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Kaddah AM, Ibrahim RSM, Gamal S, Selim YMM. Body composition analysis using dual-energy x-ray absorptiometry in an Egyptian pediatric sickle cell disease cohort. Pediatr Blood Cancer 2024; 71:e31067. [PMID: 38750615 DOI: 10.1002/pbc.31067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/09/2024] [Accepted: 04/29/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Growth failure is commonly encountered in sickle cell disease (SCD). Tissue compartment growth and development are subsequently likely to be altered in such patients. OBJECTIVE We aimed to analyze body composition in an Egyptian pediatric SCD cohort using dual-energy x-ray absorptiometry (DEXA), one of the most comprehensive and noninvasive assessment methods available. METHODS Forty children with SCD ≤18 years and 40 healthy youngsters age- and gender-matched were enrolled. Patients' demographic, clinical, and laboratory parameters were obtained from their archived files. All patients and controls were subjected to body composition assessment using a MedixDR-Whole Body DEXA System. RESULTS In SCD patients; weight and height relative to age Z scores were significantly lower (p < .001), total body lean was significantly higher (p = .006), and total body fat percentage was lower, yet the difference was not statistically significant (p = .09). There were no statistically significant variations in bone mineral density or content, basal metabolic rate, subcutaneous adipose tissue, android/gynoid fat ratio, and visceral adipose tissue. There were no significant gender disparities between SCD patients and controls. CONCLUSION Faltering growth in children with SCD should be addressed with a multidisciplinary approach including nutritional support, correction of anemia, and proper medical care. Body composition parameters assessed using DEXA were comparable between cases and controls apart from total body lean. Further clinical studies are needed with multicenter cooperation and a larger sample size to assess the usefulness of DEXA as an assessment tool for body composition in children with SCD.
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Affiliation(s)
- Ahmed Maher Kaddah
- Pediatric Hematology and BMT Unit, Department of Pediatrics, Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
| | - Rania S M Ibrahim
- Radiology Department, Pediatric Unit, Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
| | - Seham Gamal
- Pediatric Hematology and BMT Unit, Department of Pediatrics, Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
| | - Yasmeen M M Selim
- Pediatric Hematology and BMT Unit, Department of Pediatrics, Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
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Bwakura-Dangarembizi M, Dumbura C, Ngosa D, Majo FD, Piper JD, Sturgeon JP, Nathoo KJ, Amadi B, Norris S, Chasekwa B, Ntozini R, Wells JC, Kelly P, Prendergast AJ. Fat and lean mass predict time to hospital readmission or mortality in children treated for complicated severe acute malnutrition in Zimbabwe and Zambia. Br J Nutr 2023; 130:1024-1033. [PMID: 36573378 PMCID: PMC10442795 DOI: 10.1017/s0007114522004056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
HIV and severe wasting are associated with post-discharge mortality and hospital readmission among children with complicated severe acute malnutrition (SAM); however, the reasons remain unclear. We assessed body composition at hospital discharge, stratified by HIV and oedema status, in a cohort of children with complicated SAM in three hospitals in Zambia and Zimbabwe. We measured skinfold thicknesses and bioelectrical impedance analysis (BIA) to investigate whether fat and lean mass were independent predictors of time to death or readmission. Cox proportional hazards models were used to estimate the association between death/readmission and discharge body composition. Mixed effects models were fitted to compare longitudinal changes in body composition over 1 year. At discharge, 284 and 546 children had complete BIA and skinfold measurements, respectively. Low discharge lean and peripheral fat mass were independently associated with death/hospital readmission. Each unit Z-score increase in impedance index and triceps skinfolds was associated with 48 % (adjusted hazard ratio 0·52, 95 % CI (0·30, 0·90)) and 17 % (adjusted hazard ratio 0·83, 95 % CI (0·71, 0·96)) lower hazard of death/readmission, respectively. HIV-positive v. HIV-negative children had lower gains in sum of skinfolds (mean difference -1·49, 95 % CI (-2·01, -0·97)) and impedance index Z-scores (-0·13, 95 % CI (-0·24, -0·01)) over 52 weeks. Children with non-oedematous v. oedematous SAM had lower mean changes in the sum of skinfolds (-1·47, 95 % CI (-1·97, -0·97)) and impedance index Z-scores (-0·23, 95 % CI (-0·36, -0·09)). Risk stratification to identify children at risk for mortality or readmission, and interventions to increase lean and peripheral fat mass, should be considered in the post-discharge care of these children.
