perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2021-66-3-40-45perinatology-1405Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESВозможности биоимпедансометрии для оценки нутритивного статуса у детей с детским церебральным параличомPotentials of bioimpedance method for nutritional status assessment in children with cerebral palsyhttps://orcid.org/0000-0001-7416-7485ПерфиловаО. В.PerfilovaO. V.

Перфилова Ольга Владимировна – асс. кафедры педиатрии Института непрерывного профессионального развития

625023, Тюмень, ул. Одесская, д. 54  

Tyumen

cova_1976@mail.ruhttps://orcid.org/0000-0001-8968-3925ХрамоваЕ. Б.KhramovaE. B.

Храмова Елена Борисовна – д.м.н., проф., зав. кафедрой детских болезней педиатрического факультета 

625023, Тюмень, ул. Одесская, д. 54 

Tyumen

https://orcid.org/0000-0002-8632-3075ШайтароваА. В.ShaitarovaA. V.

Шайтарова Анна Владимировна – к.м.н., доц. кафедры педиатрии Института непрерывного профессионального развития

625023, Тюмень, ул. Одесская, д. 54 

Tyumen

ФГБОУ «Тюменский государственный медицинский университет» Минздрава России; ГБУЗ ТО «Областная клиническая больница №1»РоссияTyumen State Medical University; Tyumen Regional Clinical Hospital No.1Russian FederationФГБОУ «Тюменский государственный медицинский университет» Минздрава РоссииРоссияTyumen State Medical UniversityRussian Federation2021010720216634045Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20212021Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1405

Цель исследования. Определить возможности метода биоимпедансометрии в оценке нутритивного статуса у детей с детским церебральным параличом.Характеристика детей и методы исследования. Обследованы 89 детей от 6 до 17 лет с детским церебральным параличом (10,24±3,6 года). Проведены измерения роста (см), массы тела (кг), рассчитан индекс массы тела (ИМТ, кг/м2). Сформированы 2 сравниваемые группы: 1-я группа – 40 детей без недостаточности питания (z-score ИМТ не менее –1), 2-я группа – 49 детей с недостаточностью питания (z-score ИМТ –1,1 и менее). Проведена оценка компонентного состава тела методом биоимпедансометрии в 2 сравниваемых группах.Результаты. Обнаружены статистически значимые различия компонентного состава тела по параметру жировой массы между мальчиками и девочками с детским церебральным параличом как имеющих недостаточность питания, так и без нутритивного дефицита. Определено, что у пациентов с детским церебральным параличом без недостаточности питания имеются различные изменения параметров компонентного состава тела, сопоставимые с таковыми у пациентов с трофическим дефицитом, еще до изменения показателей антропометрии. По параметрам тощей массы, активной клеточной массы в группе детей без недостаточности питания установлено, что около 40% мальчиков и девочек имели результаты ниже нормы по данным показателям, что свидетельствует об измененном в тканевом составе тела и имеющемся дефиците белкового компонента.Выводы. Определены однонаправленные изменения компонентного состава тела у детей с детским церебральным параличом и недостаточностью питания и у детей без трофического дефицита. Оценка компонентного состава тела методом биоипедансметрии может служить эффективным инструментом диагностики нутритивных нарушений у детей с детским церебральным параличом.

Objectives: To study the potential of the bioimpedance method for nutritional status assessment in children with cerebral palsy.Material and methods. There were examined 89 children with cerebral palsy (average age: 10,24 years±3,6 years). Such anthropometric indicators as body height (cm), body weight (kg) and body mass index (BMI, kg/m2) were investigated. The scientists formed two comparison groups: Group 1: 40 children without malnutrition (z-score BMI over 1), Group 2: 49 children with malnutrition (z-score BMI is 1,1 and less). The body composition was evaluated by bioimpedancemetry in both groups of comparison.Results. The scientist found significant differences in body composition in terms of fat mass between boys and girls with cerebral palsy, both with malnutrition and without nutritional deficiency. They determined that children with cerebral palsy without malnutrition demonstrate various changes in the parameters of the body composition comparable to those in patients with trophic deficiency, even before the anthropometry indicators change. According to the parameters of lean mass, active cell mass in the group of children without malnutrition, the results of 40% of boys and girls were below the normative values, which indicated an altered tissue composition of the body and existing deficiency of the protein component.Conclusion. The scientists determined unidirectional changes in the body component composition in children with cerebral palsy and malnutrition and in children without trophic deficiency. The assessment of the body by bioimpedance measurement can serve as an effective tool for the diagnosis of nutritional disorders in children with cerebral palsy.

