Article
Licensed
Unlicensed Requires Authentication

Nutritional status and metabolic profile in neurologically impaired pediatric surgical patients

  • EMAIL logo , , , , , , , , , and
Published/Copyright: February 21, 2017
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 30 Issue 3

Abstract

Background:

Malnutrition is reported in pediatric neuromotor disability and impacts the child’s health. We described the nutritional and metabolic status in neurologically impaired (NI) children undergoing surgery.

Methods:

Anthropometry, body composition, hormonal and nutritional evaluations were performed in 44 NI subjects (13.7±8.0 years). Energy needs were calculated by Krick’s formula. Metabolic syndrome (MS) was defined applying the following criteria (≥3 defined MS): fasting blood glucose >100 mg/dL and/or homeostasis model assessment for insulin resistance (HOMA-IR) >97.5th percentile, trygliceride level >95th percentile, high-density lipoprotein (HDL)-cholesterol level <5th percentile, systolic/diastolic pressure >95th percentile; whilebody mass index – standard deviation score (BMI-SDS) <2 and biochemical malnutrition markers (≥2) defined undernutrition.

Results:

Energy intake was not adequate in 73.8% of the patients; no correlation between energy intake and BMI was noted. Undernutrition was noted in 34.1% of patients and MS in 11.36% of subjects. Fifty percent of the patients presented with insulin resistance, which was not related to BMI, body composition or other MS components.

Conclusions:

Nutritional and metabolic monitoring of disabled children and young adults is recommended to prevent adverse outcomes associated with malnutrition.

Keywords: children; disabilities; metabolic syndrome; nutrition; pediatric surgery
Corresponding author: Prof. Gloria Pelizzo, MD, Pediatric Surgery Unit, Children’s Hospital, Istituto Mediterraneo di Eccellenza Pediatrica, Via dei Benedettini n. 1, 90144 Palermo, Italy

Acknowledgments

The authors thank Antonella Tomasi for nursing care, Dr. Davide Gandini for patient care, Antonio Prisco and Linda Geca for technical support, Dr. C. Torre and Dott.ssa G. Testa for technical support in the hormonal evaluation and Dr. L. Kelly for English revision of the manuscript.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. World Health Organization. Management of severe malnutrition: a manual for physicians and other senior health workers. Geneva, 1999. Available at: http://www.who.int/nutrition/publications/en/manage_severe_malnutrition_eng.pdf.Search in Google Scholar

2. WHO, UNICEF, and SCN informal consultation on community-based management of severe malnutrition in children. SCN Nutrition Policy Paper No. 21. 2006. Available at: http://www.who.int/child_adolescent_health/documents/pdfs/fnb_v27n3_suppl.pdf.10.1177/15648265060273S307Search in Google Scholar

3. WHO/UNICEF/WFP/SCN Joint statement. Community-based management of severe acute malnutrition. Geneva, New York, Rome, 2007. Available at: http://www.who.int/child_adolescent_health/documents/pdfs/severe_acute_malnutrition_en.pdf.Search in Google Scholar

4. Pelletier DL, Frongillo EA Jr, Schroeder DG, Habicht JP. The effects of malnutrition on child mortality in developing countries. Bull World Health Organ 1995;73:443–8.Search in Google Scholar

5. Pelletier DL. The potentiating effects of malnutrition on child mortality: epidemiologic evidence and policy implications. Nutr Rev 194;152:409–15.10.1111/j.1753-4887.1994.tb01376.xSearch in Google Scholar

6. Abdallah AM, El-Sherbeny SS, Khairy S. Nutritional status of mentally disabled children in Egypt. Egyptian Journal of Hospital Medicine 2007;29:604–15.10.21608/ejhm.2007.17704Search in Google Scholar

7. Tuzun EH, Guven DK, Eker L, Elbasan B, Bulbul SF. Nutritional status of children with cerebral palsy in Turkey. Disabil Rehabil 2013;35:413–7.10.3109/09638288.2012.694965Search in Google Scholar

8. Werner D. Disabled village children. Trop Geogr Med 1993;45:229–32.Search in Google Scholar

9. Rempel G. The importance of good nutrition in children with cerebral palsy. Phys Med Rehabil Clin N Am 2015;26:39–56.10.1016/j.pmr.2014.09.001Search in Google Scholar

