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Assessment of nutritional status in paediatric outpatients using bioelectrical impedance analysis and anthropometric
1Department of Clinical Nutrition, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Paediatric outpatients often have low fat-free mass, a condition more prevalent than undernutrition indicated by BMI z-scores. Body composition analysis is crucial for accurate nutritional assessment and personalized interventions in children.
Area of Science:
- Pediatrics
- Nutrition Science
- Body Composition Analysis
Background:
- Assessing nutritional status in paediatric outpatients is critical for early intervention.
- Traditional methods like anthropometric z-scores may not fully capture body composition abnormalities.
- Bioelectrical impedance analysis (BIA) offers a complementary approach to evaluate body composition.
Purpose of the Study:
- To investigate the nutritional status of paediatric outpatients using both bioelectrical impedance analysis (BIA) and anthropometric z-scores.
- To compare body composition parameters across different clinical diagnostic groups (non-illness, illness, simple obesity) and with healthy controls.
Main Methods:
- Retrospective analysis of 2015 paediatric outpatients from 2017-2019.
- Nutritional status assessed via anthropometry (BMI z-scores) and BIA (fat-free mass index, fat mass index).
- Patients categorized into non-illness, illness, and simple obesity groups; illness subgroups compared to healthy controls.
Main Results:
- Undernutrition prevalence (BMI z-scores) was 14.0%, higher in the non-illness group (21.3%).
- Low fat-free mass index (FFMI) was prevalent in 41.6% of outpatients, significantly higher in non-illness (48.4%) and illness (47.0%) groups compared to simple obesity (10.7%).
- Specific illness subgroups showed distinct body composition differences compared to controls, including lower FFMI and fat mass index in haematology/oncology and gastroenterology, and altered z-scores in nephrology/rheumatology.
Conclusions:
- Low FFMI is more common than undernutrition by BMI z-scores in paediatric outpatients.
- Body composition varies significantly across different paediatric illnesses.
- BIA is recommended for accurate nutritional assessment and tailored interventions in paediatric outpatient clinics.
Aim:
To investigate paediatric outpatients' nutritional status using bioelectrical impedance analysis and anthropometric z-scores.
Methods:
A retrospective data analysis of tertiary paediatric hospital outpatients from 2017 to 2019 was conducted. Patients were categorised into three groups (non-illness, illness and simple obesity) according to clinical diagnoses. The nutritional status was evaluated using anthropometric and bioelectrical impedance analysis. In addition, body composition measurements of patients in three subgroups of the illness group and age- and gender-matched healthy controls were compared.
Results:
A total of 2015 paediatric outpatients were enrolled. According to body mass index z-scores, undernutrition prevalence among participants was 14.0% (non-illness group, 21.3%; illness group, 11.4%). Body composition measurements indicated that 41.6% of participants had a low fat-free mass index, and the proportions of participants with a low fat-free mass index in the non-illness, illness and simple obesity groups were 48.4, 47.0 and 10.7%, respectively. Compared with healthy controls, the haematology and oncology subgroup had a significantly lower fat-free mass index and fat mass index; the nephrology and rheumatology subgroup had significantly lower height-for-age z-scores but higher fat mass index; and the gastroenterology subgroups had lower fat mass index, fat-free mass index and body mass index z-scores.
Conclusions:
The results suggested the low fat-free mass index prevalence was greater than the low body mass index z-score prevalence among paediatric outpatients, and body composition parameters varied across different illnesses. Body composition analysis is recommended in nutrition clinics for accurate paediatric outpatient nutritional assessment, thereby providing timely individualised nutritional interventions.
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