Is Grip Strength a Good Marker of Nutritional Risk and Body Composition in Sick Children?

Abstract

ABSTRACT OBJECTIVE To determine if grip strength is a good marker of nutritional risk and body composition and to explore the relationship between grip strength and length of hospital stay (LOS) in sick children. DESIGN Secondary data analysis was performed based on dataset collected between 2005 and 2017. PARTICIPANTS/METHODS Of the total, 1,130 participants included in this study, 535 healthy children and 595 sick aged 5 –16 years. The degree of malnutrition risk was determined for the study participants using the Paediatric Yorkhill Malnutrition Score (PYMS) and dietetic assessment. Fat mass index (FMI) z-scores and fat-free mass index (FFMI) z-scores were calculated using the R GAMLSS package. MAIN OUTCOME MEASURES The relationship between hand grip strength z-score adjusted for height or age and lean index, fat index, FMI z-score and FFMI z-score were assessed by multivariate regression analysis model. RESULTS Hand grip strength adjusted for height or age was significantly higher in healthy children compared to sick (p < 0.0001). No association was found between grip strength and LOS. Grip strength was positively correlated with lean index in healthy and sick children (p < 0.05) but not with fat index. A significant difference was found in grip strength z-score between high and low PYMS score, adjusted for height (-0.706; p = 0.001) or age (-0.553; p < 0.0001). Lean index and health status were significant independent predictors of grip strength (p < 0.0001). Receiver operating characteristics (ROC) curves indicated that hand grip strength adjusted for height and for age show fair accuracy as a diagnostic test, with area under curve (AUC) values of 0.697 and 0.717, respectively, in distinguishing between patients with high and low risk of malnutrition. CONCLUSION In clinical practice, hand grip strength might be used as a predictors of patients’ nutrition status and FFM in paediatric patients.