10. Groce N, Challenger E, Berman-Bieler R. Farkas A, Yilmaz N, et al. Malnutrition and disability: unexplored opportunities for collaboration. Paediatr Int Child Health 2014;34:308–14.10.1179/2046905514Y.0000000156Search in Google Scholar

11. Kyle UG, Lucas LA, Mackey G, Silva JC, Lusk J, et al. Implementation of nutrition support guidelines may affect energy and protein intake in the Pediatric Intensive Care Unit. J Acad Nutr Diet 2016;116:844–51.10.1016/j.jand.2016.01.005Search in Google Scholar

12. Manning EM, Shenkin A. Nutritional assessment in the critically ill. Crit Care Clin 1995;11:603–34.10.1016/S0749-0704(18)30055-1Search in Google Scholar

13. Marshall WA, Tanner JM. Variations in patterns of pubertal changes in boys. Arch Dis Child 1969;45:13–23.10.1136/adc.45.239.13Search in Google Scholar PubMed PubMed Central

14. Marshall WA, Tanner JM. Variations in patterns of pubertal changes in girls. Arch Dis Child 1969;44:291–303.10.1136/adc.44.235.291Search in Google Scholar PubMed PubMed Central

15. Stevenson RD. Use of segmental measures to estimate stature in children with cerebral palsy. Arch Pediatr Adolesc Med 1995;149:658–62.10.1001/archpedi.1995.02170190068012Search in Google Scholar PubMed

16. Tagliabue A, Cena H, Trentani C, Lanzola E, Silva S. How reliable is bio-electrical impedance analysis for individual patients? Int J Obes Relat Metab Disord 1992;16:649–52.Search in Google Scholar

17. Cena H, Fonte ML, Casali PM, Maffoni S, Roggi C, et al. Epicardial fat thickness: threshold values and lifestyle association in male adolescents. Pediatric Obesity 2015;10:205–11.10.1111/ijpo.227Search in Google Scholar PubMed

18. Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P. Elia M, et al. Composition of the ESPEN Working Group. Bioelectrical impedance analysis–part I: review of principles and methods. Clin Nutr 2004;23:1226–43.10.1016/j.clnu.2004.06.004Search in Google Scholar PubMed

19. Lukaski HC, Johnson PE, Bolonchuk WW, Lykken GI. Assessment of fat-free mass using bioelectrical impedance measurements of the human body. Am J Clin Nutr 1985;41:810–7.10.1093/ajcn/41.4.810Search in Google Scholar PubMed

20. Turconi G, Bazzano R, Roggi C, Cena H. Reliability and relative validity of a quantitative food-frequency questionnaire for use among adults in Italian population. Int J Food Sci Nutr 2010;61:846–62.10.3109/09637486.2010.495329Search in Google Scholar PubMed

21. Krick J, Murphy PE, Markham JF, Shapiro BK. A proposed formula for calculating energy needs of children with cerebral palsy. Dev Med Child Neurol 1992;34:481–7.10.1111/j.1469-8749.1992.tb11468.xSearch in Google Scholar PubMed

22. Fleisch A. Basal metabolism standard and its determination with the “metabocalculator”. Helv Med Acta 1951;18:23–44.Search in Google Scholar

23. Cacciari E, Milani S, Balsamo A, Spada E, Bona G, et al. Italian cross-sectional growth charts for height, weight and BMI (2–20 years). J Endocrinol Invest 2006;29:581–93.10.1007/BF03344156Search in Google Scholar PubMed

24. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Search in Google Scholar PubMed

25. Third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in adults (adult treatment panel III). Bethesda, National Heart, Lung, and Blood Institute, 2001.10.1001/jama.285.19.2486Search in Google Scholar PubMed

26. d’Annunzio G, Vanelli M, Pistorio A, Minuto N, Bergamino L, et al. Insulin resistance and secretion indexes in healthy Italian children and adolescents: a multicentre study. Acta Biomedica 2009;80:21–8.Search in Google Scholar

27. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1999:22(Suppl 1):S5–19.10.2337/diacare.21.1.S5Search in Google Scholar

28. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–76.10.1542/peds.114.S2.555Search in Google Scholar

29. Ego A. Definitions: small for gestational age and intrauterine growth retardation. J Gynecol Obstet Biol Reprod 2013;42: 872–94.10.1016/j.jgyn.2013.09.012Search in Google Scholar

30. Balcazar H, Haas J. Classification schemes of small-for-gestational age and type of intrauterine growth retardation and its implications to early neonatal mortality. Early Hum Dev 1990;24:219–30.10.1016/0378-3782(90)90029-ISearch in Google Scholar

31. Stevenson RD, Roberts CD, Vogtle L. The effects of non-nutritional factors on growth in cerebral palsy. Dev Med Child Neurol 1995;37:124–30.10.1111/j.1469-8749.1995.tb11981.xSearch in Google Scholar

32. Coniglio SJ, Stevenson RD. Growth hormone deficiency in two children with cerebral palsy. Dev Med Child Neurol 1995;37:1013–5.10.1111/j.1469-8749.1995.tb11957.xSearch in Google Scholar

33. Coniglio SJ, Stevenson RD, Rogol AD. Apparent growth hormone deficiency in children with cerebral palsy. Dev Med Child Neurol 1996;38:797–804.10.1111/j.1469-8749.1996.tb15114.xSearch in Google Scholar

34. Henderson RC, Grossberg RI, Matuszewski J, Menon N, Johnson J, et al. Growth and nutritional status in residential center versus home-living children and adolescents with quadriplegic cerebral palsy. J Pediatr 2007;151:161–6.10.1016/j.jpeds.2007.02.060Search in Google Scholar

35. Engsner G, Habre D, Sjögren I, Vahlquist B. Brain growth in children with kwashiorkor. Acta Paediatr Scand 1974;63:687–94.10.1111/j.1651-2227.1974.tb16991.xSearch in Google Scholar

36. Grantham-Mcgregor S, Powell C, Walker SP, Himes JH. Nutritional supplementation, psychosocial stimulation, and mental development of stunted children: the Jamaican study. Lancet 1991;338:1–5.10.1016/0140-6736(91)90001-6Search in Google Scholar

37. Viteri FE. Protein energy malnutrition. In: Viteri FE, Walker AW, Durie PR, et al. editors. Pediatric gastrointestinal diseases. Philadelphia, PA: B.C. Decker, 1991:1596–611.Search in Google Scholar

38. Liu J, Raine A, Venables PH, Dalais C, Mednick SA. Malnutrition at age 3 years and lower cognitive ability at age 11 years: independence from psychosocial adversity. Arch Pediatr Adolesc Med 2003;157:593–600.10.1001/archpedi.157.6.593Search in Google Scholar PubMed PubMed Central

39. Smart J. Malnutrition, learning, and behavior: 25 years on from the MIT symposium. Proc Nutr Soc 1993;52:189–99.10.1079/PNS19930051Search in Google Scholar

40. Graves P. Nutrition and infant behavior: a replication study in the Katmandu Valley, Nepal. Am J Clin Nutr 1978;31:541–51.10.1093/ajcn/31.3.541Search in Google Scholar

41. Chandra RK, Kumari S. Nutrition and immunity: an overview. J Nutr 1994;124:1433S–5S.10.1093/jn/124.suppl_8.1433SSearch in Google Scholar

42. Viart P. Hemodynamic findings in severe protein-calorie malnutrition. Am J Clin Nutr 1977;30:334–48.10.1093/ajcn/30.3.334Search in Google Scholar

43. Viart P. Hemodynamic findings during treatment of protein calorie malnutrition. Am J Clin Nutr 1978;31:911–26.10.1093/ajcn/31.6.911Search in Google Scholar

44. Lewis D, Khoshoo V, Pencharz, PB, Golladay ES. Impact of nutritional rehabilitation on gastroesophageal reflux in neurologically impaired children. J Pediatr Surg 1994;29:167–70.10.1016/0022-3468(94)90312-3Search in Google Scholar

45. Sullivan PB. Nutrition and growth in children with cerebral palsy: setting the scene. Eur J Clin Nutr 2013; 67(Suppl 2):S3–4.10.1038/ejcn.2013.222Search in Google Scholar