детидетский церебральный параличнедостаточность питаниянутритивный статусбиоимпедансометрияchildrencerebral palsynutritional deficiencynutritional statusbioimpedance methodReferencesCastelli E., Fazzi E. Recommendations for the rehabilitation of children with cerebral palsy. Eur J Phys Rehabil Med 2016; 52(5):691–703.Castelli E., Fazzi E. Recommendations for the rehabilitation of children with cerebral palsy. Eur J Phys Rehabil Med 2016; 52(5):691–703.Novak I., Morgan C., Adde L., Blackman J, Boy N.R., Brunstrom-Hernandez J. et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy. Advances in Diagnosis and Treatment. JAMA Pediatr 2017; 71(9):897–907. DOI: 10.1001/jamapediatrics.2017.1689Novak I., Morgan C., Adde L., Blackman J, Boy N.R., Brunstrom-Hernandez J. et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy. Advances in Diagnosis and Treatment. JAMA Pediatr 2017; 71(9):897–907. DOI: 10.1001/jamapediatrics.2017.1689Aydin K. Turkish Cerebral Palsy Study Group. A multicenter cross-sectional study to evaluate the clinical characteristics and nutritional status of children with cerebral palsy. Clin Nutr ESPEN 2018; 26:27–34. DOI: 10.1016/j.clnesp.2018.05.002.Aydin K. Turkish Cerebral Palsy Study Group. A multicenter cross-sectional study to evaluate the clinical characteristics and nutritional status of children with cerebral palsy. Clin Nutr ESPEN 2018; 26:27–34. DOI: 10.1016/j.clnesp.2018.05.002.Sullivan P.B. Nutrition and growth in children with cerebral palsy: setting the scene. Eur J ClinNutr 2013; 67(2): 3–4. DOI: 10.1038/ejcn.2013.222Sullivan P.B. Nutrition and growth in children with cerebral palsy: setting the scene. Eur J ClinNutr 2013; 67(2): 3–4. DOI: 10.1038/ejcn.2013.222Pérez Moreno J., de la Mata Navazo S., López-Herce Arteta E., Tolín Hernani M., González Martínez F., González Sánchez M.I. et al. Influence of nutritional status on clinical outcomes in hospitalised children. An Pediatr (Barc) 2019; 5: S1695-4033(19)30065-7. DOI: 10.1016/j.anpedi.2019.01.014Pérez Moreno J., de la Mata Navazo S., López-Herce Arteta E., Tolín Hernani M., González Martínez F., González Sánchez M.I. et al. Influence of nutritional status on clinical outcomes in hospitalised children. An Pediatr (Barc) 2019; 5: S1695-4033(19)30065-7. DOI: 10.1016/j.anpedi.2019.01.014Boel L., Pernet K., Toussaint M., Ides K., Leemans G., Haan J. et al. Respiratory morbidity in children with cerebral palsy: an overview. Dev Med Child Neurol 2019; 61(6): 646–653. DOI: 10.1111/dmcn.14060Boel L., Pernet K., Toussaint M., Ides K., Leemans G., Haan J. et al. Respiratory morbidity in children with cerebral palsy: an overview. Dev Med Child Neurol 2019; 61(6): 646–653. DOI: 10.1111/dmcn.14060Lopes P.A., Amancio O.M., Araújo R.F., Vitalle M.S., Braga J.A. Food pattern and nutritional status of children with cerebral palsy. Rev Paul Pediatr 2013; 31(3): 344–3449. DOI: 10.1590/S0103-05822013000300011Lopes P.A., Amancio O.M., Araújo R.F., Vitalle M.S., Braga J.A. Food pattern and nutritional status of children with cerebral palsy. Rev Paul Pediatr 2013; 31(3): 344–3449. DOI: 10.1590/S0103-05822013000300011Benfer K.A., Weir K.A., Bell K.L., Nahar B., Ware R.S. et al. Oropharyngeal dysphagia in children with cerebral palsy: comparisons between a high- and low-resource country. Disabil Rehabil 2017; 39(23): 2404–2412. DOI: 10.1080/09638288.2016.1229363.Benfer K.A., Weir K.A., Bell K.L., Nahar B., Ware R.S. et al. Oropharyngeal dysphagia in children with cerebral palsy: comparisons between a high- and low-resource country. Disabil Rehabil 2017; 39(23): 2404–2412. DOI: 10.1080/09638288.2016.1229363.Romano C., van Wynckel M., Hulst J., Broekaert I., Bronsky J., Dall’Oglio L. et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with neurological impairment. J Pediatr Gastroenterol Nutr 2017; 65: 242–264. DOI: 10.1097/MPG.0000000000001646Romano C., van Wynckel M., Hulst