PD029 - CALF CIRCUMFERENCE AS A NUTRITIONAL INDICATOR IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY

PD029

CALF CIRCUMFERENCE AS A NUTRITIONAL INDICATOR IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY

L. Buyle^1,*, J. Wells², P. Prinzie³, E. Ortibus⁴, J. De Schepper⁵, N. Smeets⁶, T. Wassenberg⁶, K. Huysentruyt¹

¹Paediatric Gastro-enterology, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium, ²Great Ormond Street Institute of Child Health, UCL, London, United Kingdom, ³Department of Psychology, Education & Child Studies, Erasmus University, Rotterdam, Netherlands, ⁴Department of Development and Regeneration , KU Leuven, Leuven, ⁵Pediatric Endocrinology, ⁶Pediatric Neurology and Metabolic Unit , UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium

Rationale: This study examined how calf circumference (CC) reflects nutritional status compared to other indicators and its association with clinical parameters in children with Cerebral Palsy (CP).

Methods: Data were derived from a 1-year prospective, longitudinal observational study of children with CP in Flanders. Z-scores were calculated for weight (WFA) and mid upper arm (MUAC) using Flemish references, triceps (TSF) and subscapular skin folds (SSF) using US references and CC using a cohort of 533 healthy UK children. Children with gross motor function classification (GMFCS) I-II were mildly and >III severely impaired. Agreement between MUAC and CC was defined as both z-scores <-2 SD. Binomial generalized mixed models estimated odds ratios (OR) for factors influencing agreement, linear mixed models examined associations between clinical variables and CC z-score.

Results: We included 330 children (63; 37 % girls), with median (Q1;Q3) age 11.3 (8.5;14.3) years. GMFCS distribution was 17% I, 33% II, 15% III, 14% IV and 21% V; 76% had spastic CP. Participants were assessed once (n=115), twice (n=69) or three times (n=146). Mean (SD) WFA, MUAC, TSF, SSF and CC z-scores were -1.19 (1.8), 0.09 (1.3),  -0.01, (1.1), 0.30 (0.9) and -1.24 (2.0), respectively. CC-MUAC agreement was higher in mild (82%) vs severe (60%) impairment (p<0.001), but GMFCS (OR 0.57, 95%CI 0.3;1.2), sex (OR 2.3, 95%CI 0.3;15.5), and age (OR 1.15, 95%CI 0.9;1.5) were not associated with agreement. CC z-score was associated with GMFCS (-0.18, 95% CI -0.3;-0.1), WFA 0.78, 95% CI 0.7;0.8), TSF (0.21, 95% CI 0.1;0.3), female sex (0.26, 95% CI 0.1;0.4) and age (0.03 years, 95% CI 0.0;0.0).

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Conclusion: CC assessment highlights the distinct body composition of children with CP and underscores the need for comprehensive nutritional evaluation, particularly in  severe impairment.

Disclosure of Interest: None declared