Risk factors of malnutrition in children with severe motor and intellectual disabilities.

• Material Type: 博士論文
• Title: Risk factors of malnutrition in children with severe motor and intellectual disabilities.
• Author/Editor: Hasegawa, Mari; Tomiwa, Kiyotaka; Higashiyama, Yukie; Kawaguchi, Chiharu; Kin, Hajime; Kubota, Masaru; Shima, Midori; Nogami, Keiji
• Author Heading: Hasegawa, Mari; Tomiwa, Kiyotaka; Higashiyama, Yukie; Kawaguchi, Chiharu; Kin, Hajime; Kubota, Masaru; Shima, Midori; Nogami, Keiji
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2020-11
• Publication Date (W3CDTF): 2020-11
• Alternative Title: 重症心身障害児における低栄養のリスク因子についての検討
• Periodical title: Brain and development
• No. or year of volume/issue: 42 10
• Volume: 42
• Issue: 10
• Pages: 738-746
• ISSN (Periodical Title): ISSN : 0387-7604
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2020-12-24
• Dissertation Number: 甲第761号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Malnutrition; Cerebral palsy; Body mass index; Associated factors; Respiratory assistance; Enteral formula; Energy requirement; Micronutrients
• Target Audience: 一般
• Note (General): type:Thesis; Background: Children with severe motor and intellectual disabilities (SMID) are at a high risk of malnutrition and often require tube feeding to maintain their nutritional status. However, determining their energy requirements is difficult since inadequate dietary intake, severe neurological impairment, respiratory assistance, and cognitive impairment are all factors that affect malnutrition in SMID. Aim: This study investigated the factors affecting malnutrition and identified problems affecting the nutritional status of children with SMID. Methods: Forty-two children with SMID with oral motor dysfunction who were receiving home medical care at one of four hospitals were enrolled. Their nutritional status was assessed using a 3-day dietary record, anthropometric measurements, and laboratory tests. The clinical findings associated with malnutrition were compared, and a body mass index (BMI) z-score less than -2SD was defined as malnutrition. The relationship between BMI z-score and other potential predictors was also investigated. Results: Thirty-three (79%) children received tube feeding, and 20 (48%) experienced malnutrition. The median age of the malnourished children was older than that of non-malnourished children. Respiratory assistance was significantly correlated with higher BMI z-score, independent of other potential confounders such as nutrition method, muscle tonus, and energy intake. Cholesterol levels were significantly higher in children receiving a standard infant formula beyond 3 years of age than in those who switched to enteral formula before 3 years of age. Conclusions: Malnutrition in children with SMID was mainly associated with age or respiratory condition. Energy requirements should be regularly re-evaluated with considering these factors.; 博士（医学）・甲第761号・令和2年12月24日; Copyright © 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.; identifier:Brain and development Vol.42 No.10 p.738-746 (2020 Nov); identifier:03877604; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3819; identifier:Brain and development, 42(10): 738-746
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.braindev.2020.06.009
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3819/1/01%e7%94%b2761%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3819/2/02%e7%94%b2761%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3819/3/03%e7%94%b2761%e6%9c%ac%e6%96%87.pdf fulltext