https://pubmed.ncbi.nlm.nih.gov/39192315/ end stage liver disease

Observational Study

BMC Pediatr. 2024 Aug 27;24(1):549.
doi: 10.1186/s12887-024-04974-x.

Comparing body composition measures in children with end stage liver disease using noninvasive bioimpedance analysis

Maryam Ekramzadeh 1 2, Seyed Ali Moosavi 3 4, Amirali Mashhadiagha 3 4, Ali Ghorbanpour 4, Nasrin Motazedian 5, Seyed Mohsen Dehghani 3, Homa Ilkhanipoor 6, Alireza Mirahmadizadeh 7
Affiliations expand
PMID: 39192315

PMCID: PMC11348767

DOI: 10.1186/s12887-024-04974-x
Abstract

Background: Chronic liver disease (CLD) in children, often leads to cirrhosis and end-stage liver disease (ESLD). CLD poses significant challenges in management and prognosis. Assessing body composition, including sarcopenia, is increasingly recognized as important in understanding outcomes in this population.

Methods: We conducted a prospective observational study, involving children aged 2 to 18 years with ESLD awaiting liver transplantation. Socio-demographic, clinical, and laboratory data were collected, and body composition was assessed using Bioelectrical Impedance Analysis (BIA). Sarcopenia was defined using age-specific cut-off points for appendicular skeletal muscle mass (aSMM) and fat-free mass (FFM).

Results: The study included 57 children (42.1% girls, 57.9% boys; median age: 10.9 years) with liver cirrhosis. Of them 11 (19.3%) died during the study. The mean duration of living with end-stage liver disease prior to participation was 5.43 years [IQR: 3.32, 8.39]. The most common etiology was biliary atresia (24.6%), followed by cryptogenic (22.8%). Deceased children exhibited significantly higher sarcopenia prevalence, lower basal metabolic rate and growth scores compared to survivors (P < 0.05), (771.0 vs. 934.0, P = 0.166) (65.0 vs. 80.5, P = 0.005). Total body and limb-specified lean mass were lower in deceased children, although not statistically significant. Similarly, total mineral (90% normal) and bone mineral content were lower in deceased children, with a significant difference observed only in water-to-FFM percentage (72.5 vs. 73.1, P = 0.009).

Conclusion: This study highlights the high prevalence of sarcopenia among children with ESLD and its association with adverse outcomes, including mortality. Bioimpedance analysis emerges as a promising, non-invasive method for assessing body composition in pediatric ESLD, warranting further investigation and integration into clinical practice.