Growth, body composition, and bone density following pediatric liver transplantation.
Amin SheikhTim CundyHelen Maria EvansPublished in: Pediatric transplantation (2018)
Patients transplanted for cholestatic liver disease are often significantly fat-soluble vitamin deficient and malnourished pretransplant, with significant corticosteroid exposure post-transplant, with increasing evidence of obesity and metabolic syndrome post-LT. Our study aimed to assess growth, body composition, and BMD in patients post-pediatric LT. Body composition and bone densitometry scans were performed on 21 patients. Pre- and post-transplant anthropometric data were analyzed. Bone health was assessed using serum ALP, calcium, phosphate, and procollagen-1-N-peptide levels. Median ages at transplant and at this assessment were 2.7 and 10.6 years, respectively. Physiological markers of bone health, median z-scores for total body, and lumbar spine aBMD were normal. Bone area was normal for height and BMAD at L3 was normal for age, indicating, respectively, normal cortical and trabecular bone accrual. Median z-scores for weight, height, and BMI were 0.6, -0.9, 1.8 and 0.6, 0.1, 0.8 pre- and post-transplant, respectively. Total body fat percentages measured on 21 body composition scans revealed 2 underweight, 7 normal, 6 overweight, and 6 obese. Bone mass is preserved following pediatric LT with good catch-up height. About 52% of patients were either overweight/obese post-transplant, potentially placing them at an increased risk of metabolic syndrome and its sequelae in later life. BMI alone is a poor indicator of nutritional status post-transplant.
Keyphrases
- body composition
- bone mineral density
- metabolic syndrome
- end stage renal disease
- resistance training
- body mass index
- ejection fraction
- newly diagnosed
- postmenopausal women
- chronic kidney disease
- peritoneal dialysis
- public health
- prognostic factors
- weight gain
- insulin resistance
- type diabetes
- computed tomography
- mental health
- patient reported outcomes
- soft tissue
- artificial intelligence
- bone loss
- deep learning
- cardiovascular disease
- bariatric surgery
- risk assessment
- bone regeneration
- skeletal muscle
- single cell
- uric acid
- human health
- high fat diet induced
- magnetic resonance
- type iii