Department of Surgery, Valencia University Medical School, Valencia, Spain.
Spine (Phila Pa 1976). 2011 Aug 15;36(18):1470-7. doi: 10.1097/BRS.0b013e3181f55083.
Cross-sectional study with level III of evidence.
To describe different anthropometric and body composition parameters of adolescent girls with adolescent idiopathic scoliosis (AIS), comparing them with the standards of a healthy age-matched population.
Body growth and development of adolescent girls with AIS seems to differ from the healthy subjects, especially at perpubertal stages. Young scoliotic adults have been found to be taller, lighter, and thinner than age-matched healthy population. Body composition profile taken from measurements of skin-fold thickness, bony diameters at different levels, and arm and legs perimeters has not been previously reported in AIS patients.
A nonconsecutive series of 52 AIS girls (mean age: 13.9 years) with an average scoliotic curve of 27° Cobb (range: 20-58) underwent an anthropometric study. None of the AIS girls had been treated previously with spinal surgery. The control group consisted of 92 girls without spine deformity, matched in age (mean: 13.8 years). Weight, height, and skin-fold thickness in millimeters at six levels were measured. Body mass index (BMI), Ponderal index, percentage of body fat, percentage of muscular tissue, fat mass, lean body mass, muscular weight, bony weight, and residual weight were calculated using standard rules to estimate body composition. The somatotype components (endomorphy, mesomorphy, and ectomorphy) were calculated according to the Carter equations. RESULTS.: Compared with the control population, scoliotic girls had a significantly lower mean weight (51.4 ± 10.2 kg vs. 54.7 ± 8.1 kg; P < 0,05), a lower BMI (20.1 ± 3.4 vs. 21.4 ± 2.4; P < 0.001), and a higher Ponderal index (43.2 ± 2.4 vs. 42.2 ± 1.6; P < 0.01). Girls with AIS showed a progressive decrease of the BMI as the age increased. The percentage of body fat was also lower in scoliotic girls, without significant statistical differences (14.1 ± 3.8 vs. 15 ± 3.6). Out of the 52 AIS girls, 11 (21.2%) showed a BMI below 17.5, which has been considered the limit for anorexia. In the control group, only 3 of 92 girls (3.3%) had BMI below that level. The somatotype differed also between scoliotics and controls: higher in the ectomorphic component (3.29 ± 1.68 vs. 2.40 ± 1.11; P < 0.001), and lower in the mesomorphic component (2.86 ± 0.82 vs. 3.70 ± 1.11; P < 0.01) in AIS patients.
The differences in some anthropometric parameters (weight, IMC, IP) and in the somatotype suggest that the idiopathic scoliosis not only disturbs normal spine growth but also seems to have implications on the whole corporal development. Whether these changes could be related to abnormal spinal growth or subsequent to nutritional changes in AIS still remains uncertain. Presumably, some endocrine factors affecting body composition and growth might be involved in the etiology of idiopathic scoliosis.
具有 III 级证据的横断面研究。
描述青少年特发性脊柱侧凸(AIS)少女的不同人体测量和身体成分参数,并将其与健康同龄人群的标准进行比较。
AIS 少女的身体生长和发育似乎与健康受试者不同,尤其是在青春期阶段。年轻的脊柱侧弯成年人比年龄匹配的健康人群更高、更轻、更瘦。来自皮褶厚度、不同水平的骨直径、手臂和腿部周长测量的身体成分特征以前并未在 AIS 患者中报道过。
对 52 名患有 AIS 的非连续系列女孩(平均年龄:13.9 岁)进行了一项人体测量研究,平均脊柱侧凸曲线为 27° Cobb(范围:20-58)。没有 AIS 女孩之前接受过脊柱手术治疗。对照组由 92 名无脊柱畸形的女孩组成,年龄匹配(平均年龄:13.8 岁)。测量六个水平的毫米体重、身高和皮褶厚度。使用标准规则计算身体质量指数(BMI)、胖指数、体脂百分比、肌肉组织百分比、脂肪量、瘦体重、肌肉重量、骨重量和残余体重,以估计身体成分。根据 Carter 方程计算体成分成分(内胚层、中胚层和外胚层)。结果:与对照组相比,脊柱侧弯女孩的平均体重明显较低(51.4 ± 10.2 千克对 54.7 ± 8.1 千克;P < 0.05),BMI 较低(20.1 ± 3.4 对 21.4 ± 2.4;P < 0.001),胖指数较高(43.2 ± 2.4 对 42.2 ± 1.6;P < 0.01)。患有 AIS 的女孩随着年龄的增长,BMI 逐渐下降。脊柱侧弯女孩的体脂百分比也较低,但无统计学差异(14.1 ± 3.8 对 15 ± 3.6)。在 52 名 AIS 女孩中,有 11 名(21.2%)的 BMI 低于 17.5,这被认为是厌食症的极限。在对照组中,只有 92 名女孩中的 3 名(3.3%)的 BMI 低于该水平。脊柱侧弯患者的体型也与对照组不同:外胚层成分较高(3.29 ± 1.68 对 2.40 ± 1.11;P < 0.001),中胚层成分较低(2.86 ± 0.82 对 3.70 ± 1.11;P < 0.01)。
一些人体测量参数(体重、BMI、IP)和体型的差异表明,特发性脊柱侧凸不仅扰乱了正常的脊柱生长,似乎还对整个身体发育产生了影响。这些变化是否与脊柱生长异常或 AIS 后的营养变化有关仍不确定。可能涉及影响身体成分和生长的一些内分泌因素与特发性脊柱侧凸的病因有关。