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Micronutrient, antioxidant, and oxidative stress status in children with severe cerebral palsy
Niikee C Schoendorfer1, Luis Vitetta, Nita Sharp
1Children's Nutrition Research Centre, The University of Queensland, Royal Children's Hospital, Herston, Australia. n.schoendorfer@uq.edu.au
Insights
Children with cerebral palsy (CP) show altered micronutrient levels, with zinc deficiencies in orally fed children and high red cell folate in enterally fed children, indicating a need for monitoring.
Area of Science:
- Biochemistry
- Pediatric Nutrition
- Clinical Chemistry
Background:
- Children with cerebral palsy (CP) often experience feeding difficulties, impacting their nutritional status.
- Limited biochemical data exists regarding micronutrient and antioxidant levels in children with CP.
- This study investigates key markers in children with CP to address the existing literature gap.
Purpose of the Study:
- To explore micronutrient and antioxidant status in children with cerebral palsy (CP).
- To compare biochemical markers between children with CP (orally and enterally fed) and healthy controls.
- To identify specific nutritional deficiencies or excesses in children with CP.
Main Methods:
- Recruited 24 children aged 4-12 years with marked CP (orally or enterally fed) and 24 age-matched controls.
- Measured red cell folate (RCF), magnesium, superoxide dismutase (SOD), glutathione reductase, peroxidase, serum methylmalonic acid, and vitamin C.
- Quantified plasma hemoglobin, C-reactive protein, α-tocopherol, cholesterol, zinc, protein carbonyls, and total antioxidant capacity.
Main Results:
- Zinc z scores were significantly lower in orally fed (O) children with CP compared to controls.
- Glutathione reductase levels were lower in orally fed (O) children with CP compared to enterally fed (E) and control groups.
- Red cell folate (RCF) concentrations were markedly elevated in enterally fed (E) children with CP compared to orally fed (O) and control groups.
- Superoxide dismutase (SOD) activity was decreased in enterally fed (E) children with CP compared to controls.
Conclusions:
- Routine monitoring of micronutrients is crucial for orally fed children with CP experiencing swallowing disorders and dietary limitations.
- Excessive micronutrient intake, especially in enterally fed children with CP, requires monitoring due to potential competitive inhibition.
- Understanding these biochemical differences can guide targeted nutritional interventions for children with CP.
Background:
Markers indicative of micronutrient and antioxidant status in children with cerebral palsy (CP) were explored due to these children's well-documented issues with food intake and the limited biochemical literature.
Materials And Methods:
Children aged 4 to 12 years with marked CP (n = 24) and controls (n = 24) were recruited. The CP group represented orally (O) or enterally fed (E) children. Concentrations of red cell folate (RCF), magnesium, superoxide dismutase (SOD), glutathione reductase, and peroxidase were measured, as well as serum methylmalonic acid and vitamin C. Plasma hemoglobin, C-reactive protein, α-tocopherol, cholesterol, zinc, protein carbonyls, and total antioxidant capacity were also quantified.
Results:
Data are reported as mean (SD) and z scores where values differ with age. Many similarities existed, but zinc z scores were reduced in O (-1.10 [0.83]) vs controls (-0.54 [0.54]) (P < .05), as well as for glutathione reductase in O (10.15 [1.69]) vs E (12.22 [2.41]) and controls (11.51 [1.67]) (P < .05). RCF was greatly increased in E (1422 [70]) vs O (843 [80]) and controls (820 [43]) (P < .001). SOD was decreased in E (24.3 [1.4]) vs controls (27.0 [2.8]) (P < .05).
Conclusion:
Considering their vast impact on physiology, micronutrients should be routinely monitored in orally fed children with swallowing disorders and dietary limitations. Excessive intakes, particularly long term in enterally fed children, should also be monitored in view of their potential for competitive inhibition, particularly at high levels.
