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Assessment of nutritional status of postoperative patients with biliary atresia
1Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai, Japan.
Insights
Biliary atresia (BA) patients with higher bilirubin levels show significantly lower midarm muscle area and prealbumin, indicating impaired protein metabolism. Regular nutritional assessments are crucial for managing these patients.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Nutritional Science
Background:
- Biliary atresia (BA) can lead to chronic hepatic dysfunction and persistent jaundice.
- Adverse effects of chronic liver disease on nutrition and growth are significant concerns in BA patients.
Purpose of the Study:
- To assess the nutritional status and protein kinetics in patients with biliary atresia.
- To identify reliable indicators of malnutrition in BA patients.
Main Methods:
- Studied 45 BA patients, divided into two groups based on total bilirubin levels (Group A: >= 2 mg/100 ml, Group B: < 2 mg/100 ml).
- Measured anthropometric parameters (height, weight, triceps skin fold, midarm circumference, midarm muscle area) and serum albumin and prealbumin levels.
- Calculated caloric and protein intake over 3 days.
Main Results:
- Mean midarm muscle area (MAMA) was significantly lower in Group A compared to Group B (p < 0.01).
- Mean prealbumin levels were significantly lower in Group A (9.9 mg/100 ml) than in Group B (18.8 mg/100 ml) (p < 0.001).
- Triceps skin fold (TSF) showed no significant difference between groups.
Conclusions:
- Midarm muscle area (MAMA) and prealbumin levels are valuable indicators of protein-energy malnutrition in BA patients with elevated bilirubin.
- Repeated nutritional assessments are essential for evaluating liver function and ensuring adequate nutrition in BA patients.
Abstract:
Some patients of biliary atresia (BA) suffer from chronic hepatic dysfunction and/or persistent jaundice. The adverse effects of chronic liver disease on nutrition and growth should be considered on BA patients. We studied 45 BA patients ranging in age from 0.5 to 38 years and divided them into 2 groups. Group A contains the patients whose total bilirubin > or = 2 mg/100 ml, and Group B contains the patients whose total bilirubin < 2 mg/100 ml. We measured height, weight, triceps skin fold (TSF), midarm circumference (MAC) and midarm muscle area (MAMA). Visceral protein kinetics was evaluated on the basis of serum albumin and prealbumin levels. Caloric and protein intake was calculated by collecting intake data for 3 days. The results of this study were; 1) The mean TSF in Group A (47th percentile) was not significantly different from that in Group B (53th percentile). 2) The mean MAMA was significantly lower (p < 0.01) in Group A (16.4th percentile) than in Group B (36.7th percentile) 3) The prealbumin level was significantly lower (p < 0.001) in Group A (mean 9.9 mg/100 ml) than in Group B (mean 18.8 mg/100 ml). The authors conclude that the evaluation of MAMA and prealbumin were very useful to characterize the low metabolic status of protein in the damaged liver. And repeated nutritional assessment was necessary to evaluate liver function and provide adequate nutrition in BA patients.