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Published in: European Spine Journal 2/2013

01-02-2013 | Original Article

Body composition in adolescent idiopathic scoliosis

Authors: Manuel Ramírez, Juana Martínez-Llorens, Juan Francisco Sanchez, Joan Bagó, Antoni Molina, Joaquim Gea, Enric Cáceres

Published in: European Spine Journal | Issue 2/2013

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Abstract

Study design

A controlled prospective cross-sectional case study.

Objective

To investigate body mass index (BMI) and corporal composition in girls with adolescent idiopathic scoliosis (AIS) and compare them with a normal population matched by sex and age.

Summary and background data

There is controversy as to whether there are real anthropometric alterations in patients with AIS. Relative to the weight or the BMI, some studies find differences and other studies do not detect them. AIS and anorexia nervosa (AN) make their debut during adolescence and both may be associated with an alteration of their subjective physical perception. Some authors propose a link between AIS and AN supported both by an alteration of physical perception and lower BMI. No studies on body composition in AIS have been published.

Methods

Adolescent idiopathic scoliosis patient surgery candidates during 2008 were studied. Body composition was evaluated using the bioelectrical impedance analysis (Bodystat, Isle of Man, UK). A study population of more than 5,000 patients that was published by Kyle et al. (Nutrition 17:534–541, 2001) was chosen as a control (group 1). Another control group (group 2) of healthy volunteers matched by sex and age was selected among a school age and university population in Barcelona, Spain. A variance analysis was used to analyze differences between the mean values of the control group 1, the European control group, and the AIS patient surgery candidates (Epiinfo 6.2001). Comparisons between the AIS patients and control group 2 were performed with the T Student test of unpaired samples using the SPSS 15.0 (Statistical Package Social Science) software.

Results

Twenty-seven women with a mean age of 17.4 years. BMI was 18.9 kg/m2 (SD 1.7; 95 % CI 18.31–19.73). In the variance analysis, a significant difference between AIS and group 1 in BMI was observed (21.0 vs. 18.9, p = 0.000004); fat-free mass (FFM = 42.6 vs. 38.9, p = 0.0000009) and fat mass (FM = 15.6 vs. 13.7, p = 0.03). Significant differences in BMI (22.13 vs. 18.9, p = 0.001; 95 % CI difference 1.85–4.60), fat mass index (FMi = 7.17 vs. 4.97, p = 0.000; 95 % CI difference 1.36–3.05) and fat-free mass index (FFMi = 14.95 vs. 13.09, p = 0.001; 95 % CI difference 0.26–1.86) between AIS and group 2 were also seen.