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Affiliation(s)
- Mutsa Bwakura-Dangarembizi
- University of Zimbabwe, Faculty of Medicine and Health Sciences, Harare, Zimbabwe
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
- University of Witwatersrand, Johannesburg, South Africa
| | - Cherlynn Dumbura
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Deophine Ngosa
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
| | - Florence D. Majo
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Joe D. Piper
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, London, UK
| | - Jonathan P. Sturgeon
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, London, UK
| | - Kusum J. Nathoo
- University of Zimbabwe, Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Beatrice Amadi
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
| | - Shane Norris
- University of Witwatersrand, Johannesburg, South Africa
| | - Bernard Chasekwa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Jonathan C. Wells
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Paul Kelly
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
- Blizard Institute, Queen Mary University of London, London, UK
| | - Andrew J. Prendergast
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, London, UK
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Eze JN, Ikefuna AN, Uwaezuoke NA, Eke AL, Eke CB. Screen viewing practices and caregivers' knowledge of the health-related effects in children and adolescents in a Nigerian Urban City. Niger J Clin Pract 2022; 25:1115-1125. [DOI: 10.4103/njcp.njcp_1706_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nartey EB, Spector J, Adu-Afarwuah S, Jones CL, Jackson A, Ohemeng A, Shah R, Koryo-Dabrah A, Kuma ABA, Hyacinth HI, Steiner-Asiedu M. Nutritional perspectives on sickle cell disease in Africa: a systematic review. BMC Nutr 2021; 7:9. [PMID: 33731225 PMCID: PMC7972183 DOI: 10.1186/s40795-021-00410-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 02/08/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is an inherited blood disorder that predominantly affects individuals in sub-Saharan Africa. However, research that elucidates links between SCD pathophysiology and nutritional status in African patients is lacking. This systematic review aimed to assess the landscape of studies in sub-Saharan Africa that focused on nutritional aspects of SCD, and highlights gaps in knowledge that could inform priority-setting for future research. METHODS The study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Inclusion criteria comprised original, peer-reviewed research published between January 1995 and November 2020 involving individuals in Africa with any phenotypic variant of SCD and at least one nutritional status outcome. Nutritional status outcomes were defined as those that assessed dietary intakes, growth/anthropometry, or nutritional biomarkers. Databases used were Ovid Embase, Medline, Biosis and Web of Science. RESULTS The search returned 526 articles, of which 76 were included in the final analyses. Most investigations (67%) were conducted in Nigeria. Studies were categorized into one of three main categories: descriptive studies of anthropometric characteristics (49%), descriptive studies of macro- or micronutrient status (41%), and interventional studies (11%). Findings consistently included growth impairment, especially among children and adolescents from sub-Saharan Africa. Studies assessing macro- and micronutrients generally had small sample sizes and were exploratory in nature. Only four randomized trials were identified, which measured the impact of lime juice, long-chain fatty acids supplementation, ready-to-use supplementary food (RUSF), and oral arginine on health outcomes. CONCLUSIONS The findings reveal a moderate number of descriptive studies, most with small sample sizes, that focused on various aspects of nutrition and SCD in African patients. There was a stark dearth of interventional studies that could be used to inform evidence-based changes in clinical practice. Findings from the investigations were generally consistent with data from other regional settings, describing a significant risk of growth faltering and malnutrition among individuals with SCD. There is an unmet need for clinical research to better understand the potential benefits of nutrition-related interventions for patients with SCD in sub-Saharan Africa to promote optimal growth and improve health outcomes.
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Affiliation(s)
- Eunice Berko Nartey
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana. .,Department of Nutrition and Dietetics, University of Health and Allied Sciences, PMB 31, Ho, V/R, Ghana.
| | | | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | | | - Alan Jackson
- Emeritus Professor of Human Nutrition, Southampton General Hospital (MP 113), Tremona Road, Southampton, SO16 6YD, UK
| | - Agartha Ohemeng
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Rajiv Shah
- Novartis Global Health and Corporate Responsibility, Forum 1, Fabrikstrasse, Basel, Switzerland
| | - Alice Koryo-Dabrah
- Department of Nutrition and Dietetics, University of Health and Allied Sciences, PMB 31, Ho, V/R, Ghana
| | - Amma Benneh-Akwasi Kuma
- Department of Hematology, School of Medicine and Surgery, University of Ghana, Korle-Bu, Ghana
| | - Hyacinth I Hyacinth
- Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta, GA, USA.,The Atlanta Sickle Cell Disease Consortium, Atlanta, USA
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Sohaei S, Amani R, Tarrahi MJ, Ghasemi-Tehrani H. The effects of curcumin supplementation on glycemic status, lipid profile and hs-CRP levels in overweight/obese women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled clinical trial. Complement Ther Med 2019; 47:102201. [DOI: 10.1016/j.ctim.2019.102201] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022] Open
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