J., Broekaert I., Bronsky J., Dall’Oglio L. et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with neurological impairment. J Pediatr Gastroenterol Nutr 2017; 65: 242–264. DOI: 10.1097/MPG.0000000000001646Snik D.A.C., Jongerius P.H., Roos N.M., Verschuren O. Nutritional care: The ‘poorchild’ of clinical care in children with cerebral palsy. J Pediatr Rehabil Med 2019; 12(2): 133–138. DOI: 10.3233/PRM-180537Snik D.A.C., Jongerius P.H., Roos N.M., Verschuren O. Nutritional care: The ‘poorchild’ of clinical care in children with cerebral palsy. J Pediatr Rehabil Med 2019; 12(2): 133–138. DOI: 10.3233/PRM-180537Oftedal S., Davies S.W.P, Boyd N.R., Stevenson D.R., Ware S.R., Keawutan P. et al. Body composition, diet, and physical activity: a longitudinal cohort study in preschoolers with cerebral palsy. Am J Clin Nutr 2017; 105(2): 369–378. DOI: 10.3945/ajcn.116.137810Oftedal S., Davies S.W.P, Boyd N.R., Stevenson D.R., Ware S.R., Keawutan P. et al. Body composition, diet, and physical activity: a longitudinal cohort study in preschoolers with cerebral palsy. Am J Clin Nutr 2017; 105(2): 369–378. DOI: 10.3945/ajcn.116.137810Snik D.A.C., de Roos N.M. Criterion validity of assessment methods to estimate body composition in children with cerebral palsy: A systematic review. Ann Phys Rehabil Med 2019; 31: S1877–0657(19)30069-7Snik D.A.C., de Roos N.M. Criterion validity of assessment methods to estimate body composition in children with cerebral palsy: A systematic review. Ann Phys Rehabil Med 2019; 31: S1877–0657(19)30069-7Sullivan P. Measurement of body composition should become routine in nutritional assessment of children with cerebral palsy. Dev Med Child Neurol 2015; 57(9): 793–4. DOI: 10.1111/dmcn.12751.Sullivan P. Measurement of body composition should become routine in nutritional assessment of children with cerebral palsy. Dev Med Child Neurol 2015; 57(9): 793–4. DOI: 10.1111/dmcn.12751.Finbråten A.K., Martins C., Andersen G.L., Skranes J., Brannsether B., Júlíusson P.B. et al. Assessment of body composition in children with cerebral palsy: a cross-sectional study in Norway. Dev Med Child Neurol 2015; 57(9): 858– 64. DOI: 10.1111/dmcn.12752.Finbråten A.K., Martins C., Andersen G.L., Skranes J., Brannsether B., Júlíusson P.B. et al. Assessment of body composition in children with cerebral palsy: a cross-sectional study in Norway. Dev Med Child Neurol 2015; 57(9): 858– 64. DOI: 10.1111/dmcn.12752.Haapala H., Peterson M.D., Daunter A., Hurvitz E.A. Agreement between Actual Height and Estimated Height Using Segmental Limb Lengths for Individuals with Cerebral Palsy. Am J Phys Med Rehabil 2015; 94(7): 539–46. DOI: 10.1097/PHM.0000000000000205Haapala H., Peterson M.D., Daunter A., Hurvitz E.A. Agreement between Actual Height and Estimated Height Using Segmental Limb Lengths for Individuals with Cerebral Palsy. Am J Phys Med Rehabil 2015; 94(7): 539–46. DOI: 10.1097/PHM.0000000000000205Brooks J., Day S., Shavelle R., Strauss D. Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts. Pediatrics 2011; 128: 299–307. DOI: 10.1097/PHM.0000000000000205Brooks J., Day S., Shavelle R., Strauss D. Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts. Pediatrics 2011; 128: 299–307. DOI: 10.1097/PHM.0000000000000205WHO child growth standards: length/height-for-age, weightfor-age, weight-for-length, weight-for height and body mass index-for-age: methods and development France: WHO, 2006; 312. Availableat:https://www.who.int/childgrowth/standards/technical_report/en/. The link is active on 17.06.2020WHO child growth standards: length/height-for-age, weightfor-age, weight-for-length, weight-for height and body mass index-for-age: methods and development France: WHO, 2006; 312. Availableat:https://www.who.int/childgrowth/standards/technical_report/en/. The link is active on 17.06.2020

The authors declare that there are no conflicts of interest present.