46. Kuperminc MN, Gottrand F, Samson-Fang L, Arvedson J, Bell K, et al. Nutritional management of children with cerebral palsy: a practical guide. Eur J Clin Nutr 2013;67(Suppl 2):S21–3.10.1038/ejcn.2013.227Search in Google Scholar

47. Culley WJ, Middleton TO. Caloric requirements of mentally retarded children with and without motor dysfunction. J Pediatric 1969;75:380–4.10.1016/S0022-3476(69)80262-3Search in Google Scholar

48. Rieken R, van Goudoever JB, Schierbeek H, Willemsen SP, Calis EA, et al. Measuring body composition and energy expenditure in children with severe neurologic impairment and intellectual disability. Am J Clin Nutr 2011;94:759–66.10.3945/ajcn.110.003798Search in Google Scholar PubMed

49. Guida B, Pietrobelli A, Trio R, Laccetti R, Falconi C, et al. Body mass index and bioelectrical vector distribution in 8-year-old children. Nutr Metab Cardiovasc Dis 2008;18:133–41.10.1016/j.numecd.2006.08.008Search in Google Scholar PubMed

50. Girma T, Kæstel P, Workeneh N, Mølgaard C, Eaton S, et al. Bioimpedance index for measurement of total body water in severely malnourished children: assessing the effect of nutritional oedema. Clin Nutr 2016;5:713–7.10.1016/j.clnu.2015.05.002Search in Google Scholar PubMed

51. Gupta D, Lammersfeld CA, Burrows JL, Dahlk SL, Vashi PG, et al. Bioelectrical impedance phase angle in clinical practice: implications for prognosis in advanced colo-rectal cancer. Am J Clin Nutr 2004;80:1634–8.10.1093/ajcn/80.6.1634Search in Google Scholar PubMed

52. Schwenk A, Beisenherz A, Römer K, Kremer G, Salzberger B, et al. Phase angle from bioelectrical impedance analysis remains an independent predictive marker in HIV-infected patients in the era of highly active antiretroviral treatment. Am J Clin Nutr 2000;72:496–501.10.1093/ajcn/72.2.496Search in Google Scholar PubMed

53. Maruyama Y, Stenvinkel P, Lindholm B. Role of interleukin-1beta in the development of malnutrition in chronic renal failure patients. Blood Purif 2005;23:275–81.10.1159/000086012Search in Google Scholar PubMed

54. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academy Press, 2010.Search in Google Scholar

55. Cranney C, Horsely T, O’Donnell S, Weiler H, Ooi D, et al. Effectiveness and safety of vitamin D. Evidence Report/Technology Assessment No. 158 prepared by the University of Ottawa Evidence-based Practice Center under Contract No. 290-02.0021. AHRQ Publication No. 07-E013. Rockville, MD: Agency for Healthcare Research and Quality, 2007.Search in Google Scholar

56. Holick MF. Vitamin D. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern nutrition in health and disease, 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2006.Search in Google Scholar

57. Norman AW, Henry HH. Vitamin D. In: Bowman BA, Russell RM, editors. Present knowledge in nutrition, 9th ed. Washington DC: ILSI Press, 2006.Search in Google Scholar

58. Yu H, Rohan T. Role of the insulin-like growth factor family in cancer development and progression. J Natl Cancer Inst 2000;92:1472–89.10.1093/jnci/92.18.1472Search in Google Scholar PubMed

59. Rajpathak SN, Gunter MJ, Wylie-Rosett J, Ho GY, Kaplan RC, et al. The role of insulin-like growth factor-I and its binding proteins in glucose homeostasis and type 2 diabetes. Diabetes Metab Res Rev 2009;25:3–12.10.1002/dmrr.919Search in Google Scholar PubMed PubMed Central

60. Juul A, Holm K, Kastrup KW, Pedersen SA, Michaelsen KF, et al. Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency. J Clin Endocrinol Metab 1997;82:2497–502.Search in Google Scholar

61. Thissen JP, Ketelslegers JM, Underwood LE. Nutritional regulation of the insulin-like growth factors. Endocr Rev 1994;15:80–101.10.1210/edrv-15-1-80Search in Google Scholar PubMed

