1.Prealbumin measurement in hospitalized children with different score of Screening Tool for the Assess-ment of Malnutrition in Pediatrics and its value
Bin WU ; Zhiwei LIN ; Fengxiu CHEN
Chinese Journal of Clinical Nutrition 2016;24(3):129-133
Objective To investigate the difference of serum prealbumin in hospitalized children and its value in Screening Tool for the Assessment of Malnutrition in Pediatrics ( STAMP) in hospital-izedchildren.Methods 867hospitalizedchildrenwererecruitedfromMarch2013toApril2014in the First Affiliated Hospital of Fujian Medical University .All the patients were assessed using STAMP and collected venous blood sample for measuring serum prealbumin within 24 hours after admission.All the patients were surveyed for information regarding gender , age, dietary changes, etc.and their clini-cal data and laboratory results during hospitalization collected .The patients were divided into high mal-nutrition risk group ( HMRG) and low malnutrition risk group ( LMRG) according to STAMP scores upon admission. Results There were 463 children ( 53.4%) in HMRG, and 404 in LMRG (46.6%).Compared with the LMRG, the HMRG had significantly lower serum prealbumin [ (144.7 ± 50.6) mg/L vs.(173.6 ±71.3) mg/L, t=6.795, P=0.000].After controlling for age, course of disease, white blood cell count, albumin, glutamic-oxalacetic transaminase, C-reactive protein in covariance analysis, the HMRG still had significantly lower serum prealbumin than the LMRG [ estimate ( 95% CI): 139.8 ( 134.9 -144.8 ) mg/L vs.157.9 ( 151.9 -163.8 ) mg/L, F =20.433 , P=0.000 ) .Clinical cure rates in HMRG with low serum prealbumin , HMRG with normal serum pre-albumin, LMRG with low serum prealbumin, and LMRG with normal serum prealbumin were 62.9%(95/151), 80.5% (251/312), 77.1% (27/35), and 98.1% (362/369) (χ2 =112.80, P=0.000 ) , respectively; incidences of hospital acquired infection were 21.9% ( 33/151 ) , 8.7%( 27/312 ) , 22.9% ( 8/35 ) , and 1.9% ( 7/369 ) (χ2 =63.55 , P =0.000 ) , respectively. Conclusion High malnutrtion could be distinguished more accurately using the combination of the as-sessment of malnutrition screening tools and serum prealbumin measurement .
2.Influence factors of malnutrition risk in hospitalized children
Fengxiu CHEN ; Zhiwei LIN ; Bin WU
Chinese Journal of Clinical Nutrition 2015;23(1):17-22
Objective To investigate the influence factors of malnutrition risk in hospitalized children,in order to provide theoretical basis for early identifying hospitalized children at the risk of malnutrition and for guiding clinical nutritional intervention.Methods Hospitalized children in the Department of Pediatrics of our hospital from March 1st 2013 to April 30th 2014 were included and assessed using Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP).Questionnaire survey was conducted and clinical data was recorded.The children were divided into two groups according to STAMP scores upon admission,namely high malnutrition risk group and low malnutrition risk group.Comparing the differences of basic characteristics,laboratory examinations,and treatments between the two groups,associated factors of statistical significance were detected.With the associated factors identified in single factor analysis as independent variables and STAMP score-based group division as the dependent variable,multifactor unconditional Logistic regression analysis was performed to explore the independent risk factors influencing STAMP scores of hospitalized children.Results A total of 1 406 hospitalized children were included,of whom 738 were at high malnutrition risk,and the other 668 were at low malnutrition risk.Single factor analysis indicated that fever before admission (Z =-3.809,P =0.000),severity of condition (x2 =14.068,P =0.000),age (x2 =5.813,P =0.017),and length of fever before admission (t =2.793,P =0.005) were associated with high malnutrition risk of hospitalized children.Non-conditional Logistic regression suggested that severity of condition (OR =1.557,95% CI:1.164-2.083,P =0.003),length of fever before admission (OR =1.039,95% CI:1.011-1.068,P =0.006),and granulocyte count (OR =1.032,95% CI:1.004-1.061,P =0.027) were risk factors of high malnutrition risk in hospitalized children,and age (OR =0.942,95% CI:0.909-0.977,P =0.001) was protective factor.Conclusion Age,severity of condition,length of fever before admission,and granulocyte count can provide helpful information for early identification of hospitalized children at high malnutrition risk.