Conclusion

The conclusion is that there is a real alteration of body composition in AIS. The BMI, FFMi and FMi are lower than in the general population in the series under study.
Literature
1.
go back to reference Siu King Cheung C, Tak Keung Lee W, Kit Tse Y, Ping Tang S, Man Lee K, Guo X, Qin L, Chun Yiu Cheng J (2003) Abnormal peripuberal anthropometric measurements and growth pattern in adolescent idiopathic scoliosis: a study of 598 patients. Spine 28(18):2152–2157PubMedCrossRef Siu King Cheung C, Tak Keung Lee W, Kit Tse Y, Ping Tang S, Man Lee K, Guo X, Qin L, Chun Yiu Cheng J (2003) Abnormal peripuberal anthropometric measurements and growth pattern in adolescent idiopathic scoliosis: a study of 598 patients. Spine 28(18):2152–2157PubMedCrossRef
2.
go back to reference Loncar-Dusek M, Pecina M, Prebeg Z (1991) A longitudinal study of growth velocity and development of secondary gender characteristics versus onset of idiopathic scoliosis. Clin Orthop 270:278–282PubMed Loncar-Dusek M, Pecina M, Prebeg Z (1991) A longitudinal study of growth velocity and development of secondary gender characteristics versus onset of idiopathic scoliosis. Clin Orthop 270:278–282PubMed
3.
go back to reference Lonstein JE, Carlson JM (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg 66A:1061 Lonstein JE, Carlson JM (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg 66A:1061
4.
go back to reference Wei-Jun W, Xu S, Zhi-Wei W, Xu-Sheng Q, Zhen L, Yong Q (2012) Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis. Eur Spine J 21(1):77–83PubMedCrossRef Wei-Jun W, Xu S, Zhi-Wei W, Xu-Sheng Q, Zhen L, Yong Q (2012) Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis. Eur Spine J 21(1):77–83PubMedCrossRef
5.
go back to reference Sadat-Ali M, Al-Othman A, Bubshait D, Al-Dakhneel D (2008) Does scoliosis causes low bone mass? A comparative study between siblings. Eur Spine J 17(7):944–947PubMedCrossRef Sadat-Ali M, Al-Othman A, Bubshait D, Al-Dakhneel D (2008) Does scoliosis causes low bone mass? A comparative study between siblings. Eur Spine J 17(7):944–947PubMedCrossRef
6.
go back to reference Park WW, Suh KT, Kim SJ, Lee JS (2009) Decreased ostegenic differentiation of mesenchymal stem cell and reduced bone mineral density in patients with adolescent idiopathic scoliosis. Eur Spine J 18(12):1920–1926PubMedCrossRef Park WW, Suh KT, Kim SJ, Lee JS (2009) Decreased ostegenic differentiation of mesenchymal stem cell and reduced bone mineral density in patients with adolescent idiopathic scoliosis. Eur Spine J 18(12):1920–1926PubMedCrossRef
7.
go back to reference Carr AJ, Jefferson RJ, Weisz I (1989) Correction of body height in scoliosis patients using ISIS scanning. Spine 14:220–222PubMedCrossRef Carr AJ, Jefferson RJ, Weisz I (1989) Correction of body height in scoliosis patients using ISIS scanning. Spine 14:220–222PubMedCrossRef
8.
go back to reference Cheng JCY, Leung SSF, Chiu BSK et al (1998) Can we predict body height from segmental bone length measurements? A study of 3647 children. J Pediatr Orthop 18(3):387–393PubMed Cheng JCY, Leung SSF, Chiu BSK et al (1998) Can we predict body height from segmental bone length measurements? A study of 3647 children. J Pediatr Orthop 18(3):387–393PubMed
9.
go back to reference Willner S (1975) The proportion of legs to trunk in girls with idiopathic structural scoliosis. Acta Orthop Scand 46:84–89PubMedCrossRef Willner S (1975) The proportion of legs to trunk in girls with idiopathic structural scoliosis. Acta Orthop Scand 46:84–89PubMedCrossRef
10.
go back to reference Drummond DS, Rogala EJ (1980) Growth and maturation of adolescents with idiopathic scoliosis. Spine 5:507–511PubMedCrossRef Drummond DS, Rogala EJ (1980) Growth and maturation of adolescents with idiopathic scoliosis. Spine 5:507–511PubMedCrossRef
11.
go back to reference Duval-Beaupere G (1971) In: Zorab PA (ed) Scoliosis and growth. Churchill Livingstone, London, pp 58–61 Duval-Beaupere G (1971) In: Zorab PA (ed) Scoliosis and growth. Churchill Livingstone, London, pp 58–61
12.
go back to reference Dangerfield PH, Davey RC, Chockalingam N, Cochrane T, Dorgan JC (2005) Body composition in females with adolescent idiopathic scoliosis. J Bone Joint Surg 88-B(Suppl II):230–231 Dangerfield PH, Davey RC, Chockalingam N, Cochrane T, Dorgan JC (2005) Body composition in females with adolescent idiopathic scoliosis. J Bone Joint Surg 88-B(Suppl II):230–231
13.
