RESUMEN
The aim of the present study was to investigate the neutrophil-to-lymphocyte ratio (NLR) level in children with cerebral palsy (CP) living at home or the rehabilitation center. The correlation of NLR with different severities of motor impairment was assessed. This was a single-center, cross-sectional, observational study. A total of 80 CP children who were either living at home (n=34) or at the rehabilitation center (n=46) were included. Demographic characteristics, anthropometric parameters and complete blood counts were recorded, and the NLR values were calculated. The severity of motor impairment was evaluated and categorized according to the Gross Motor Functional Classification System (GMFCS) level. The mean age of CP participants was 8.52±1.92 years. The percentage of children with CP who were malnourished (underweight, stunted and wasted) was higher amongst those at the rehabilitation center compared with those living at home. The mean NLR of children with CP in the rehabilitation center was significantly higher compared with the patients living at home (P=0.003). Participants from the rehabilitation center had severe motor impairment (GMFCS levels IV-V) and significantly higher NLR values than those with mild motor impairments (GMFCS levels II-III; P=0.006). However, there were no differences in NLR values in relation to severity of motor impairment in CP children living at home. CP children had some degree of neuroinflammation and systemic inflammation. NLR may be a potential simple inflammatory parameter that may be used to predict the severity of the motor impairment, particularly in CP children living at a rehabilitation center.
RESUMEN
Adequate nutrition is crucial for children with cerebral palsy (CCP). However, conventional nutritional assessments may be inadequate for defining undernourished CCP. Leptin, an adipocyte hormone controlling energy expenditure, could be a useful marker. Objectives of this cross-sectional analytic study were to explore correlations between serum leptin level and nutritional status, anthropometric measurements, and biochemical parameters in 86 CCP (aged 9 ± 2 years). Subscapular (SST) and triceps (TST) skinfold thicknesses, weight, and calculated height were obtained. Body mass index and weight-for-height (WH) Z-scores were calculated. Complete blood count and serum levels of leptin and albumin were collected. CCP were classified as undernourished if their WHZ was < -2 according to the World Health Organization criteria. Correlations between anthropometric measurements, biochemical data, and serum leptin levels were evaluated. From 86 CCP, 11 (12%) children were undernourished, and SST, hemoglobin, and hematocrit were significantly lower. Serum leptin levels of nourished and undernourished CCP were 5.4 ± 6.2 and 2.9 ± 1.6 ng/mL (p < 0.001), while the reported value from normal children was 4.9 ng/mL. Serum leptin levels demonstrated a significant correlation with SST and TST (r = 0.83 and 0.72; p < 0.001). Serum leptin was the only marker significantly correlated with WHZ (r = 0.45, p < 0.001) while adjusting for covariates. A serum leptin level of 2.2 ng/mL was the optimal cutoff point for defining adequate nutritional status (WHZ ≥ -2). The measurement of serum leptin should be included in a care scheme of CCP especially during surgical evaluation.