62. Elnenaei MO, Alaghband-Zadeh J, Sherwood R, Awara MA, Moniz C, et al. Leptin and insulin growth factor 1: diagnostic markers of the refeeding syndrome and mortality. Br J Nutr 2011;106:906–12.10.1017/S0007114511001097Search in Google Scholar PubMed

63. Nivet-Antoine V, Golmard JL, Coussieu C, Piette F, Cynober L, et al. Leptin is better than any other biological parameter for monitoring the efficacy of renutrition in hospitalized malnourished elderly patients. Clin Endocrinol 2011;75:315–20.10.1111/j.1365-2265.2011.04047.xSearch in Google Scholar PubMed

64. Haspolat K, Ece A, Gürkan F. Atamer Y, Tutanç M, et al. Relationships between leptin, insulin, IGF-1 and IGFBP-3 in children with energy malnutrition. Clin Biochem 2007;40:201–5.10.1016/j.clinbiochem.2006.11.008Search in Google Scholar PubMed

65. Despres JP, Lemieux I, Bergeron J, Pibarot P, Mathieu P, et al. Abdominal obesity and the metabolic syndrome: contribution to global cardi- ometabolic risk. Arterioscler Thromb Vasc Biol 2008;28:1039–49.10.1161/ATVBAHA.107.159228Search in Google Scholar PubMed

66. Reaven GM. The metabolic syndrome: time to get off the merry-go-round? J Intern Med 2011;269:127–36.10.1111/j.1365-2796.2010.02325.xSearch in Google Scholar PubMed

67. Mandavia CH, Pulakat L, Demarco V, Sowers JR. Over-nutrition and metabolic cardiomyopathy. Metabolism 2012;61:1205–10.10.1016/j.metabol.2012.02.013Search in Google Scholar PubMed PubMed Central

68. Hermans MP, Amoussou-Guenou KD, Bouenizabila E, Sadikot SS, Ahn SA, et al. The normal-weight type 2 diabetes phenotype revisited. Diabetes Metab Syndr 2016; 10(2 Suppl 1):S82–8.10.1016/j.dsx.2016.01.035Search in Google Scholar PubMed

69. Benziger CP, Bernabé-Ortiz A, Gilman RH, Checkley W, Smeeth L, et al. Metabolic abnormalities are common among South American Hispanics subjects with normalexcess ody weight: The CRONICAS Cohort Study. PLoS One 2015;10:e0138968.10.1371/journal.pone.0138968Search in Google Scholar PubMed PubMed Central

70. Ramsaran C, Maharaj RG. Normal weight obesity among young adults in Trinidad and Tobago: prevalence and associated factors. Int J Adolesc Med Health 2015. doi: 10.1515/ijamh-2015-0042.10.1515/ijamh-2015-0042Search in Google Scholar PubMed

71. Adams MS, Khan NZ, Begum SA, Wirz SL, Hesketh T, et al. Feeding difficulties in children with cerebral palsy: low-cost caregiver training in Dhaka, Bangladesh. Child Care Health Dev 2012;38:878–88.10.1111/j.1365-2214.2011.01327.xSearch in Google Scholar PubMed

72. Tsatsoulis A, Mantzaris MD, Bellou S, Andrikoula M. Insulin resistance: an adaptive mechanism becomes maladaptive in the current environment – an evolutionary perspective. Metabol Clin Exper 2013;62:622–33.10.1016/j.metabol.2012.11.004Search in Google Scholar PubMed

73. Schenk S, Saberi M, Olefsky JM. Insulin sensitivity: modulation by nutrients and inflammation. J Clin Invest 2008;118:2992–3002.10.1172/JCI34260Search in Google Scholar PubMed PubMed Central

74. Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol 2011;29:415–45.10.1146/annurev-immunol-031210-101322Search in Google Scholar PubMed

75. Bjorntorp P. Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease? J Intern Med 1991;230:195–201.10.1111/j.1365-2796.1991.tb00431.xSearch in Google Scholar PubMed

