Body composition and components of energy expenditure in children with end-stage liver disease

Greer, R., Lehnert, M., Lewindon, P., Cleghorn, Geoffrey J., & Shepherd, R. W. (2003) Body composition and components of energy expenditure in children with end-stage liver disease. Journal of Pediatric Gastroenterology and Nutrition, 36(3), pp. 358-363.

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Background: Better understanding of body composition and energy metabolism in pediatric liver disease may provide a scientific basis for improved medical therapy aimed at achieving optimal nutrition, slowing progression to end-stage liver disease (ESLD), and improving the outcome of liver transplantation. Methods: Twenty-one children less than 2 years of age with ESLD awaiting liver transplantation and 15 healthy, aged-matched controls had body compartment analysis using a four compartment model (body cell mass, fat mass, extracellular water, and extracellular solids). Subjects also had measurements of resting energy expenditure (REE) and respiratory quotient (RQ) by indirect calorimetry. Nine patients and 15 control subjects also had measurements of total energy expenditure (TEE) using doubly labelled water. Results: Mean weights and heights were similar in the two groups. Compared with control subjects, children with ESLD had higher relative mean body cell mass (33 ± 2% vs 29 ± 1% of body weight, P < 0.05), but had similar fat mass, extracellular water, and extracellular solid compartments (18% vs 20%, 41% vs 38%, and 7% vs 13% of body weight respectively). Compared with control subjects, children with ESLD had 27% higher mean REE/body weight (0.285 ± 0.013 vs 0.218. ± 0.013 mJ/kg/24h, P < 0.001), 16% higher REE/unit cell mass (P < 0.05); and lower mean RQ (P < 0.05). Mean TEE of patients was 4.70 ± 0.49 mJ/24h vs 3.19 ± 0.76 in controls, (P < 0.01). Conclusions: In children, ESLD is a hypermetabolic state adversely affecting the relationship between metabolic and non-metabolic body compartments. There is increased metabolic activity within the body cell mass with excess lipid oxidation during fasting and at rest. These findings have implications for the design of appropriate nutritional therapy.

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40 citations in Scopus
27 citations in Web of Science®
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ID Code: 89504
Item Type: Journal Article
Refereed: Yes
Additional Information: Cited By :37
Export Date: 1 September 2015
Correspondence Address: Shepherd, R.W.; Department of Pediatrics, Washington Univ. School of Medicine, St. Louis Children's Hospital, One Children's Place, St. Louis, MO 63110, United States; email:
Keywords: Body composition, Energy expenditure, Nutrition, Paediatric liver disease, lipid, water, article, calorimetry, child, clinical article, controlled study, energy metabolism, height, human, hypermetabolism, lipid oxidation, liver disease, liver transplantation, priority journal, respiratory quotient, weight, body height, body water, body weight, case control study, chronic disease, female, infant, liver failure, male, metabolism, nutritional status, nutritional support, oxygen consumption, pathophysiology, physiology, Calorimetry, Indirect, Case-Control Studies, Humans
DOI: 10.1097/00005176-200303000-00010
ISSN: 0277-2116
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Deposited On: 04 Nov 2015 01:31
Last Modified: 26 Jun 2017 03:01

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