Bio-impedance vector analysis in Malawian children with severe acute malnutrition : A diagnostic study in a low- income setting

Kool, J. (Jacintha) (2015) Bio-impedance vector analysis in Malawian children with severe acute malnutrition : A diagnostic study in a low- income setting. thesis, Medicine.

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Abstract

2 SUMMARY Background/objectives: Severe acute malnutrition (SAM) is diagnosed according the criteria of the WHO guidelines. Measurement of weight, length/height and mid upper arm circumference (MUAC) and determination of edema is required to distinguish between two phenotypes: kwashiorkor and marasmus. Bio-electrical impedance vector analysis (BIVA) is a known method to measure body composition but it has not been investigated yet whether this method can help to assess the nutritional status of children with SAM. This study aims to identify changes in body composition during the stabilization of children with SAM. Methods: Firstly the use of BIVA in correlation with de traditional anthropometry was analyzed in a cross-sectional study design. Secondly the changes in bio-electrical impedance between the start and end of the stabilization treatment phase were recorded in a longitudinal design. 80 participants with SAM (43 male), between 6 months and 8 years old, were admitted to a Nutritional Rehabilitation Unit (NRU). The BIVA parameters , normalized by height, are: resistance (R/H), which reflects body fluids and reactance (Xc/H), which reflects the amount of soft tissue. Results: A sufficient negative correlation is seen between MUAC and R/H ratio in patients with kwashiorkor (r = -0,440, p = 0,003) and a stronger correlation in patients with marasmus (r=-0,644, p = 0,001) during the stabilization. The Z-scores of weight-for-height/length only correlates with the R/H value of children with kwashiorkor (r=0,621, p= >0,001). Secondly, BIVA demonstrated the difference between marasmus and kwashiorkor at the start (p<0,001) and end (p<0,001) of the stabilization phase. Kwashiorkor (p<0,001) as well as marasmus (p<0,001) show a significant change in BIVA parameters after the stabilization. Conclusion: BIVA can detect significant changes in body composition during the stabilization of children with SAM. Further studies should evaluate whether BIVA is a useful add-on to the traditional anthropometry to guide therapy SAM in a low-income setting.

Item Type:	Thesis (Thesis)
Supervisor name:	Rheenen, Dr. P.F. van and Pediatric Gastroenterologist at the University Medical Cente
Supervisor name:	Voskuijl, Dr. W.P. Paediatrician and Senior Lecturer at the
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:01
Last Modified:	25 Jun 2020 11:01
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2157

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