Handgrip strength as a surrogate marker of lean mass and risk of malnutrition in paediatric patients

Mckirdy, S., Nichols, B., Williamson, S. and Gerasimidis, K. (2021) Handgrip strength as a surrogate marker of lean mass and risk of malnutrition in paediatric patients. Clinical Nutrition, 40(9), pp. 5189-5195. (doi: 10.1016/j.clnu.2021.08.005) (PMID:34464858)

Abstract

Background & Aims: The use of handgrip strength (HGS) as a proxy of nutritional status in sick children has not been studied. This study created HGS centile charts in healthy children and explored the utility of HGS z-scores as markers of body composition and screening of malnutrition risk in sick children. Methods: Data from 535 healthy children aged 5-16 years were used for the development of HGS centiles adjusted either for age or height. In 595 sick children, relationships between HGS z-scores with body composition, malnutrition risk (Paediatric Yorkhill Malnutrition Score-PYMS), length of hospital stay (LOS) and biomarkers of disease severity were explored. The use of HGS z-score to identify sick children in need of further dietetic assessment was investigated. Results: Children scoring at high malnutrition risk with PYMS had lower HGS z-scores for age (by 0.51 SD, p<0.001) and height (by 0.46 SD, p=0.001) than those who scored low. A HGS z-score at cut-offs of -0.81 SD and -1.2 SD for age and height, respectively, was predictive of need for dietetic intervention in sick children with sensitivity of 79% and 70% and specificity of 56% and 69%, respectively. HGS z-scores were predictive of fat free mass (FFM) in sick and healthy (all p<0.001) children, while fat mass was not. HGS z-scores were inversely related with plasma CRP (rho, age: -0.21; height: -0.23, both p=0.001). HGS was not predictive of LOS. Conclusion: HGS is predictive of FFM, could compliment assessment of malnutrition risk, and may help identify children for further dietetic intervention on admission to hospital.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Nichols, Mr Ben and Mckirdy, Miss Shona and Gerasimidis, Professor Konstantinos
• Authors: Mckirdy, S., Nichols, B., Williamson, S., and Gerasimidis, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Nutrition
• Publisher: Elsevier
• ISSN: 0261-5614
• ISSN (Online): 1532-1983
• Published Online: 13 August 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Clinical Nutrition 40(9): 5189-5195
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
300280		The Role of Dietary D-serine in Health and Disease	Andrew Roe	Biotechnology and Biological Sciences Research Council (BBSRC)	BB/R006539/1	III - Bacteriology