Measurement of Body Composition by Air Displacement Plethysmography in Pediatric Intestinal Failure Patients
Condition: Short Bowel Syndrome
MeSH terms: Short Bowel Syndrome; Intestinal Failure; Syndrome
Study type: Observational

Summary: 
      This study will determine if air-displacement plethysmography (ADP) provides accurate
      measurement of body composition (percent body fat and fat-free mass) in pediatric patients
      with intestinal failure, as compared to body composition measured by alternative standard
      methods, including deuterium dilution, bioimpedance analysis (BIA), dual x-ray absorptiometry
      (DXA) when clinically indicated, and routine anthropometric measurements.
    

Detailed description: 
      Infants and children with intestinal failure (IF) require prolonged periods of parenteral
      nutrition (PN) for sustenance and growth until intestinal adaptation allows adequate enteral
      intake. Lean body mass (or muscle mass) preservation and accrual is an important goal during
      this phase of nutritional rehabilitation. However, lean body mass is not accurately measured
      by currently available anthropometric techniques. Thus, despite weight gain, muscle mass
      depletion can remain undetected.

      Little data exist in the field of measuring body composition in patients with intestinal
      failure, where changes in body weight are commonly taken to indirectly measure
      gastrointestinal absorptive function. Body composition analysis is of particular importance
      in the management of these patients, since it can help guide medical, surgical and/or
      nutrition interventions, including titration of enteral or parenteral nutrition. To the
      investigators' knowledge there are no studies examining whether air-displacement
      plethysmography (ADP) is a valid measure of body composition in patients with intestinal
      failure.

      The investigators propose a non-randomized, prospective cohort study to validate ADP as a
      measure of body composition in infants and children with IF.

      The investigators will apply non-radioactive (stable) isotope techniques to examine the
      accuracy of ADP in measuring body composition in these children.

      The investigators will also compare ADP with bioimpedance analysis and routine anthropometry.
      Additionally, if subjects have had a recent dual-energy X- ray absorptiometry (DXA) scan, the
      investigators will compare the ADP estimates of body composition to those obtained from DXA.
      The investigators hypothesize that ADP is a feasible and accurate technique for body
      composition measurements, and that the device can be used to serially measure lean body mass
      and fat mass changes in this cohort. If the feasibility and accuracy of ADP for body
      composition analysis can be demonstrated, the technique is likely to have wider applications
      in other pediatric illnesses.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with intestinal failure between 2-17 years of age inclusive will be recruited
        through the Center for Advanced Intestinal Rehabilitation (CAIR) program at Boston
        Children's Hospital.
      
Biospecimen description: 
      Urine samples
    
Keywords: Short Bowel Syndrome; Congenital Short Bowel Syndrome; Body Composition; Parenteral Nutrition; Intestinal Failure