Assessment of protein-energy malnutrition in children with chronic arthritis
E Unsal1, B Büyükgebiz, N Cevik
1Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
Insights
Children with juvenile chronic arthritis (JCA) face a high risk of protein-energy malnutrition (PEM). Many show abnormal nutritional markers, even without obvious signs, highlighting the need for early screening.
Area of Science:
- Pediatrics
- Rheumatology
- Nutrition Science
Background:
- Protein-energy malnutrition (PEM) is a significant concern in children with juvenile chronic arthritis (JCA).
- Estimates suggest PEM affects 10-50% of JCA patients.
- Inflammation in JCA may contribute to malnutrition, often without clear clinical indicators.
Purpose of the Study:
- To assess the nutritional status of children with JCA.
- To compare the nutritional parameters of JCA patients with healthy controls.
- To identify the prevalence and characteristics of malnutrition in JCA.
Main Methods:
- A comprehensive nutritional assessment profile with 9 parameters was utilized.
- Thirty-eight children with JCA were evaluated.
- Nutritional status was compared against 23 healthy, age- and sex-matched controls.
Main Results:
- Abnormalities in height-for-age (30%) and weight-for-age (27%) were observed.
- 71% of JCA patients exhibited abnormal somatic protein stores.
- Significantly lower visceral protein stores were found in JCA patients compared to controls.
Conclusions:
- Children with JCA are at high risk for complicated malnutrition and PEM.
- Inflammation associated with JCA can lead to malnutrition, potentially masked by a lack of overt symptoms.
- Nutritional screening is crucial for early detection of PEM in pediatric arthritis patients.
Abstract:
Protein-energy malnutrition (PEM) has been estimated to occur in 10 to 50% of children with juvenile chronic arthritis (JCA). Thirty-eight children with JCA were evaluated and their nutritional status determined, and they were compared with 23 healthy sex and age-matched children as controls. A standardized, 9-parameter comprehensive nutritional assessment profile was used. The simple anthropometric measurements, height and weight for age, were abnormal in 30% and 27% of the patients, respectively. A detailed evaluation revealed that 71% had abnormal somatic protein stores, and that they also had significantly low levels of visceral protein stores, when compared to their healthy peers. The results were consistent with the fact that inflammation put the JCA patients at significant risk for developing complicated malnutrition and it might result in PEM without any obvious signs of malnutrition. A nutritional screening test would be very useful in detecting early PEM in children with chronic arthritis.