Prospective study evaluating the value of subjective global assessment and national risk score 2002 for post-operative risk detection in living related donor liver transplant recipients

Background: Chronic liver disease may be associated with protein energy malnutrition. Those malnourished patients undergoing liver transplantation suffer great morbidities and even mortalities. Estimating the degree of malnutrition in patients with end stage liver disease is a difficult job, Subjective Global Assessment (SGA) and Nutritional Risk Score-2002 (NRS-2002) are among many tools that can give an overview for the nutritional status of the patients. Aim: To detect the efficacy and the predictive validity of SGA and NRS 2002 for post-operative risk detection for liver transplant patients. Patients & Methods: 30 recipients of end stage liver disease had undergone a nutritional assessment by SGA score & NRS-2002 score, to be compared with the parameters of outcome of post-operative liver transplantation (ALT, AST, INR, Bilirubin, time spent in ICU, hospital infective episodes & number of antibiotic courses). Results: Patients declared as malnourished by SGA and NRS-2002 had higher post operative ALT & AST value, more prolonged INR, spent more time at ICU and hospital, suffered from more infective episodes and had more antibiotic courses in a significant statistical manner. Conclusion: SGA and NRS-2002 could be useful, simple and dependable tools to be used for risk detection of post-operative morbidities after liver transplantation.

Conjugated Linoleic Acid and Dietary Fats Differentially Affect Hepatic ACAT Activity and LDL-Cholesterol in Postweanling Pigs Fed Low-Fat Diets

ABSTRACT：Two separate studies tested the hypoth- esis that plasma low-density lipoprotein cholesterol LDL-C ） can be decreased by conjugated linoleic acid （CLA） by depressing hepatic acyl-coenzyme A： cholesterol acyltransferase （ACAT） activity. In the first experiment, 3 groups of 6 early-weaned piglets were fed low-fat diets containing either 1.5% CLA, 1.5% corn oil or 1.5% beef tallow;fat provided 8% of the energy intake. In the second experiment, 4 groups of 6 early-weaned piglets were fed high-fat di- ets containing either 15% beef tallow, 12% beef tal- low plus 3% CLA, 15% corn oil, or 12% corn oil plus 3% CLA; fat provided 29% of energy intake. Cholesterol was balanced across diets in both experi-ments. In pigs fed the low-fat diets, all dietary fats in- creased LDL-C and triacylglycerols and decreased high-density lipoprotein cholesterol （ HDL-C ） and very low-density lipoprotein cholesterol （VLDL-C）. LDL-C was the same in pigs fed low-fat tallow or low-fat CLA diets. However, ACAT activity was near- ly 80% higher in pigs fed the low-fat tallow diet than in pigs fed the low-fat CLA diets. All high-fat diets increased LDL-C, HDL-C and triacylglycerols equally with no effect on VLDL-C. There were no unique fat- ty acid effects of the high-fat diets on ACAT activity. We conclude that supplemental fats had differential effects on hepatic ACAT activity and LDL-C, but on- ly in pigs fed low-fat diets.

Central body fat distribution indices in Thai preschool children

Background: Central obesity is associated with adverse health outcomes. This study aimed to determine the characteristics of central body fat distribution in Thai preschool children and to examine factors that could influence on body fat distribution of children. Methods: The total 811, 5 - 6 years old children were randomly sampled from 9 primary schools in Saraburi province. Body weight and height were measured in each child. Waist circumference (WC) was measured at the umbilicus level and hip circum-ference (HC) at the level yielding maximum circumference over buttock. Subcutaneous skinfold was measured on biceps, triceps, subscapular, suprailiac and abdominal regions. Total body fat (TBF) was measured with bioelectrical impedance analyzer. Results: Mean values of WC, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) of boys were not different from those of girls. Even though trunk skinfolds of both genders were similar, girls tended to have slightly greater biceps, triceps and subscapular skinfolds than boys. Strongly positive correlation was found between WC, WHtR, trunk skinfold and child’s BMI (p = 0.01) as well as between WC, WHtR, trunk skinfold and child’s TBF (p = 0.01). Multiple regression analysis demonstrated, in both genders, that BMI, age and TBF were strongly associated with WC (Adjusted R2 0.92 - 0.93) and WHtR (Adjusted R2 0.90 - 0.92) and that BMI and TBF were strongly associated with trunk skinfold (Adjusted R2 0.88 - 0.89). The association between WHR and TBF for boys and between WHR and BMI for girls were found to be weak in this study. Conclusion: No gender difference in body fat distribution indices was found in Thai preschool children. Change in central body fat distribution of children could be strongly influenced by their changes in age, BMI and TBF.

Calcium Intake in Relation to Body Mass Index and Fatness in Thai School-Aged Children

An emerging evidence suggests that dietary calcium may play a role in the regulation of body weight in humans. This study examined the relationship of calcium intake with body mass index and body fatness in Thai children. Methods: A cross-sectional study in 1570, 6 - 12 year-old children were conducted in representative provinces of Thailand. Body weight, height, sitting height and 4 sites skinfolds thickness were measured as well as the dietary intake using a 24 h recall and a food frequency questionnaire (FFQ). General linear model (GLM) analysis was used to determine the effect of calcium intake on body mass index (BMI) and body fatness of children. Results: There were no differences in parental education and family’s socio-economic status between genders. Girls had significantly greater sitting height (p?= 0.035), sitting height to height ratio (p?= 0.014) and sum of four skinfold thickness (p?= 0.001) than boys. Mean calcium intake was lower in girls than in boys. GLM analysis demonstrated that lower calcium intake among children was associated with higher body weight, BMI and sum 4-skinfold thickness. Conclusion: Lower calcium intake is associated with higher BMI and body fatness of Thai children. Further studies need to determine the optimal calcium intake to prevent overweight and obesity in children.