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Comparative study of autonomic nervous system activity in malnourished and normal children in India
M Bedi1, R Babbar, A S Chakrabarty
1Department of Physiology, Maulana Azad Medical College, New Delhi, India. jiap@ren.nic.in
Insights
Malnourished children exhibit compromised autonomic nervous system function, with impaired parasympathetic responses and altered sympathetic activity. This study highlights significant differences in autonomic function tests between malnourished and healthy children.
Area of Science:
- Pediatric Nutrition
- Autonomic Nervous System Physiology
- Child Health
Background:
- Limited data exists on the link between autonomic functions and malnutrition in children.
- Autonomic dysfunction may contribute to the pathophysiology of childhood malnutrition.
- Understanding these relationships is crucial for effective intervention strategies.
Purpose of the Study:
- To investigate and compare autonomic nervous system (ANS) function in malnourished children versus healthy controls.
- To assess both parasympathetic and sympathetic nervous system functions in pediatric malnutrition.
- To establish potential correlations between nutritional status and ANS parameters.
Main Methods:
- Autonomic function tests were administered to 30 malnourished children and 30 healthy controls (ages 5-10).
- Parasympathetic function was evaluated using resting heart rate, standing-to-lying ratio, lying-to-standing ratio, and Valsalva ratio.
- Sympathetic function was assessed via hand grip test and galvanic skin resistance.
Main Results:
- Malnourished children showed significantly lower weight-for-age, height-for-age, and weight-for-height Z-scores.
- Parasympathetic function was significantly impaired: higher resting heart rate and lower ratios for standing-to-lying, lying-to-standing, and Valsalva maneuver.
- Sympathetic function showed a significantly higher galvanic skin resistance in malnourished children, with no difference in hand grip strength.
Conclusions:
- Autonomic nervous system function is significantly compromised in children with malnutrition.
- Both parasympathetic and sympathetic branches of the ANS are affected.
- These findings underscore the systemic impact of malnutrition on physiological regulation in children.
Abstract:
Information on the relationship between autonomic functions and malnutrition in children is scant. In the present study, autonomic function tests were conducted in 30 normal subjects and 30 malnourished children aged between 5 and 10 years. The tests performed included tests for parasympathetic functions (resting heart rate, standing-to-lying ratio, lying-to-standing ratio and Valsalva ratio) and tests to assess sympathetic function (hand grip test, galvanic skin resistance). The malnourished children had significantly lower mean weights-for-age (-2.6 Z vs -1.5 Z; p = 0.001), heights-for-age (-2.5 Z vs -1.5 Z; p = 0.001) and weights-for-height (-1.6 Z vs -0.8 Z; p = 0.001). Parasympathetic function tests evaluated were significantly affected in malnourished children. Resting heart rate was significantly higher in the malnourished group (90.6 vs 82.5/min; p = 0.001). The other parasympathetic function tests had significantly lower mean values than in the control group, namely, standing-to-lying ratio (1.25 vs 1.32; p = 0.026), lying-to-standing ratio (1.23 vs 1.29; p = 0.021) and Valsalva ratio (1.26 vs 1.28; p = 0.037). Of the sympathetic function tests conducted, there were no differences between the two groups for hand grip test but galvanic skin resistance was significantly higher in the malnourished subjects (190.1 vs 149.73; p = 0.001). It is concluded that autonomic nervous system function is significantly compromised in malnourished children.