Breij Laura M, van de Ven Rick A H, Hulst Raquel Y, Smorenburg Ana R P, Gorter Jan Willem, Verschuren Olaf W
Rehabilitation Centre 'De Hoogstraat', Utrecht, Netherlands.
Rehabilitation Center Tolbrug, Jeroen Bosch Hospital, 's-Hertogenbosch, Netherlands.
Disabil Rehabil. 2024 Feb;46(3):509-514. doi: 10.1080/09638288.2023.2167007. Epub 2023 Jan 17.
To measure body composition by using bioelectrical impedance analysis (BIA) and body mass index (BMI) and to investigate the correlation and agreement between BMI and fat mass percentage in children with spastic Cerebral Palsy.
BIA was used to assess fat mass percentage and BMI was determined from body weight and height. BMI and fat mass percentage were both categorized into five categories. The association between fat mass percentage and BMI was assessed using Pearson's correlation coefficient. Agreement between BMI and fat mass percentage was investigated with weighted Cohen's kappa coefficient.
One hundred and three children with CP across all Gross Motor Function Classification Levels (61% boys, mean age 9 years) were included. Mean BMI was 18.3 kg/m and mean fat mass was 24.9%. A large inter-subject variability was found with a weak correlation between BMI and fat mass percentage in children with a BMI < 20 kg/m. Little agreement ( = 0.299, CI 0.16-0.44) between the categorization of children based on BMI and based on fat mass percentage was found.
The large inter-subject variability in fat mass percentage combined with little agreement between the BMI and BIA categories suggests that BMI is not a suitable measure of fat mass in children with CP.IMPLICATIONS FOR REHABILITATIONUsing body mass index (BMI) and instead of fat mass percentage increases the risk of misclassifying body composition in children with spastic Cerebral Palsy.Children with a BMI < 20 kg/m are more at risk to be misclassified for body composition.
采用生物电阻抗分析（BIA）和体重指数（BMI）测量身体成分，并研究痉挛型脑瘫患儿BMI与脂肪量百分比之间的相关性和一致性。
采用BIA评估脂肪量百分比，根据体重和身高确定BMI。BMI和脂肪量百分比均分为五类。使用Pearson相关系数评估脂肪量百分比与BMI之间的关联。采用加权Cohen's kappa系数研究BMI与脂肪量百分比之间的一致性。
纳入了所有粗大运动功能分级水平的103例脑瘫患儿（61%为男孩，平均年龄9岁）。平均BMI为18.3kg/m，平均脂肪量为24.9%。发现BMI<20kg/m的患儿个体间差异较大，BMI与脂肪量百分比之间的相关性较弱。基于BMI和基于脂肪量百分比对儿童进行分类之间的一致性较低（κ=0.299，CI 0.16 - 0.44）。
脂肪量百分比的个体间差异较大，且BMI与BIA分类之间的一致性较低，这表明BMI不是评估脑瘫患儿脂肪量的合适指标。
使用体重指数（BMI）而非脂肪量百分比会增加痉挛型脑瘫患儿身体成分误分类的风险。BMI<20kg/m的患儿身体成分被误分类的风险更高。
