Shurtleff David B, Walker William Otis, Duguay Sharon, Peterson Do, Cardenas Diana
Department of Pediatrics, University of Washington, Seattle, USA.
J Spinal Cord Med. 2010;33(4):410-9. doi: 10.1080/10790268.2010.11689720.
To evaluate the appropriate use of arm span measurements as a substitute for height/linear length to evaluate obesity in people with myelomeningocele by comparing calculated body mass indices (BMIs) with recently published BMI graphs by the Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics standards (NCHS) published in 2000.
Retrospective analysis of collected data on patients seen in the University of Washington Birth Defects Clinic from July 1, 1965, through June 1, 2008. Observations included degree of paralysis, presence of scoliosis, height (linear length), weight, and arm span. We compared published CDC/NCHS BMIs with our data using both height and arm span in place of height/linear length. There were 14,701 measures collected during 4968 visits from 709 patients. Mean values were calculated using age, gender, and lesion level as independent variables.
Comparison of BMI means of patients with myelomeningocele suggests that our observations using arm span and height are comparable with the CDC/NCHS BMI means using height for the 2 least paralyzed groups but not for those groups with paralysis from high-level lesions that are more likely to exhibit lower extremity deformities or scoliosis.
Published CDC/NCHS graphs, with their percentiles, are appropriate for estimating normal growth by BMI for children born with myelomeningocele when arm span is substituted for length if severe body differences due to high-level paralysis are taken into consideration.
通过将计算得出的体重指数(BMI)与疾病控制和预防中心(CDC)最近发布的BMI图表以及2000年发布的国家卫生统计中心标准(NCHS)进行比较,评估使用臂展测量替代身高/直线长度来评估脊髓脊膜膨出患者肥胖情况的适用性。
对1965年7月1日至2008年6月1日在华盛顿大学出生缺陷诊所就诊的患者收集的数据进行回顾性分析。观察指标包括瘫痪程度、脊柱侧弯的存在、身高(直线长度)、体重和臂展。我们使用身高和臂展替代身高/直线长度,将已发布的CDC/NCHS的BMI与我们的数据进行比较。在709名患者的4968次就诊中收集了14701项测量数据。使用年龄、性别和病变水平作为自变量计算平均值。
脊髓脊膜膨出患者BMI平均值的比较表明,对于两组瘫痪程度最轻的患者,我们使用臂展和身高得出的观察结果与CDC/NCHS使用身高得出的BMI平均值相当,但对于那些因高位病变导致瘫痪且更易出现下肢畸形或脊柱侧弯的患者组则不然。
如果考虑到高位瘫痪导致的严重身体差异,当用臂展替代长度时,已发布的CDC/NCHS图表及其百分位数适用于估算脊髓脊膜膨出患儿通过BMI反映的正常生长情况。