Effects of Malnutrition on Left Ventricular Mass in a North-Malagasy Children Population

BACKGROUND: Malnutrition among children population of less developed countries is a major health problem. Inadequate food intake and infectious diseases are combined to increase further the prevalence. Malnourishment brings to muscle cells loss with development of cardiac complications, like arrhythmias, cardiomyopathy and sudden death. In developed countries, malnutrition has generally a different etiology, like chronic diseases. The aim of our study was to investigate the correlation between malnutrition and left ventricular mass in an African children population. METHODS: 313 children were studied, in the region of Antsiranana, Madagascar, with age ranging from 4 to 16 years old (mean 7,8 ± 3 years). A clinical and echocardiographic evaluation was performed with annotation of anthropometric and left ventricle parameters. Malnutrition was defined as a body mass index (BMI) value age- and sex-specific of 16, 17 and 18,5 at the age of 18, or under the 15(th) percentile. Left ventricle mass was indexed by height(2.7) (LVMI). RESULTS: We identified a very high prevalence of children malnutrition: 124 children, according to BMI values, and 100 children under the 15(th) percentile. LVMI values have shown to be increased in proportion to BMI percentiles ranging from 29,8 ± 10,8 g/m(2.7) in the malnutrition group to 45 ± 15,1 g/m(2.7) in >95(th) percentile group. LVMI values in children < 15(th) BMI percentile were significantly lower compared to normal nutritional status (29,8 ± 10,8 g/m(2,7) vs. 32,9 ± 12,1 g/m(2,7), p = 0.02). Also with BMI values evaluation, malnourished children showed statistically lower values of LVMI (29,3 ± 10,1 g/m(2,7) vs. 33,6 ± 12,5 g/m(2,7), p = 0.001). CONCLUSION: In African children population, the malnourishment status is correlated with cardiac muscle mass decrease, which appears to be reduced in proportion to the decrease in body size.