From the University of Sydney (G.A.D., S.P.G., M.P.M.), Faculty of Medicine and Health; Children's Hospital at Westmead (G.A.D., S.P.G., K.M.D.C., J.B., M.P.M.); University of Sydney (K.M.D.C., M.J.M., J.B.), School of Health Sciences; Faculty of Health and Medicine (J.N.B.), University of Newcastle, Australia; Departments of Pediatrics (R.R.S.) and Neurology (M.E.S.), Carver College of Medicine, University of Iowa, Iowa City; Division of Neurology (S.W.Y.) and Department of Occupational Therapy (T.E.), Children's Hospital of Philadelphia; Department of Neurology (S.W.Y., T.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Fondazione IRCCS Istituto Neurologico Carlo Besta (I.M., M.F., E.P., D.P.), Milan, Italy; Centre for Neuromuscular Diseases (M.L., M.M.R.), University College London, Queen Square; University College London Institute of Child Health & Great Ormond Street Hospital (T.B., F.M.), London, England; Translational Neurosciences (Pediatrics) (R.S.F.), St. Jude Children's Research Hospital, Memphis, TN; and Department of Neurology (J.E.S., K.J.E., D.N.H.), University of Rochester, NY.
Neurology. 2021 Oct 26;97(17):e1727-e1736. doi: 10.1212/WNL.0000000000012725. Epub 2021 Sep 7.
This study examined the association between body mass index (BMI) and disability in children with Charcot-Marie-Tooth disease (CMT).
We conducted a cross-sectional analysis of 477 patients with CMT who were 3 to 20 years of age from the Inherited Neuropathy Consortium and 316 age- and sex-matched healthy children from the 1,000 Norms Project. BMI was categorized according to the International Obesity Task Force (IOTF) criteria, and BMI categorization was compared with healthy children. IOTF categories (adult equivalent BMI cut points) were severely underweight (BMI <17 kg/m), underweight (BMI ≥17-<18.5 kg/m), healthy weight (BMI ≥18.5-<25 kg/m), overweight (BMI ≥25-<30 kg/m), and obese (BMI ≥30 kg/m). Scores on the 0 to 44-point CMT Pediatric Scale (CMTPedS), a well-validated measure of disability, were examined in relation to BMI.
There was a higher proportion of children with CMT categorized as severely underweight (5.7% vs 0.3%), underweight (10.3% vs 5.1%), and obese (7.3% vs 3.8%) ( < 0.05). Fewer children with CMT were categorized as healthy weight (61.8% vs 74.4%) ( < 0.05), and the proportion of overweight (14.9% vs 16.5%) between groups was similar. CMTPedS scores (mean ± SD) for weight categories were as follows: severely underweight 27 ± 9, underweight 20 ± 8, healthy weight 17 ± 9, overweight 17 ± 9, and obese 22 ± 10. Compared to children with a healthy weight with CMT, being severely underweight was associated with being more disabled ( < 0.001), as was being obese ( = 0.015).
The proportion of children with CMT who are underweight or obese is higher compared to age- and sex-matched healthy children. In children with CMT, being underweight or obese is associated with greater disability, when compared to children with CMT of healthy weight.
本研究旨在探讨儿童腓骨肌萎缩症(CMT)患者的体重指数(BMI)与残疾之间的关系。
我们对来自遗传性神经病变联盟的 477 名年龄在 3 至 20 岁的 CMT 患者和来自 1000 名正常儿童计划的 316 名年龄和性别匹配的健康儿童进行了横断面分析。根据国际肥胖工作组(IOTF)标准对 BMI 进行分类,并将 BMI 分类与健康儿童进行比较。IOTF 类别(成人等效 BMI 切点)为严重消瘦(BMI<17kg/m)、消瘦(BMI≥17-<18.5kg/m)、健康体重(BMI≥18.5-<25kg/m)、超重(BMI≥25-<30kg/m)和肥胖(BMI≥30kg/m)。采用 0 至 44 分的 CMT 儿科量表(CMTPedS)评估残疾评分,该量表是一种经过充分验证的残疾衡量标准。
CMT 患者中严重消瘦(5.7%对 0.3%)、消瘦(10.3%对 5.1%)和肥胖(7.3%对 3.8%)的比例较高(<0.05)。CMT 患者中健康体重的比例较低(61.8%对 74.4%)(<0.05),而超重(14.9%对 16.5%)的比例相似。体重类别下的 CMTPedS 评分(平均值±标准差)如下:严重消瘦 27±9,消瘦 20±8,健康体重 17±9,超重 17±9,肥胖 22±10。与健康体重的 CMT 儿童相比,严重消瘦和肥胖的 CMT 儿童残疾程度更高(<0.001)。
CMT 患者体重不足或肥胖的比例高于年龄和性别匹配的健康儿童。在 CMT 儿童中,与健康体重的 CMT 儿童相比,体重不足或肥胖与更大的残疾有关。