76. John O. Holloszy exercise-induced increase in muscle insulin sensitivity. J Appl Physiol 2005;99:338–43.10.1152/japplphysiol.00123.2005Search in Google Scholar PubMed

77. Benson AC, Torode ME, Fiatarone Singh MA. Effects of resistance training on metabolic fitness in children and adolescents: a systematic review. Obes Rev 2008;9:43–66.10.1111/j.1467-789X.2007.00388.xSearch in Google Scholar PubMed

78. Engsberg JR, Ross SA, Collins DR. Increasing ankle strength to improve gait and function in children with cerebral palsy: a pilot study. Pediatr Phys Ther 2006;18:266–75.10.1097/01.pep.0000233023.33383.2bSearch in Google Scholar PubMed

79. Eek MN, Tranberg R, Zügner R, Alkema K, Beckung E. Muscle strength training to improve gait function in children with cerebral palsy. Dev Med Child Neurol 2008;50:759–64.10.1111/j.1469-8749.2008.03045.xSearch in Google Scholar PubMed

80. Hegazi MA, Soliman OE, Hasaneen BM, El-Arman M, El-Galel NA, et al. Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy. J Pediatr 2012;88:267–74.10.2223/JPED.2197Search in Google Scholar PubMed

81. Hamza RT, Ismail MA, Hamed AI. Growth hormone deficiency in children and adolescents with cerebral palsy: relation to gross motor function and degree of spasticity. Pak J Biol Sci 2011;14:433–40.10.3923/pjbs.2011.433.440Search in Google Scholar PubMed

82. Devesa J, Casteleiro N, Rodicio C, López N, Reimunde P. Growth hormone deficiency and cerebral palsy. Ther Clin Risk Manag 2010;6:413–8.10.2147/TCRM.S12312Search in Google Scholar PubMed PubMed Central

83. Guha N, Nevitt SP, Francis M, Woodland JA, Böhning D, et al. The effects of recombinant human insulin-like growth factor-I/insulin-like growth factor binding protein-3 administration on body composition and physical fitness in recreational athletes. J Clin Endocrinol Metab 2015;100: 3126–31.10.1210/jc.2015-1996Search in Google Scholar PubMed

84. Donzeau A, Bouhours-Nouet N, Fauchard M, Decrequy A, Boux de Casson M, et al. Birth weight is associated with the IGF-1 response to GH in children: programming of the anabolic action of GH? J Clin Endocrinol Metab 2015;100:2972–8.10.1210/jc.2015-1603Search in Google Scholar PubMed

85. Slattery M, Bredella MA, Stanley T, Torriani M, Misra M. Effects of recombinant human growth hormone (rhGH) administration on body composition and cardiovascular risk factors in obese adolescent girls. Int J Pediatr Endocrinol 2014;2014:22.10.1186/1687-9856-2014-22Search in Google Scholar PubMed PubMed Central

86. So WY, Song M, Park YH, Cho BL, Lim JY, et al. Body composition, fitness level, anabolic hormones, and inflammatory cytokines in the elderly: a randomized controlled trial. Aging Clin Exp Res 2013;25:167–74.10.1007/s40520-013-0032-ySearch in Google Scholar PubMed

87. Toumba M, Neocleous V, Shammas C, Jossif A, Skordis N. Effects of growth hormone on heart structure and function in adolescence. Georgian Med News 2012;210:34–9.Search in Google Scholar

88. Ekström K, Carlsson-Skwirut C, Ritzén, EM, Bang P. Insulin-like growth factor-I and insulin-like growth factor binding protein-3 cotreatment versus insulin-like growth factor-I alone in two brothers with growth hormone insensitivity syndrome: effects on insulin sensitivity, body composition and linear growth. Horm Res Paediatr 2011;76:355–66.10.1159/000330410Search in Google Scholar PubMed

89. Finnerty CC, Ali A, McLean J, Benjamin N, Clayton RP, et al. Impact of stress-induced diabetes on outcomes in severely burned children. J Am Coll Surg 2014;218:783–95.10.1016/j.jamcollsurg.2014.01.038Search in Google Scholar PubMed PubMed Central

90. Sebranek JJ, Lugli AK, Coursin DB. Glycaemic control in the perioperative period. Br J Anaesth 2013;111(Suppl 1):i18–34.10.1093/bja/aet381Search in Google Scholar PubMed

