Jayaprakash, Kavitha;
Wells, Jonathan CK;
Rajwal, Sanjay;
Mushtaq, Talat;
Kyrana, Eirini;
(2024)
Preservation of fat mass at the expense of lean mass in children with end-stage chronic liver disease.
Pediatric Transplantation
, 28
(5)
, Article e14767. 10.1111/petr.14767.
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Preservation of fat mass at the expense of lean mass in children with end-stage chronic liver disease_.pdf - Accepted Version Access restricted to UCL open access staff until 20 June 2025. Download (411kB) |
Abstract
Background: Sarcopenia predicts morbidity and mortality in end-stage chronic liver disease (ESCLD). Here, we describe changes in body composition in children with ESCLD before and after liver transplantation (LT). // Methods: Retrospective analysis of whole body DXA scans performed before and after LT over 4 years. Appendicular and whole-body fat mass and lean mass were expressed as fat mass (FMI) and lean mass (LMI) index z-scores. Sarcopenia was defined as leg LMI z-score <−1.96. // Results: Eighty-three DXA scans of children before or after LT were studied. Sarcopenia had a positive correlation with weight (0.8, p < .01), height (0.48, p < .05), and BMI z-score (0.77, p < .01), as well as arm, trunk, and total mean mass indices. It correlated negatively with indices of hypersplenism: PLTs (−0.57, p < .01), Neu (−0.50, p < .05), WCC (−0.44, p < .05), and days to discharge (−0.46, p < .05). At baseline: 13/25 (52%) children were sarcopenic and stayed in the hospital after LT for longer. Eight were stunted with a higher WCC and Ne/Ly ratio. All had normal FM indices. One year after LT, 12/26 children remained sarcopenic. Seven were stunted. Two years after LT, 5/15 were sarcopenic, and 5 were stunted. Three years after LT, 1/10 was sarcopenic, and 2 were stunted. By 4 years after LT, 1/7 was sarcopenic, and the same one was stunted. FM indices remained normal. // Conclusions: Sarcopenic patients stayed longer in the hospital after LT. Lean mass indices were mostly within the normal range by 4 years after LT. 32% of children were stunted, and markers of inflammation were correlated with stunting. Fat mass was preserved at the cost of lean mass.
| Type: | Article |
|---|---|
| Title: | Preservation of fat mass at the expense of lean mass in children with end-stage chronic liver disease |
| Location: | Denmark |
| DOI: | 10.1111/petr.14767 |
| Publisher version: | http://dx.doi.org/10.1111/petr.14767 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Bone density; children; fat mass; liver disease; sarcopenia |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10194439 |
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