Hasija R P, Khubchandani R P, Shenoi S
Pediatric Rheumatology Clinic, Jaslok Hospital & Research Center, Gopalrao Deshmukh Marg, Mumbai, India.
Clin Exp Rheumatol. 2008 Jan-Feb;26(1):146-50.
To study the prevalence of joint hypermobility in children from Mumbai, India and to study its association with malnutrition.
In a cross-sectional field study from September '02 to February '03 in Mumbai, 829 children of the lower urban socio-economic strata, between 3 and 19 years of age were evaluated independently by two observers for hypermobility using the Beighton 9-point scoring system. A score of >or= 4/9 was considered positive. Their nutritional status was stratified using standard Indian growth charts and hypermobility was quantified in various nutritional groups. Musculoskeletal symptoms were assessed by a questionnaire given to parents. Standard tests of significance (Chi square test, p<0.05-significant) were applied.
58.7% of the population studied, had a Beighton score >or= 4/9. There was a declining prevalence of joint hypermobility noted with increasing age. Near equal sex incidence was noted. A higher incidence of finger signs was noted in comparison to elbow hyperextension, knee hyperextension and hands-to-floor. 26% of the hypermobile population had musculoskeletal symptoms as compared with 17.2% of the non-hypermobile population (p<0.05). A positive Beighton score was found in 452/734 (61.5%) children with Grade 3 and 4 malnutrition in comparison to 35/95 (36.8%) children with normal nutrition or mild grades (Grade 1 and 2) of malnutrition (p<0.05). In the group with Grade 3 and 4 malnutrition, 26.1% of those hypermobile had musculoskeletal symptoms in comparison to 17.7% of their non-hypermobile counterparts (p<0.05).
In our study population: 1. A high prevalence of hypermobility using Beighton's score was noted; 2. Finger signs of the Beighton score were more common than the other signs; 3. Moderate and severe malnutrition were associated with hypermobility; 4. Musculoskeletal symptoms were linked to joint hypermobility; 5. Moderate and severely malnourished hypermobile children were more likely to have musculoskeletal symptoms as compared to their non-hypermobile counterparts.
研究印度孟买儿童关节活动过度的患病率，并探讨其与营养不良的关系。
在2002年9月至2003年2月于孟买开展的一项横断面现场研究中，829名年龄在3至19岁之间、来自城市社会经济底层的儿童由两名观察者独立使用贝顿9分评分系统评估关节活动过度情况。评分≥4/9被视为阳性。使用标准印度生长图表对他们的营养状况进行分层，并对不同营养组的关节活动过度情况进行量化。通过向家长发放问卷来评估肌肉骨骼症状。应用标准显著性检验（卡方检验，p<0.05为显著）。
在所研究的人群中，58.7%的人贝顿评分≥4/9。随着年龄增长，关节活动过度的患病率呈下降趋势。男女发病率相近。与肘部过度伸展、膝部过度伸展和双手触地相比，手指体征的发生率更高。26%的关节活动过度人群有肌肉骨骼症状，而非关节活动过度人群的这一比例为17.2%（p<0.05）。在3级和4级营养不良的734名儿童中，452名（61.5%）贝顿评分呈阳性，而营养正常或轻度营养不良（1级和2级）的95名儿童中，有35名（36.8%）贝顿评分呈阳性（p<0.05）。在3级和4级营养不良组中，关节活动过度的儿童中有26.1%有肌肉骨骼症状，而非关节活动过度的儿童中这一比例为17.7%（p<0.05）。
在我们的研究人群中：1. 使用贝顿评分发现关节活动过度的患病率很高；2. 贝顿评分中的手指体征比其他体征更常见；3. 中度和重度营养不良与关节活动过度有关；4. 肌肉骨骼症状与关节活动过度有关；5. 与非关节活动过度的儿童相比，中度和重度营养不良的关节活动过度儿童更易出现肌肉骨骼症状。
