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Impact of malnutrition on liver and spleen stiffness in children evaluated by shear wave elastography
Mehmet Akif Agir1, Mehmet Ozturk2, Muslu Kazım Korez3
1Division of Pediatric Gastroenterology, Department of Pediatrics, Faculty of Medicine, Selcuk University, Konya, Turkey. mehmetakif_68@hotmail.com.
Insights
Childhood malnutrition impacts liver and spleen stiffness, with severe cases showing higher liver stiffness and younger children exhibiting lower spleen stiffness. Shear wave elastography (SWE) can non-invasively assess these organ changes.
Area of Science:
- Pediatric gastroenterology and hepatology
- Medical imaging and diagnostics
- Nutritional science
Background:
- Childhood malnutrition causes significant metabolic and structural changes in organs like the liver and spleen.
- The effect of malnutrition on organ biomechanics, particularly liver and spleen stiffness, remains incompletely understood.
- Elastography, specifically shear wave elastography (SWE), offers a non-invasive method to evaluate these biomechanical alterations.
Purpose of the Study:
- To evaluate the impact of malnutrition on liver and spleen stiffness in children using shear wave elastography (SWE).
- To compare stiffness measurements in malnourished children with those in healthy controls.
- To investigate the relationship between malnutrition severity, age, and organ stiffness.
Main Methods:
- Prospective enrollment of 308 children (aged 0-18 years) classified as malnourished or healthy based on WHO growth standards.
- Liver and spleen stiffness measured using SWE by a single pediatric radiologist blinded to nutritional status.
- Statistical analysis comparing groups, malnutrition severity subgroups, and age categories.
Main Results:
- Overall liver stiffness did not differ between malnourished and healthy children, but severe malnutrition showed significantly higher liver stiffness (p=0.018).
- Spleen stiffness was significantly lower in malnourished children aged 0-6 years compared to controls (p<0.001).
- Both liver and spleen stiffness increased with age (p=0.014 and p=0.013, respectively).
Conclusions:
- Malnutrition is linked to age- and severity-dependent changes in liver and spleen stiffness.
- Elevated liver stiffness was observed only in severe malnutrition cases; reduced spleen stiffness was noted in younger malnourished children.
- SWE is a valuable non-invasive tool for assessing organ-level effects of malnutrition, guiding future research on reversibility and clinical significance.
Objectives:
This study aimed to assess the impact of malnutrition on liver and spleen stiffness in children using shear wave elastography (SWE) and to compare the findings with those of healthy controls.
Methods:
A total of 308 children aged 0-18 years were prospectively enrolled and classified as either malnourished or healthy according to World Health Organization (WHO) growth reference standards (weight-for-height Z-scores for children under 5 years and BMI-for-age Z-scores for those aged 5 years and older). Liver and spleen stiffness measurements were obtained using SWE by a single pediatric radiologist blinded to nutritional status. Statistical comparisons were performed between groups, across malnutrition severity subgroups, and within different age categories.
Results:
Liver stiffness did not differ significantly between malnourished children overall and healthy controls, but it was markedly higher in those with severe malnutrition compared to mild or moderate cases (p = 0.018). Spleen stiffness was significantly lower in malnourished children aged 0-6 years compared to controls (p < 0.001). Both liver and spleen stiffness values increased with age (p = 0.014 and p = 0.013, respectively).
Conclusion:
Our findings indicate that malnutrition is associated with age- and severity-dependent alterations in liver and spleen stiffness. Liver stiffness was elevated only in children with severe malnutrition, whereas spleen stiffness was reduced in younger children but not in older ones. SWE may serve as a valuable non-invasive tool for assessing organ-level effects of malnutrition, and these results may guide future research on the reversibility and clinical significance of such changes.
What Is Known:
• Childhood malnutrition is associated with profound metabolic and structural alterations in vital organs such as the liver and spleen. However, its impact on organ biomechanics, as assessed by elastography, has not been clearly defined.
What Is New:
• Malnutrition leads to organ-specific biomechanical changes, with increased liver stiffness in severe cases and reduced spleen stiffness particularly in younger children. • Shear wave elastography provides a non-invasive approach to characterize these alterations.
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