title: Body composition in paediatric intestinal failure patients receiving long-term parenteral nutrition.
abstract: OBJECTIVE
  Outcome of children with intestinal failure (IF) has improved on treatment with parenteral nutrition (PN). The effects of PN and IF on body composition (BC) are unknown. The aim was to review BC in PN-treated children and those weaned off and to compare with reference data.
  
  
  METHODS
  Children on long-term/home PN underwent measurement of regional fat mass (FM) and lean mass (LM) using dual energy X-ray absorptiometry. Underlying diseases were intestinal enteropathy, n=15, short bowel syndrome (SBS), n=8 and intestinal dysmotility, n=11. PN duration was median 10 years. Fat Mass Index (FMI) and Lean Mass Index (LMI) were compared in children with and without intestinal inflammation, steroid treatment and according to PN dependency.
  
  
  RESULTS
  34 children aged 5-20 years were studied. They were short, mean height SD score (SDS) -1.8 (p<0.001) and light (mean weight SDS -0.86, p<0.001) with high body mass index (BMI) SDS: mean 0.4 (p=0.04) and low Limb LMI SDS -0.9 (p<0.001). Children with SBS had low FMI SDS -0.8 (p=0.01). BC did not significantly differ between diagnostic groups or with steroid treatment. Patients with intestinal inflammation (n=20) had higher BMI SDS than those without, p=0.007. Totally, PN-dependent children, n=11 had higher BMI SDS, p=0.004, total body FMI SDS, p=0.008 and trunk FMI SDS, p=0.001 compared with patients partially dependent and off PN.
  
  
  CONCLUSIONS
  Significantly low limb LM was seen in all patient groups with high FM in children on total PN. Children with IF requiring PN treatment >27 days may benefit from BC monitoring and PN adjustment according to results in order to maximise linear growth and health in later life.
authors.affiliation: Department of Paediatric and Adolescent Medicine, Medical University Vienna, , Vienna, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Pichler
authors.forename: Sirinuch
authors.initials: S
authors.lastname: Chomtho
authors.forename: Mary
authors.initials: M
authors.lastname: Fewtrell
authors.forename: Sarah
authors.initials: S
authors.lastname: Macdonald
authors.forename: Susan
authors.initials: S
authors.lastname: Hill
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000704:Analysis of Variance; D001823:Body Composition / Q000187:drug effects / Q000502:physiology*; D050218:Body Fat Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000503:physiopathology*; D007410:Intestinal Diseases / Q000628:therapy*; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012015:Reference Standards; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Gastroenterology; Nutrition