91. Bosarge PL, Kerby JD. Stress-induced hyperglycemia: is it harmful following trauma? Adv Surg 2013;47:287–97.10.1016/j.yasu.2013.03.002Search in Google Scholar PubMed

92. Rakitin A, Kõks S, Haldre S. Metabolic syndrome and anticonvulsants: a comparative study of valproic acid and carbamazepine. Seizure 2016;38:11–6.10.1016/j.seizure.2016.03.008Search in Google Scholar PubMed

93. Katsiki N, Mikhailidis DP, Nair DR. The effects of antiepileptic drugs onvascular risk factors: a narrative review. Seizure 2014;23:677–84.10.1016/j.seizure.2014.05.011Search in Google Scholar PubMed

94. Liang H, Li H, Hu Y, Li S, Lü L, et al. Effects of Topiramate for atypicalantipsychotic-induced body weight gain and metabolic adversities: a systematicreview and meta-analysis. Zhonghua Yi Xue Za Zhi 2016;96:216–23.Search in Google Scholar

95. Belcastro V, D’Egidio C, Striano P, Verrotti A. Metabolic and endocrineeffects of valproic acid chronic treatment. Epilepsy Res 2013;107:1–8.10.1016/j.eplepsyres.2013.08.016Search in Google Scholar PubMed

96. Verrotti A, D’Egidio C, Mohn A, Coppola G, Chiarelli F. Weight gain following treatment with valproic acid: pathogenetic mechanisms and clinical implications. Obes Rev 2011;12:e32–43.10.1111/j.1467-789X.2010.00800.xSearch in Google Scholar

97. Mania M, Kasradze S, Okujava N. Valproic acid related metabolic syndrome in patients with epilepsy. Georgian Med News 2011;194:43–7.Search in Google Scholar

98. Verrotti A, Manco R, Agostinelli S, Coppola G, Chiarelli F. The metabolic syndrome in overweight epileptic patients treated with valproic acid. Epilepsia 2010;51:268–73.10.1111/j.1528-1167.2009.02206.xSearch in Google Scholar

99. Nanau RM, Neuman MG. Adverse drug reactions induced by valproic acid. Clin Biochem 2013;46:1323–38.10.1016/j.clinbiochem.2013.06.012Search in Google Scholar

100. Eyman RK, Strauss DJ, Grossman HJ. Survival of children with severe developmental disability. In: Rosenbloom L, editor. Diagnosis and management of neurological disabilities in childhood. Bailliere’s Clinical Pediatrics. London: Bailliere Tindall Ltd, 1996:543–56.Search in Google Scholar

101. Strauss D. Shavelle RM, Anderson TW. Life expectancy of children with cerebral palsy. Pediatr Neurol 1998;18:143–9.10.1016/S0887-8994(97)00172-0Search in Google Scholar

102. Blair E, Watson L, Badawi N, Stanley FJ. Life expectancy among people with cerebral palsy in Western Australia. Dev Med Child Neurol 2001;43:508–15.10.1017/S0012162201000949Search in Google Scholar

103. Hutton JL, Cooke T, Pharoah PO. Life expectancy in children with cerebral palsy. Br Med J 1994;309:431–5.10.1136/bmj.309.6952.431Search in Google Scholar

104. Hutton JL, Colver AF, Mackie PC. Effect of severity of disability on survival in north east England cerebral palsy cohort. Arch Dis Child 2000;83:468–74.10.1136/adc.83.6.468Search in Google Scholar

105. Strauss D, Shavelle R. Life expectancy of adults with cerebral palsy. Dev Med Child Neurol 1998;40: 369–75.Search in Google Scholar

106. DeVivo MJ, Ivie CS. Life expectancy of ventilator-dependent persons with spinal cord injuries. Chest 1995;108:226–32.10.1378/chest.108.1.226Search in Google Scholar

107. DeVivo M, Stover SL. Long-term survival and causes of death. In: Stover S, DeLisa J, Whiteneck G, editors. Spinal cord injury. Gaithersburg, MD: Aspen, 1995:289–316.Search in Google Scholar

