Assessment of mass spectrometric indicators of organic acids metabolism in children with sarcopenia on the background of protein-energy insufficiency. Pilot study

Introduction. The geriatric problem of sarcopenia is relevant for both therapists and pediatricians. Secondary sarcopenia is diagnosed at any age in severe diseases, as well as muscle loss and muscle strength due to protein-energy malnutrition (PEM) or morbid obesity. Diagnostic criteria have been developed for the adult category and are not approved for children.

The aim. To develop a method for laboratory diagnostics of sarcopenia based on the assessment of mass spectrometric indices of organic acid metabolism in children with sarcopenia against the background of protein-energy malnutrition.

Materials and methods. A single-center cohort study conducted in 18 patients (from 9 to 18 years, average age 11 ± 2.11 years) with PEM and cerebral palsy. All subjects underwent anthropometry, bioimpedancemetry (Diamant Aist), laboratory diagnostics and determination of organic acids in urine using gas chromatography in combination with mass spectrometric detection and fl ionization detection. Sarcopenia was diagnosed using the bioimpedance method in 10 children; the comparison group consisted of 8 patients. Statistical analysis was carried out using the StatTech v program. 3.1.8.

Results and discussion. In sarcopenia, lower levels of homogentisic, pyruvic (pyruvate), 3-hydroxybutyric acids and the TMA/TMAO ratio in urine are observed than in PEM alone, which is explained by a pronounced cellular energy deficit. A correlation was found between the percentage of fat mass in the component composition of the body and the levels of homogentisic, pyruvic (pyruvate), 3-Hydroxybutyric acids, the TMA / TMAO ratio in urine, as well as between the percentage of active cell mass in the component composition of the body and the levels of homogentisic, pyruvic (pyruvate), 3-Hydroxybutyric acids, the TMA / TMAO ratio in urine. The result of the ROC analysis, sarcopenia can be diagnosed in children with protein-energy malnutrition if the level of pyruvic acid in urine is less than 30.5255 mmol and 3-Hydroxybutyric acid is less than 3.0715 mmol.

Conclusions. Mass spectrometry is promising for the differential diagnosis of protein-energy malnutrition and sarcopenia in protein-energy malnutrition, as well as monitoring nutritional support.

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