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Biomedical subjects

M Azcue

Publications and source records attributed to M Azcue.

5 recordsLinked to original sources
PubMed1997

Energy expenditure and body composition in children with Crohn's disease: effect of enteral nutrition and treatment with prednisolone.

BACKGROUND: Malnutrition and growth retardation are common complications of Crohn's disease in children. The contribution of resting energy expenditure (REE) to malnutrition is unclear. AIMS: To characterise the REE and body composition in children with Crohn's disease and compare them with normal controls and patients with anorexia nervosa; to compare the effects of prednisolone and enteral nutrition on energy expenditure and body composition. SUBJECTS: Twenty four children with Crohn's disease, 19 malnourished females with anorexia nervosa, and 22 healthy control subjects were studied. METHODS: In children with Crohn's disease measurements were done when the disease was acute and repeated at one and three months after treatment with either prednisolone or enteral nutrition. Resting energy expenditure was measured by indirect calorimetry and body composition by anthropometry, bioelectrical impedance analysis, total body potassium, H218O, and bromide space studies. RESULTS: Body weight and ideal body weight were significantly lower in patients with Crohn's disease than in healthy controls. Lean tissue was depleted and there was an increase in extracellular water. Per unit of lean body mass, there was no difference between REE in patients with Crohn's disease and controls, whereas patients with anorexia nervosa had significantly reduced REE. With enteral nutrition all body compartments and REE increased significantly (p < 0.001). In a subgroup of age-matched men there was a significant increase in height after three months of enteral nutrition compared with prednisolone (p < 0.01). Those treated with steroids did not show a significant change in height but did show an increase in all body compartments. However, intracellular water as well as lean body mass accretion were significantly higher in the enteral nutrition group than in the prednisolone group. CONCLUSIONS: Despite being malnourished, children with Crohn's disease fail to adapt their REE per unit of lean body mass. This might be a factor contributing to their malnutrition. Lean tissue accretion is higher in patients treated with enteral nutrition than in those treated with prednisolone.

Adolescent↗
PubMed1996

Use of bioelectrical impedance analysis measurements in the clinical management of malnutrition.

It is valuable to be able to measure the body composition of malnourished (undernourished) patients and to monitor their response to refeeding. The use of direct measurements, such as total body water, extracellular water, and total body potassium for clinical monitoring is expensive and cumbersome. We therefore have developed predictive equations for these variables by using fixed-frequency bioelectrical impedance analysis (BIA). Our equations deliberately do not include weight because they are used to predict changes in body composition in patients who are gaining weight during refeeding. BIA could predict changes in body composition with significantly greater precision than anthropometry alone. We conclude that BIA can be used to monitor changes in body composition in patients during refeeding.

Body Composition↗
PubMed1993

Use of bioelectrical impedance analysis to measure total body water in patients with cystic fibrosis.

The purpose of this study was to measure whole-body bioelectrical variables and to validate the technique of bioelectrical impedance analysis (BIA) as a measure of total body water (TBW) in patients with cystic fibrosis (CF). In 20 normally nourished males with CF, aged 7 to 39 years, bioelectrical impedance measurements were compared with TBW measured by isotopic distribution of H2(18)O. The relationship between the two measurements was found to be highly significant (r = 0.96; p < 0.0001). The major genotype mutation delta F508 was found to have no effect on BIA. Comparison of the CF patients with 21 normal controls matched for age and TBW volumes as measured by H2(18)O volume of distribution showed no difference in electrical parameters. However, the slope of the regression lines (H2(18)O, H2/R) was significantly steeper for the CF subjects (p < 0.03) than for controls. These data show that BIA can be used to measure TBW in patients with CF. However, the predictive equations developed in healthy control subjects should not be used; rather, separate predictive equations for patients with CF will need to be developed.

Adolescent↗
PubMed1990

Body compartment changes in sick children.

Our studies showed that there are important changes in body composition in children in response to dieting and refeeding. Similarly, we showed changes in body composition in response to renal transplantation, which would be expected to restore more normal homeostasis, but in its early phases changes in body composition are complicated by the use of high doses of drugs, notably steroid. Some of the changes in body composition can be predicted from changes in weight but the majority cannot. Relatively simple measurements like the four skinfolds as a means of determining body fat are surprisingly accurate, except in extremely obese subjects. Similarly, the measurements of fat free body mass are useful. However, this measurement does not discriminate changes within fat free body mass in the proportions of body cell mass versus extracellular mass. Similarly, none of these measurements provide any information regarding the composition of body cell mass with regard to its potassium and protein content (as reflected by total body nitrogen). The main drawback with total body nitrogen measurements is the radiation exposure. Thus, we have had to limit the inclusion of total body nitrogen measurements. It has been estimated that two total body nitrogen measurements provide a gonadal dose of radiation roughly equivalent to that experienced by an individual living in a large North American city, that means 30 to 50 mREM per each total body nitrogen measurement. It becomes ethically possible then to carry out nitrogen measurements where it can be argued that their measurement is essential in monitoring the safety and well being of the subject; or alternatively if the subject's life expectancy is limited.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