title: Nutritional evaluation of children with chronic cholestatic disease.
abstract: OBJECTIVE
  To evaluate the nutritional status of children with persistent cholestasis and to compare the anthropometric indices between children with and without liver cirrhosis and children with and without jaundice.
  
  
  METHODS
  Children with persistent cholestasis, i.e. increased direct bilirrubin or changes in the canalicular enzyme gamma-glutamyl transferase (GGT), were included. The anthropometric measures were weight (W), height or length (H), arm circumference (AC), triceps skinfold thickness (TST), arm muscle circumference (AMC), and body mass index (BMI).
  
  
  RESULTS
  Ninety-one children with cholestasis, with current median age of 12 months, were evaluated. W/age (A) and H/A indices below -2 Z-scores were observed in 33% and 30.8% of patients, respectively. Concerning the W/H index and BMI, only 12% and 16% of patients, respectively, were below -2 Z-scores. Regarding AC, 43.8% of 89 evaluated patients had some depletion. Observing the TST, 64% of patients had depletion, and 71.1% of the 45 evaluated patients had some degree of depletion regarding the ACM index.
  
  
  CONCLUSIONS
  Evaluation using weight in patients with chronic liver diseases may overestimate the nutritional status due to visceromegaly, subclinical edema, or ascites. Indices that correlate weight and height, such as W/H and BMI, may also not show depletion because of the chronic condition in which there are depletion of both weight and height. TST, AC, and ACM are parameters that better estimate nutritional status and should be part of the management of patients with liver diseases and cholestasis.
authors.affiliation: Group of Pediatric Hepatology and Gastroenterology, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Pediatric Gastroenterology Group, School of Medicine, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Francislaine Veiga
authors.initials: FV
authors.lastname: da Silva
authors.affiliation: Pediatric Gastroenterology Group, School of Medicine, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Electronic address: pmferri.liu@gmail.com.
authors.forename: Priscila Menezes
authors.initials: PM
authors.lastname: Ferri
authors.affiliation: Pediatric Gastroenterology Group, School of Medicine, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Medical Pediatric Gastroenterologist, Brazil.
authors.forename: Thaís Costa
authors.initials: TC
authors.lastname: Nascentes Queiroz
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Pamela
authors.initials: P
authors.lastname: de Souza Haueisen Barbosa
authors.affiliation: Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Cassiano de Oliveira
authors.affiliation: Medical Pediatric Gastroenterologist, Brazil.
authors.forename: Laura Jácome
authors.initials: LJ
authors.lastname: de Melo Pereira
authors.affiliation: Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Interdisciplinary Laboratory of Medical Investigation, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Simões E Silva
authors.affiliation: Pediatric Gastroenterology Group, School of Medicine, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Penna
authors.affiliation: Pediatric Gastroenterology Group, School of Medicine, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Druve Tavares Fagundes
authors.affiliation: Pediatric Gastroenterology Group, School of Medicine, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Electronic address: alexfer1403@gmail.com.
authors.forename: Alexandre Rodrigues
authors.initials: AR
authors.lastname: Ferreira
mesh_terms: D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D015362:Child Nutrition Disorders / Q000209:etiology / Q000503:physiopathology*; D002675:Child, Preschool; D002779:Cholestasis / Q000150:complications / Q000503:physiopathology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D007565:Jaundice / Q000150:complications / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology*; D008297:Male; D015596:Nutrition Assessment; D012885:Skinfold Thickness
keywords: Anthropometry; Antropometria; Chronic liver disease; Colestase neonatal; Doença hepática crônica; Neonatal cholestasis; Nutrition; Nutrição