Mid‐upper arm circumference, Physical Examination, and Inflammatory Parameters in Pediatric Patients with Solid Tumors: Useful Markers in Clinical Practice?

Abstract

Background: Childhood cancer comprises a group of diseases primarily of embryonal origin, affecting children and adolescents aged 0 to 19 years. Hospitalization and oncological treatment can contribute to malnutrition or exacerbate pre-existing nutritional deficits. This study aimed to analyze the associations between anthropometric indicators, indirect body composition measures, and inflammatory parameters in pediatric patients with solid tumors to determine whether these markers reflect only nutritional risk or concurrent nutritional compromise. Methods: An observational, descriptive, and retrospective study was conducted with 85 pediatric patients hospitalized. Univariate and multivariate logistic regression analyses were performed to evaluate the association between anthropometric indicators, indirect body composition measures, and inflammatory parameters. Results: While most patients exhibited adequate nutritional status based on anthropometric indices, over 40% showed nutritional deficits when assessed using arm anthropometry. Patients with low prealbumin levels were eight times more likely to present reduced muscle mass upon physical examination (OR: 8.04, p=0.009). Those with low albumin levels had a fourfold increased likelihood of presenting inadequacies in physical exams and mid-upper arm circumference measurements, in both univariate and multivariate models. A similar association was observed with C-reactive protein (CRP) levels for muscle loss (OR: 3.55, p=0.025), fat loss (OR: 4.18, p=0.012), and mid-upper arm circumference (OR: 5.25, p=0.010) in both models. Conclusion: Prealbumin and albumin should not be used in isolation for malnutrition classification. Arm anthropometry appears to be a more sensitive tool for assessing nutritional status in children and adolescents with cancer.