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Presenter: Kate, Tavener, London, United Kingdom
Authors: Kate Tavener, Jonathan Hind, Dhamyanthi Thangarajah
Kate Tavener1, Jonathan Hind1, Dhamyanthi Thangarajah1.
1Paediatric Liver, GI and Nutrition Centre, King’s College Hospital, London, United Kingdom
Introduction: Children totally dependent on parenteral nutrition (PN) have altered body composition (BC) with increased whole body fat mass compared to healthy children . This may have long-term health consequences. Little is known about the effect intestinal transplantation (ITX) has on BC in children. We piloted the use of bioelectrical impedance analysis (BIA) in children on home parenteral nutrition (HPN) and those who were post ITX.
Methods: BC was assessed using whole body BIA (InBody S10) in children attending our intestinal rehabilitation clinic over a 4 month period. Anthropometric measures were recorded (weight, height and body mass index (BMI) z-scores). Descriptive statistics are presented as median (range). Body composition measures are presented as percentage of total body weight.
Results: 10 children (6 male) underwent BIA analysis from October 2016-January 2017. 6 children (3 males) were on HPN; diagnoses were short bowel syndrome (SBS) (2), enteropathy (1) and motility disorders (3). 4 children (3 males) were post ITX. Initial diagnoses were SBS (3) and enteropathy (1). Results for each group are shown in table 1. BC measures suggest that fat mass is lower and skeletal mass higher post ITX whereas mineral mass is unchanged (see figure 1). BIA was well tolerated by all children and helped stimulate discussion on a healthy, active lifestyle. The analysis was time efficient, taking 10 minutes per patient.
Conclusion: BIA is a practical, non-invasive and time efficient method of assessing BC in this patient group. Our data suggest a trend toward lower fat mass and higher skeletal mass in children post ITX compared to those on HPN, however mineral mass appears unchanged. Larger adequately powered studies are needed as BC outcomes may influence nutritional and physical rehabilitation post transplantation.
 Pichler J, Chomtho S, Fewtrell M, MacDonald S, Hill S. Body composition in paediatric intestinal failure patients receiving long-term parenteral nutrition. Archives of Disease in Childhood. 2014;99(2):147-53
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