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Bone quality and nutritional status in children with congenital heart defects
Chico-Barba Laura Gabriela1, Vivanco-Muñoz Nalleli, Avilés-Toxqui Dalia Patricia
1Department of Pediatric Cardiology, National Cardiology Institute Ignacio Chávez, Mexico City, Mexico.
Insights
Children with congenital heart defects (CHDs) exhibit lower bone quality, indicated by reduced speed of sound (SOS) in the radius, compared to healthy peers. This bone quality reduction occurs independently of their nutritional status.
Area of Science:
- Pediatric Cardiology
- Pediatric Orthopedics
- Nutritional Science
Background:
- Congenital heart defects (CHDs) can impact overall child development.
- Bone quality assessment is crucial for understanding long-term health outcomes in children with CHDs.
- Quantitative ultrasound offers a non-invasive method for evaluating bone status.
Purpose of the Study:
- To assess bone quality and nutritional status in children with CHDs.
- To compare bone parameters and nutritional status between children with CHDs and healthy controls.
- To investigate the relationship between CHDs, bone quality, and nutritional status.
Main Methods:
- A cross-sectional study comparing 75 children with CHDs (age 0-6 years) to 106 healthy children.
- Bone status measured via speed of sound (SOS) at the radius and tibia using quantitative ultrasound.
- Nutritional status assessed using the Waterloo and Gómez indices; statistical analyses included t-tests, ANOVA, and regression.
Main Results:
- Children with CHDs had a higher prevalence of malnutrition compared to healthy children (p<0.001).
- Radius SOS was significantly lower in children with CHDs (3484±180 m/s) versus healthy children (3575±159 m/s; p=0.001).
- A positive correlation was found between CHDs and reduced SOS (r²=0.455, p<0.001), independent of nutritional status.
Conclusions:
- Children with CHDs demonstrate reduced bone quality, evidenced by lower radius SOS values.
- The findings suggest impaired bone quality in children with CHDs, irrespective of nutritional status.
- Quantitative ultrasound is a valuable tool for evaluating bone health in pediatric cardiology patients.
Abstract:
The aim of this study was to evaluate bone quality and nutritional status in children with congenital heart defects (CHDs) using quantitative ultrasound. A cross-sectional study was designed. A population-based sample of 75 children with CHD (age: 0--6yr) from the Department of Pediatric Cardiology at the National Cardiology Institute "Ignacio Chávez" was compared with 106 healthy children during 2009. Weight and height were determined in both groups; bone status was measured at the radius and tibia as speed of sound (SOS). Nutritional status was defined according to the Waterloo and Gómez index. Chi-square test, Student's t-test, and analysis of variance were used to determine the statistical differences. A linear regression analysis adjusted by age, weight, height, type of CHD, and birth weight was made. Both groups were similar in sex distribution, prematurity, and birth weight. Acyanotic cardiopathy with increased pulmonary flow was the most frequent (61.3%). Prevalence of malnutrition was higher in CHD group compared with healthy children (p<0.001), and radius SOS was lower in children with CHD compared with healthy children (3484±180 vs 3575±159m/s, respectively; 95% confidence interval: 39.8--143; p=0.001). A positive correlation was found between CHD and reduced SOS in the adjusted linear regression model, r²=0.455 (p<0.001). Children with CHD have lower SOS radius values compared with healthy children, suggesting reduced bone quality regardless of the nutritional status.
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