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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3819

Title: Risk factors of malnutrition in children with severe motor and intellectual disabilities.
Other Titles: 重症心身障害児における低栄養のリスク因子についての検討
Authors: Hasegawa, Mari
Tomiwa, Kiyotaka
Higashiyama, Yukie
Kawaguchi, Chiharu
Kin, Hajime
Kubota, Masaru
Shima, Midori
Nogami, Keiji
Keywords: Malnutrition
Cerebral palsy
Body mass index
Associated factors
Respiratory assistance
Enteral formula
Energy requirement
Issue Date: Nov-2020
Publisher: Elsevier
Citation: Brain and development Vol.42 No.10 p.738-746 (2020 Nov)
Abstract: Background: Children with severe motor and intellectual disabilities (SMID) are at a high risk of malnutrition and often require tube feeding to maintain their nutritional status. However, determining their energy requirements is difficult since inadequate dietary intake, severe neurological impairment, respiratory assistance, and cognitive impairment are all factors that affect malnutrition in SMID. Aim: This study investigated the factors affecting malnutrition and identified problems affecting the nutritional status of children with SMID. Methods: Forty-two children with SMID with oral motor dysfunction who were receiving home medical care at one of four hospitals were enrolled. Their nutritional status was assessed using a 3-day dietary record, anthropometric measurements, and laboratory tests. The clinical findings associated with malnutrition were compared, and a body mass index (BMI) z-score less than -2SD was defined as malnutrition. The relationship between BMI z-score and other potential predictors was also investigated. Results: Thirty-three (79%) children received tube feeding, and 20 (48%) experienced malnutrition. The median age of the malnourished children was older than that of non-malnourished children. Respiratory assistance was significantly correlated with higher BMI z-score, independent of other potential confounders such as nutrition method, muscle tonus, and energy intake. Cholesterol levels were significantly higher in children receiving a standard infant formula beyond 3 years of age than in those who switched to enteral formula before 3 years of age. Conclusions: Malnutrition in children with SMID was mainly associated with age or respiratory condition. Energy requirements should be regularly re-evaluated with considering these factors.
Description: 博士(医学)・甲第761号・令和2年12月24日
Copyright © 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
URI: http://hdl.handle.net/10564/3819
ISSN: 03877604
Academic Degrees and number: 24601A761
Degree-granting date: 2020-12-24
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2020年度

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