Nutritional status and metabolic profile in neurologically impaired pediatric surgical patients

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; while-body 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.