Anthropometric and Bioelectrical Impedance

measurement of paediatric oncology patients

Author: Rendes AndreiCo-author: Mihalcea Iordan Alexandru

Coordinators: Conf. dr. Marginean Oana, dr. Chincesan Mihaela, dr. Florian Gabriela

Poor nutritional status of the children with malignant diseases is a serious problem nowadays; it express a high grade of nutritional deterioration and has a negative impact on antineoplasic treatment;

Dietary measures that have to be applied in order to stop this deterioration and most important,to have a high efficiency of the treatment;

Introduction

There are studies which shows that paediatric patients hospitalized for long periods (especially because of chronic diseases) suffer a significant weight loss,but the nutritional status’ worsening of the oncology ones has a special significance;

The tumoral mass increasing in their body hide the loss of fat tissue and muscle mass,creating measurement errors concerning total body weight.

To determine the nutritional status of the paediatric oncology patients comparatively to paediatric patients suffering from other diseases,by using a device which measures body composition in order to demonstrate the higher grade of malnutrition of the children with malignant diseases.

Purpose

Prospective study,performed between October 2013 and March 2014;

45 patients divided in two groups: -gr I: 15 oncology patients, -gr II: 30 patients with other diseases; Patients: -recruited by the legal consent of relatives; -included by age between 5 and 18 years old with

no difference of gender or modality of treatment; -we excluded patients with amputations of limbs;

Matherials and method

We measured: -anthropometry: height, weight, BMI, triceps skin fold

thickness, mid upper arm circumference (we used Switzerland Growth Chart in order to convert the results in standard deviation for age and sex,

considering normal values between -2.5 and +2.5 SD) -bioelectrical impedance analysis(Ω), fat%, fat

mass(kg), fat free mass(kg), total body water(kg,%), muscle mass(kg);

The results’ values follow the Gauss curve; The results were statistically evaluated by using the

T-Student test.

We used for anthropometry measurements,the following:

-a paper measurement tape for TSF,-a digital caliper for MUAC, -a stadiometer for height;

We used for bioelectrical impedance parameters measurement,a TANITA Body Composition Analyzer (BC-420MA),that uses bioelectrical impedance vectors and mathematic ecuations for body composition calculation;

The children with malignant diseases have height,weight and BMI lower than the control group,but withouth statistical significance (p>0.05).

-no statistically significant difference according to BIA,TBW(kg),FFM,muscle mass

-We found statistically significant difference concerning TBW%,fat%,fat mass,TSF,MUAC.

Results

TBW (%) oncology group control group

Number of values 15 30

Minimum 54,40 45,20

25% Percentile 57,00 52,13

Median 61,40 58,35

75% Percentile 64,10 63,00

Maximum 70,60 68,60

Mean 61,76 57,45

Std. Deviation 5,095 6,648

p-0.03

40

50

60

70

80

TBW

%

fat (%) oncology group control group

Number of values 15 30

Minimum 3,400 6,600

25% Percentile 9,800 13,83

Median 15,60 20,35

75% Percentile 21,80 28,95

Maximum 25,70 38,40

Mean 15,23 21,57

Std. Deviation 7,170 9,067

p-0.02

0

10

20

30

40

50

fat%

fat mass (kg) oncology group control group

Number of values 15 30

Minimum 1,400 1,700

25% Percentile 2,500 3,600

Median 4,400 6,350

75% Percentile 6,100 12,48

Maximum 19,20 28,60

Mean 5,533 8,833

Std. Deviation 4,791 6,561

p-0.05

0

10

20

30

40

fatkg

p-0.05

-5

0

5

10

MUAC

SD

MUAC (DS) oncology group control group

Number of values 15 30

Minimum -2,680 -2,910

25% Percentile -1,310 -0,7775

Median -0,3300 0,7650

75% Percentile 0,6900 2,458

Maximum 3,420 6,920

Mean -0,1900 0,9550

Std. Deviation 1,489 2,321

p-0.05

-4

-2

0

2

4

6

TSF

SD

TSF(DS) oncology group control group

Number of values 15 30

Minimum -3,210 -2,840

25% Percentile -2,440 -0,9675

Median -0,2300 0,9800

75% Percentile 0,8300 2,288

Maximum 5,620 5,630

Mean -0,4287 0,8277

Std. Deviation 2,263 2,134

Considering the purpose of our study,the statistically significant results that we found (the arm’s anthropometry and the statistically significant body composition parameters) show the relevance of the nutritional status’ higher grade of deterioration on oncology paediatric patients;

-in this case,the higher percentage of TBW at these patients is due to intravenous rehydration and corticotherapy.

Discussion

Considering these results,the study reveals that paediatric oncology patients have a more precarious nutritional status than the patients suffering from other diseases,so,dietary intervention is undeniable in their case.

Conclusion

1. Bauer J.; Jurgens H.; Fruhwald M.C.- Important aspects of nutrition in children with cancer. Adv. Nutr. 2011;

2. Joosten KFM, Hulst JM- Prevalence of malnutrition in pediatric hospital patients.Curr Opin Pediatr 2008.

3. Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis—part I. Review of principles and methods. Clin Nutr 2004;

4. Foster KF, Lukaski HC. Whole-body impedanced what does it measure? Am J Clin Nutr 1996;64:388S–96S.

References

Thank you for attention!