3.Relationship among maternal gut,vaginal microbiota and microbiota in meconium and vernix caseosa in newborns
Jinqian MA ; Pianpian FAN ; Tao ZHENG ; Lin ZHANG ; Yuanzhi CHEN ; Jian SHEN ; Fengxiu OUYANG
Journal of Shanghai Jiaotong University(Medical Science) 2024;44(1):50-63
Objective·To analyze the diversity and composition of the maternal gut microbiota and vaginal microbiota in late pregnancy,neonatal meconium microbiota and vernix caseosa microbiota,and analyze the similarities,differences and correlations.Methods·This is a prospective study.Maternal stool samples and vaginal swabs in late-pregnancy,and neonatal meconium samples were collected from 11 mother-infant pairs at Xinhua Hospital,Shanghai Jiao Tong University School of Medicine from August to November 2018;the vernix caseosa from three sites(forehead,axilla,and inguinal crease)and meconium samples were collected from 14 healthy newborns at International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine in December 2018.All births were vaginal deliveries.The 16S rRNA gene V3?V4 region sequencing was used.The diversity,composition and similarities/differences of the maternal gut microbiota,the vaginal microbiota,and the neonatal meconium microbiota from the 11 mother-infant pairs,as well as the neonatal vernix caseosa microbiota and the meconium microbiota from the 14 newborns were analyzed.Results·The number of operational taxonomic units(OTUs),ACE index,Chao1 index,and Shannon index of maternal gut microbiota were all higher than those of vaginal microbiota;the ACE indices and the Chao1 indices of the vernix caseosa microbiota at three sites were all higher than those of meconium microbiota(P<0.01).The β diversity varied among the maternal gut microbiota,vaginal microbiota,and neonatal meconium microbiota(P<0.01).The β diversity of neonatal vernix caseosa microbiota from three sites(forehead,axilla,and inguinal crease)was similar,but different from meconium microbiota(P<0.01).At the phylum level,the dominant bacteria were Firmicutes(52.76%)and Bacteroidetes(41.67%)in the maternal gut microbiota,Firmicutes(74.36%)and Actinobacteria(21.25%)in the maternal vaginal microbiota,and Firmicutes(84.22%)and Proteobacteria(8.80%)in the neonatal vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Proteobacteria in the two batches of samples(81.11%and 88.72%,respectively).At the genus level,the dominant bacteria were Bacteroides(35.42%)and Faecalibacterium(10.12%)in the maternal gut microbiota,Lactobacillus(69.10%)and Bifidobacterium(11.30%)in the vaginal microbiota,and Lactobacillus(79.81%)and Pseudomonas(3.23%)in the vernix caseosa microbiota.The dominant bacterium in the neonatal meconium was Escherichia in the two batches of samples(55.21%and 31.18%,respectively).Conclusion·The α diversity of maternal gut microbiota is higher than that of vaginal microbiota and neonatal meconium microbiota,and it is higher in neonatal vernix caseosa than that in meconium microbiota.The Firmicutes is the predominant phylum in the maternal late-pregnancy gut microbiota,vaginal microbiota,and neonatal vernix microbiota.Lactobacillus is the predominant genus in both maternal vaginal and neonatal vernix caseosa microbiota.Proteobacteria in phylum and Escherichia in genus are predominant in meconium microbiota.The microbiota composition is similar in vernix caseosa at different body sites,but there are differences between the vernix caseosa microbiota and meconium microbiota.