Nicholls D, Wells J C, Singhal A, Stanhope R
Brain and Behavioural Sciences Unit, Institute of Child Health, London, UK.
Eur J Clin Nutr. 2002 Sep;56(9):857-65. doi: 10.1038/sj.ejcn.1601403.
Body mass index (BMI) or equivalent weight for height indices are the most widely used measures of body composition in early onset and adolescent eating disorders. Although of value as screening instruments the limitation in disease states is their inability to discriminate fat and fat-free components of body weight.
To compare height-adjusted fat and fat-free components of body composition in children and young adolescents with different types of eating disorders with those of age matched reference children.
Weight, height, triceps and subscapular skinfold thickness were measured in 172 children (aged 7-16 y) with eating disorders receiving specialist treatment. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated using Slaughter's and Deurenberg's equations and normalisation for height. Using data from 157 normal children, representative of the UK 1990 growth reference data, reference curves for FMI and FFMI+/-2 s.d. were derived. Results for patient groups were superimposed on these reference curves.
FMI and FFMI were both reduced in eating disorders associated with malnutrition, including anorexia nervosa (AN). AN subjects did not differ from other subjects with comparable degrees of malnutrition. Children with eating disorders of normal weight, such as bulimia nervosa and selective eating, did not differ significantly from reference children in their relative FM and FFM.
FM and FFM merit independent consideration in disorders of malnutrition in children, rather than expressing data as percentage body fat or percentage BMI. The implications of loss of FFM on growth and development merit further investigation.
体重指数（BMI）或身高对应的等效体重指数是早期发病和青少年饮食失调中最广泛使用的身体成分测量指标。尽管作为筛查工具具有价值，但在疾病状态下，它们的局限性在于无法区分体重中的脂肪和无脂肪成分。
比较不同类型饮食失调的儿童和青少年与年龄匹配的参照儿童身体成分中经身高调整后的脂肪和无脂肪成分。
对172名接受专科治疗的饮食失调儿童（7至16岁）测量体重、身高、肱三头肌和肩胛下皮褶厚度。使用斯劳特（Slaughter）和德伦伯格（Deurenberg）方程并根据身高进行标准化计算脂肪量指数（FMI）和去脂体重指数（FFMI）。利用157名正常儿童的数据（代表英国1990年生长参考数据）得出FMI和FFMI±2标准差的参考曲线。将患者组的结果叠加在这些参考曲线上。
与营养不良相关的饮食失调，包括神经性厌食症（AN），FMI和FFMI均降低。AN患者与其他具有可比营养不良程度的患者没有差异。体重正常的饮食失调儿童，如神经性贪食症和选择性进食，其相对脂肪量（FM）和去脂体重（FFM）与参照儿童没有显著差异。
在儿童营养不良性疾病中，脂肪量（FM）和去脂体重（FFM）值得独立考虑，而不是将数据表示为体脂百分比或BMI百分比。去脂体重（FFM）减少对生长发育的影响值得进一步研究。
