018 NEXS 100

PY - 2018/4

Y1 - 2018/4

N2 - Introduction: Despite expanding use of bio-impedance (BI), little is known about its pathophysiologic significance and biological correlates Objective: Determine correlations of BI parameters with anthropometry and biomarkers of electrolyte homeostasis, inflammation and liver function in children with severe acute malnutrition (SAM). Methods: We studied Ethiopian children with SAM (mid-arm circumference <11·0 cm or weight-for-height <70% of the NCHS growth reference median and/or nutritional oedema) at hospitalization. Impedance (Z, Ohm), resistance (R, Ohm), reactance (Xc, Ohm) and phase angle (PA, degree) were measured at 50 kHz. R and Xc were height-indexed. Anthropometric Z-scores were calculated. Serum phosphate, Ca, Na, K, Mg, alkaline phosphatase, bilirubin, α1-acid glycoprotein, albumin and haemoglobin were measured. Healthy children were used for BI comparison. Correlates of BI were established using forward selection after comparing models using likelihood ratio test. Results: The sample comprised 55 children with SAM (age 36 ± 24 months; 60% males; 72.7% oedematous) and 80 healthy control children (age 28 ± 15 months; 47.5% males). Oedematous children had the lowest BI parameters compared with reference and non-oedematous children. Similarly, they had lower serum albumin, K and alkaline phosphatase levels than non-oedematous children. Oedema was independent negative correlate of R, Xc and PA. Serum albumin level and weight-for-height Z-score were positive correlates of R, whereas serum calcium and Cl levels were positive correlates of Xc. MUAC correlated positively with PA. Conclusion: Nutritional oedema explained the divergence of BI parameters from normality. Soft tissue mass, serum albumin, Ca and Cl accounted for variability of BI parameters in children with SAM.

AB - Introduction: Despite expanding use of bio-impedance (BI), little is known about its pathophysiologic significance and biological correlates Objective: Determine correlations of BI parameters with anthropometry and biomarkers of electrolyte homeostasis, inflammation and liver function in children with severe acute malnutrition (SAM). Methods: We studied Ethiopian children with SAM (mid-arm circumference <11·0 cm or weight-for-height <70% of the NCHS growth reference median and/or nutritional oedema) at hospitalization. Impedance (Z, Ohm), resistance (R, Ohm), reactance (Xc, Ohm) and phase angle (PA, degree) were measured at 50 kHz. R and Xc were height-indexed. Anthropometric Z-scores were calculated. Serum phosphate, Ca, Na, K, Mg, alkaline phosphatase, bilirubin, α1-acid glycoprotein, albumin and haemoglobin were measured. Healthy children were used for BI comparison. Correlates of BI were established using forward selection after comparing models using likelihood ratio test. Results: The sample comprised 55 children with SAM (age 36 ± 24 months; 60% males; 72.7% oedematous) and 80 healthy control children (age 28 ± 15 months; 47.5% males). Oedematous children had the lowest BI parameters compared with reference and non-oedematous children. Similarly, they had lower serum albumin, K and alkaline phosphatase levels than non-oedematous children. Oedema was independent negative correlate of R, Xc and PA. Serum albumin level and weight-for-height Z-score were positive correlates of R, whereas serum calcium and Cl levels were positive correlates of Xc. MUAC correlated positively with PA. Conclusion: Nutritional oedema explained the divergence of BI parameters from normality. Soft tissue mass, serum albumin, Ca and Cl accounted for variability of BI parameters in children with SAM.

KW - Correlates

KW - Bio-electrical impedance

KW - Severe acute malnutrition

KW - Biochemical

U2 - 10.1016/j.clnu.2017.02.017

DO - 10.1016/j.clnu.2017.02.017

M3 - Journal article

C2 - 28262322

SN - 0261-5614

VL - 37

SP - 701

EP - 705

JO - Clinical Nutrition

JF - Clinical Nutrition

IS - 2

ER -

Biochemical and anthropometric correlates of bio-electrical impedance parameters in severely malnourished children: A cross-sectional study

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