Utility of Subjective Global Nutritional Assessment Tool for the Assessment of Malnutrition in Pediatric Patients with Chronic Liver Disease
	    		
		   		
		   			
		   		
	    	
    	 
    	10.5223/pghn.2023.26.6.346
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Anwesha RAY
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Srikanta BASU
			        		
			        		;
		        		
		        		
		        		
			        		Praveen KUMAR
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Pediatrics, Kalawati Saran Children’s Hospital and Lady Hardinge Medical College, New Delhi, India
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
            
            
            	- From:Pediatric Gastroenterology, Hepatology & Nutrition
	            		
	            		 2023;26(6):346-354
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	 Purpose:Approximately 30% of children with chronic liver disease (CLD) are malnourished.However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. 
				        	
				        
				        	Methods:This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. 
				        	
				        
				        	Results:A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), midupper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). 
				        	
				        
				        	Conclusion:In our study, more than one-third of children with CLD were malnourished.Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.