Sarcopenia and malnutrition in children with extrahepatic portal vein obstruction

Malnutrition is an imbalance between nutrient requirements and intake and sarcopenia is defined as a clinical condition characterized by the reduction of muscle mass and function. Our study aims to determine the frequency of sarcopenia and malnutrition and to establish the relationship between sarcopenia and clinical outcomes in children with extrahepatic portal vein obstruction (EHPVO).

This was a retrospective, single-center study evaluating children with EHPVO between 2000 and 2024, with an abdominal CT scan performed. Psoas muscle surface area was measured at two intervertebral lumbar disc levels, L3-4 and L4-5.

Seventy patients aged between 1 and 16 years whose CT images were available were included in the study. The frequency of sarcopenia among the patients included in the study was 58.6%, as calculated from the L3-4 and/or L4-5 levels. Eighteen-point six percent of the patients were classified as underweight, 17.1% were wasted, and 15.7% were stunted. Furthermore, 31.4% of the patients were either underweight and/or wasted and/or stunted, conditions that are classified as malnutrition. The frequency of sarcopenic malnutrition was 24.3%. When the patients with EHPVO are stratified according to the presence of sarcopenia, no significant differences in demographic and laboratory features have been observed between the two groups.

To our knowledge, this is the first study that analyses the frequency of sarcopenia and its relation with malnutrition in children with EHPVO. The frequency of sarcopenia was similar to those observed in cirrhotic pediatric patients in recent studies. Because of the retrospective design of the study, it was not possible to assess functional muscle parameters of the patients. The major challenges in diagnosing sarcopenia in children include the absence of a gold standard test and reference data for healthy body composition.