McDonald Craig M, Abresch-Meyer Allison L, Nelson Mindy Dopler, Widman Lana M
Shriners Hospitals for Children Northern California, Sacramento, California 95817, USA.
J Spinal Cord Med. 2007;30 Suppl 1(Suppl 1):S97-104. doi: 10.1080/10790268.2007.11754612.
BACKGROUND/OBJECTIVE: To determine the body composition of adolescents with spinal cord injury (SCI) and to assess whether established cutoff values for obesity determined by body mass index (BMI) are valid for this population.
Sixty patients, aged 10-21 years, with traumatic SCI (50 with paraplegia and 10 with tetraplegia) were compared with 60 gender-, age-, and BMI-matched controls (CTRL). Dual-energy x-ray absorptiometry was used to estimate regional and total bone mineral content, lean tissue mass, fat tissue mass, and body fat percentage. BMI was calculated from measured weight and stature (kg/m2).
Total percent body fat was significantly higher in the paraplegia group (31.4% +/- 1.2%; mean +/- SE) than in the tetraplegia and CTRL groups (25.7% +/- 2.7% and 22.9% +/- 1.1%, respectively). This change in percent total body fat was associated with a reduction of lean tissue mass in the paraplegia (37.6 +/- 1.1 kg; mean +/- SE) and tetraplegia (32.8 +/- 2.5 kg) subjects as compared to the CTRL group (46.2 +/- 1.0 kg; P < 0.001). Total fat mass was significantly greater in the paraplegia group (19.3 +/- 1.3 kg) than the CTRL and tetraplegia groups (14.9 +/- 1.2 kg and 11.7 +/- 3.0 kg, respectively). Regional measurements revealed that the greatest reduction of lean tissue mass in the SCI subjects occurred in the lower extremities, followed by the trunk. As a result of these changes in body composition, the optimal BMI for classifying obesity (trunk fat percent >30 in males and >35 in females) in subjects with SCI was 19 kg/m2 as compared to 25 kg/m2 in able-bodied subjects.
Patients aged 10 to 21 years with SCI have significantly decreased lean tissue mass and bone mineral content, and increased fat mass. As a result, traditional BMI cutoff criteria significantly underestimate obesity in this population. New clinically applicable criteria to define obesity should be established for SCI children and adolescents with SCI.
背景/目的：确定脊髓损伤（SCI）青少年的身体成分，并评估根据体重指数（BMI）确定的肥胖既定临界值对此类人群是否有效。
将60例年龄在10 - 21岁的创伤性SCI患者（50例截瘫患者和10例四肢瘫患者）与60例性别、年龄和BMI匹配的对照组（CTRL）进行比较。采用双能X线吸收法估算局部和全身骨矿物质含量、瘦组织质量、脂肪组织质量和体脂百分比。根据测量的体重和身高计算BMI（kg/m²）。
截瘫组的全身脂肪百分比（31.4%±1.2%；均值±标准误）显著高于四肢瘫组和对照组（分别为25.7%±2.7%和22.9%±1.1%）。与对照组（46.2±1.0 kg；P<0.001）相比，截瘫（37.6±1.1 kg；均值±标准误）和四肢瘫（32.8±2.5 kg）患者全身脂肪百分比的这种变化与瘦组织质量的减少有关。截瘫组的总脂肪量（19.3±1.3 kg）显著高于对照组和四肢瘫组（分别为14.9±1.2 kg和11.7±3.0 kg）。局部测量显示，SCI患者瘦组织质量减少最多的部位是下肢，其次是躯干。由于身体成分的这些变化，SCI患者中肥胖分类的最佳BMI（男性躯干脂肪百分比>30，女性>35）为19 kg/m²，而健全人则为25 kg/m²。
10至21岁的SCI患者瘦组织质量和骨矿物质含量显著降低，脂肪量增加。因此，传统的BMI临界标准显著低估了该人群的肥胖情况。应为患有SCI的儿童和青少年建立新的临床适用的肥胖定义标准。
