Prevalence of Moderate Malnutrition in School-age Children and Its Association with Hypertension and Microalbuminuria

Ranti Astria Hannah^1, , Nanan Sekarwana¹ and Sjarief H Effendi¹

¹Department of Child Health, Faculty of Medicine Universitas Padjadjaran/Dr.Hasan Sadikin General Hospital Bandung, Indonesia

Cite this paper

Ranti Astria Hannah, Nanan Sekarwana and Sjarief H Effendi. Prevalence of Moderate Malnutrition in School-age Children and Its Association with Hypertension and Microalbuminuria. American Journal of Clinical Medicine Research. 2017; 5(1):6-9. doi: 10.12691/AJCMR-5-1-2

Abstract

Background. Previous studies has linked childhood severe malnutrition with hypertension; also association between hypertension and microalbuminuria. Currently there is no study on blood pressure and microalbuminuria in moderately malnourished school-age children. Methodology/Principal Findings. A cross-sectional study on children aged 6‒12 years from 3 public elementary schools in Bandung, Indonesia between July to September 2016. Weight, height and blood pressure of subjects were measured. Nutritional status were determined using WHO Child Growth Standards. Blood pressure levels were classified, and microalbuminuria were measured using Advia 1800 Analyzer (Siemens, Germany). Sample size was calculated with 18% estimated prevalence, 95% confidence, and 5% precision. Prevalence data were presented as percentage. Differences of blood pressure and microalbuminuria in moderately malnourished and well-nourished subjects were analyzed using Mann Whitney dan Chi-square tests, statistical significance was represented by p<0,05. Out of 235 subjects, 74 were moderately malnourished (prevalence 31,5%) and 161 were well-nourished. The median of systolic blood pressure, diastolic blood pressure and microalbuminuria in the moderately malnourished group were 95 mmHg; 62,5 mmHg; and 5,5 mcg/mg respectively, compared to 95 mmHg; 60 mmHg; and 4 mcg/mg respectively (p=0,741; 0,495; 0,217). Conclusions. The prevalence of moderate malnutrition in Indonesian school-age children is quite high. There were no significant differences of blood pressure and microalbuminuria between moderately malnourished and well-nourished children.

Keywords

moderate malnutrtion, children, hypertension, microalbuminuria

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Onis MD, Brown D, Blössner M, Borghi E. Levels & Trends in Child Malnutrition UNICEF-WHO-The World Bank Joint Child Malnutrition Estimates. 2012.
[2]	World Health Organization. Joint Child Malnutrition Estimates – Levels and Trends (2016 edition). Retrieved from www.who.int/nutgrowthdb/estimates2015/en.
[3]	Partnership for Child Development. The anthropometric status of school children in five countries in th Partnership for Child Development. Proceedings of the Nutrition Society. 1998; 57: 149-58.
[4]	Drake L, Maier C, Jukes M, Patrikios A. School-Age Children: Their Nutrition and Health. London: SCN Working Group on Nutrition of School-Age Children; 2002.
[5]	Srivastava A, Mahmood SE, Srivastava PM, Shrotriya VP, Kumar B. Nutritional status of school-age children - A scenario of urban slums in India. Archives of Public Health. 2012; 70(8): 1-8.
[6]	Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar 2013. Retrieved from www.depkes.go.id.
[7]	US Departement of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. 2005.
[8]	Xu H, Huang X, Risérus U, Cederholm T, Lindholm B, Ärnlöv J, et al. Urinary albumin excretion, blood pressure changes and hypertension incidence in the community:effect modification by kidney function. Nephrol Dial Transplant 2014 0: 1-8.
[9]	Luyckx VA, Bertram JF, Brenner BM, Fall C, Hoy WE, Ozanne SE, et al. Fetal and child health-impact on kidney development and long-term risk of hypertension and kidney disease. Lancet. 2013; 382(9888): 273-83.
[10]	Genovesi S AL, Gallieni M, Aiello A, Mandal SK, Doneda A, dkk. High prevalence of hypertension in normal and underweight Indian children. J Hypertens. 2011; 29(2): 217-21.
[11]	Adekanmbi AF, Obadina OO, Fetuga MB, Adejumo AO. Prevalence of malnutrition and high blood pressure amongst adolescents in semi-urban area of Ogun State south- western Nigeria. AJOL. 2016; 69(6).
[12]	Ramoshaba NE, Zatu MC, Hay L, Mabata LR. The Relationship between Blood Pressure and Anthropometric Indicators in Rural South African Children: Ellisras Longitudinal Study. J Obes Weight Loss Ther. 2015; 5(1).
[13]	Sesso R, Barreto GP, Neves J, Sawaya AL. Malnutrition is associated with increased blood pressure in childhood. Nephron Clin Pract.2004; 97: c61-6.
[14]	Koroshi A. Microalbuminuria, is it so important? Hippokratia 2007; 11(3): 105-7.
[15]	Knight EL, Kramer HM, Curhan GC. High-normal blood pressure and microalbuminuria Am J Kidney Dis. 2003; 41: 588-95.
[16]	Ide LEY, Akani NA. Microalbuminuria: It's significance, risk factors and methods of detection. Niger Health J. 2011; 11(1).
[17]	Piernas C, Wang D, Du S, Zhang B, Wang Z, Su C, et al. The double burden of under- and overnutrition and nutrient adequacy among Chinese preschool and school-aged children in 2009-2011. Eur J Clin Nutr. 2015;69(12):1323-9.
[18]	Yeasmin S, Islam K. Prevalence and determinants of undernutrition among school age slum children in Dhaka City, Bangladesh. J Nutr Health Sci. 2016;3(2):201.
[19]	WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Technical Report Series No. 854. Geneva, World Health Organization, 1995
[20]	Fallah Z, Qorbani M, Motlagh ME, Heshmat R, Ardalan G, Kelishadi R. Prevalence of prehypertension and hypertension in a nationally representative sample of Iranian children and adolescents: The caspian-iv study. Int J Prev Med. 2014; 5 (Suppl 1): S57-64.
[21]	Koebnick C, Black MH, Wu J, Martinez MP, Smith N, Kuizon BD, et al. The prevalence of primary pediatric prehypertension and hypertension in a real-world managed care system. J Clin Hypertens (Greenwich). 2013; 15(11): 784-92.
[22]	Riley M, Bluhm B. High blood pressure in children and adolescents. Am Fam Physician. 2012; 85(7): 693-700.
[23]	Manopunya S, Khositseth S. Hypertension in Thai children: a report from a hospital in suburban area. J Med Assoc Thai. 2010; 93(Suppl)(7): S99-108.
[24]	Chandrashekhar T, Sreeramareddy, Chew WF, Yap SF. Blood pressure and its associated factors among primary school children in suburban Selangor, Malaysia: A cross-sectional survey. J Family Community Med. 2013; 0(2): 90-7.
[25]	Lauer RM, Clarke WR. Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics. 1989; 84: 633-41.
[26]	Jones CA FM, Eberhardt MS, Chavers B, Coresh J, Engelgau M, et al. Microalbuminuria in the US population: third National Health and Nutrition Examination Survey. Am J Kidney Dis 2002; 39: 445-59.
[27]	Flynn JT. Microalbuminuria in children with primary hypertension. J Clin Hypertens. 2011: 1-4.