108. Strauss D, Shavelle RM, Ashwal S. Life expectancy and median survival time in the permanent vegetative state. Pediatr Neurol 1999;21:626–31.10.1016/S0887-8994(99)00051-XSearch in Google Scholar

Received: 2016-9-19
Accepted: 2017-1-9
Published Online: 2017-2-21
Published in Print: 2017-3-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Adrenocortical neoplasms in adulthood and childhood: distinct presentation. Review of the clinical, pathological and imaging characteristics
  4. Original Articles
  5. Assessment of health-related quality of life in Egyptian adolescents with type 1 diabetes: DEMPU survey
  6. Non-HDL-cholesterol and C-reactive protein in children and adolescents with type 1 diabetes
  7. Nutritional status and metabolic profile in neurologically impaired pediatric surgical patients
  8. Vascular risk factors are associated with retinal arteriolar narrowing and venular widening in children and adolescents with type 1 diabetes
  9. Are aromatase inhibitors in boys with predicted short stature and/or rapidly advancing bone age effective and safe?
  10. Increased prevalence of bicuspid aortic valve in Turner syndrome links with karyotype: the crucial importance of detailed cardiovascular screening
  11. Resting energy expenditure in girls with Turner syndrome
  12. AMH levels in girls with various pubertal problems
  13. Bone age in unilateral spastic cerebral palsy: is there a correlation with hand function and limb length?
  14. Novel germline mutation (Leu512Met) in the thyrotropin receptor gene (TSHR) leading to sporadic non-autoimmune hyperthyroidism
  15. A novel DAX-1 mutation in two male siblings presenting with precocious puberty and late-onset hypogonadotropic hypogonadism
  16. Case Reports
  17. Adrenarche unmasks compound heterozygous 3β-hydroxysteroid dehydrogenase deficiency: c.244G&gt;A (p.Ala82Thr) and the novel 931C&gt;T (p.Gln311*) variant in a non-salt wasting, severely undervirilised 46XY
  18. Three cases of Gordon syndrome with dominant KLHL3 mutations
  19. Unexplained cyanosis caused by hepatopulmonary syndrome in a girl with APECED syndrome
https://doi.org/10.1515/jpem-2016-0369
Keywords for this article
children; disabilities; metabolic syndrome; nutrition; pediatric surgery

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Adrenocortical neoplasms in adulthood and childhood: distinct presentation. Review of the clinical, pathological and imaging characteristics
  4. Original Articles
  5. Assessment of health-related quality of life in Egyptian adolescents with type 1 diabetes: DEMPU survey
  6. Non-HDL-cholesterol and C-reactive protein in children and adolescents with type 1 diabetes
  7. Nutritional status and metabolic profile in neurologically impaired pediatric surgical patients
  8. Vascular risk factors are associated with retinal arteriolar narrowing and venular widening in children and adolescents with type 1 diabetes
  9. Are aromatase inhibitors in boys with predicted short stature and/or rapidly advancing bone age effective and safe?
  10. Increased prevalence of bicuspid aortic valve in Turner syndrome links with karyotype: the crucial importance of detailed cardiovascular screening
  11. Resting energy expenditure in girls with Turner syndrome
  12. AMH levels in girls with various pubertal problems
  13. Bone age in unilateral spastic cerebral palsy: is there a correlation with hand function and limb length?
  14. Novel germline mutation (Leu512Met) in the thyrotropin receptor gene (TSHR) leading to sporadic non-autoimmune hyperthyroidism
  15. A novel DAX-1 mutation in two male siblings presenting with precocious puberty and late-onset hypogonadotropic hypogonadism
  16. Case Reports
  17. Adrenarche unmasks compound heterozygous 3β-hydroxysteroid dehydrogenase deficiency: c.244G&gt;A (p.Ala82Thr) and the novel 931C&gt;T (p.Gln311*) variant in a non-salt wasting, severely undervirilised 46XY
  18. Three cases of Gordon syndrome with dominant KLHL3 mutations
  19. Unexplained cyanosis caused by hepatopulmonary syndrome in a girl with APECED syndrome
Downloaded on 15.4.2026 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2016-0369/html
Scroll to top button