Etiological Patterns of Protein-Energy Malnutrition in a Pediatric Clinic in China

BACKGROUND Protein-energy malnutrition (PEM) often occurs within 5 years of age. Untreated PEM in early childhood can affect growth and cognitive function later in life. However, the etiologies of PEM in children are still poorly explored. This study investigated the etiological distribution of PEM in children attending a pediatric health clinic. MATERIAL AND METHODS The study involved 286 children with PEM who visited the West China Second University Hospital Child Healthcare for Xinchuan West China Center for Child Development and Excellence from January to December 2022. Patients were divided into moderate and mild PEM groups according to the severity of PEM. A retrospective analysis of the etiology of PEM was conducted. RESULTS The top 5 etiologies of PEM were food allergy (FA) (57.0%), small for gestational age (SGA) (26.6%), dietary behavior problems (14.3%), premature infants (8.0%), and recurrent respiratory tract infections (RRTI) (4.5%). The proportions of SGA and RRTI patients in the moderate PEM group were significantly greater than the mild PEM group (P<0.001). The proportion of patients with 2 or more etiologies in the moderate PEM group was significantly greater than the mild PEM group (P<0.001). CONCLUSIONS The primary reasons for PEM in the investigated children were FA and SGA. Moderate PEM cases were mostly attributed to multiple etiologies. A multidisciplinary management approach involving pediatricians, nutritionists, and social workers is essential for addressing the complex needs of affected children. The importance of early diagnosis and timely management should be emphasized to reduce the number of PEM cases.