go back to reference Koch KD, Buchanan R, Birch JG, Morton AA, Gatchel RJ, Browne RH (2001) Adolescents undergoing surgery idiopathic scoliosis. How physical and psychological characteristics relate to patient satisfaction with the cosmetic result. Spine 26(19):2119–2124PubMedCrossRef Koch KD, Buchanan R, Birch JG, Morton AA, Gatchel RJ, Browne RH (2001) Adolescents undergoing surgery idiopathic scoliosis. How physical and psychological characteristics relate to patient satisfaction with the cosmetic result. Spine 26(19):2119–2124PubMedCrossRef
14.
go back to reference Liu Z, Qiu Y, Qiu X, Sun X (2009) Body mass index in Chinese girls with adolescent idiopathic scoliosis. Eur Spine J 18(suppl 4):S445–S470 Liu Z, Qiu Y, Qiu X, Sun X (2009) Body mass index in Chinese girls with adolescent idiopathic scoliosis. Eur Spine J 18(suppl 4):S445–S470
15.
go back to reference Smith FM, Latchford G, Hall RM, Millner PA, Dickson RA (2002) Indications of disordered eating behavior in adolescent patients with idiopathic scoliosis. J Bone Joint Surg 84-B:392–394CrossRef Smith FM, Latchford G, Hall RM, Millner PA, Dickson RA (2002) Indications of disordered eating behavior in adolescent patients with idiopathic scoliosis. J Bone Joint Surg 84-B:392–394CrossRef
16.
go back to reference Li W-G, Qiu Y (2008) Decreased lean mass in adolescent idiopathic scoliosis. Stud Health Technol Inform 140:344 Li W-G, Qiu Y (2008) Decreased lean mass in adolescent idiopathic scoliosis. Stud Health Technol Inform 140:344
17.
go back to reference Melendo E, Ramírez M, Martínez J, Bagó J, Saló G, Cáceres E (2007) Body composition alterations in patients with adolescent idiopathic scoliosis. Relationship with work capacity. Eur Spine J 16:137CrossRef Melendo E, Ramírez M, Martínez J, Bagó J, Saló G, Cáceres E (2007) Body composition alterations in patients with adolescent idiopathic scoliosis. Relationship with work capacity. Eur Spine J 16:137CrossRef
19.
go back to reference Cobb JR (1948) Outline for the study of scoliosis. In: American academy of orthopaedic surgeons: instructional course lectures, vol 5, pp 61–75 Cobb JR (1948) Outline for the study of scoliosis. In: American academy of orthopaedic surgeons: instructional course lectures, vol 5, pp 61–75
20.
go back to reference Kyle UG, Genton L, Slosman DO, Pichard C (2001) Fat free mass and fat mass percentiles in 5225 healthy subjects aged 15 to 98 years. Nutrition 17:534–541PubMedCrossRef Kyle UG, Genton L, Slosman DO, Pichard C (2001) Fat free mass and fat mass percentiles in 5225 healthy subjects aged 15 to 98 years. Nutrition 17:534–541PubMedCrossRef
21.
go back to reference Pietrobelli A et al (2003) Predicting fat free mass in children using bioimpedance analysis. Acta diabetol 40:S212–S215PubMedCrossRef Pietrobelli A et al (2003) Predicting fat free mass in children using bioimpedance analysis. Acta diabetol 40:S212–S215PubMedCrossRef
22.
go back to reference Casas YG, Schiller BC, DeSouza CA, Seals DR (2001) Total and regional body composition across ageing in healthy Hispanic and white women of similar socioeconomic status. Am J Clin Nutr 73:13–18PubMed Casas YG, Schiller BC, DeSouza CA, Seals DR (2001) Total and regional body composition across ageing in healthy Hispanic and white women of similar socioeconomic status. Am J Clin Nutr 73:13–18PubMed
23.
go back to reference World Health Organization (1995) The use and interpretation of antropometry. WHO, Geneva World Health Organization (1995) The use and interpretation of antropometry. WHO, Geneva
24.
25.
go back to reference Mazess RB, Barden HS, Ohlrich ES (1990) Skeletal and body-composition effects of anorexia nervosa. Am J Clin Nutr 52:438–441PubMed Mazess RB, Barden HS, Ohlrich ES (1990) Skeletal and body-composition effects of anorexia nervosa. Am J Clin Nutr 52:438–441PubMed
26.
go back to reference Garcia MT, Muñoz Calvo MT, Barrios V, Martinez G, Martos Moreno GA, Hawkins F, Argente J (2007) Regional fat distribution in adolescents with anorexia nervosa: effect of duration of malnutrition and weight recovery. Eur J Endocrinol 157:473–479CrossRef Garcia MT, Muñoz Calvo MT, Barrios V, Martinez G, Martos Moreno GA, Hawkins F, Argente J (2007) Regional fat distribution in adolescents with anorexia nervosa: effect of duration of malnutrition and weight recovery. Eur J Endocrinol 157:473–479CrossRef
27.
go back to reference Weinbrenner T, Zittrmann A, Gouni-Berthold I, Stehle P, Berthold HK (2003) Body mass index and disease duration are predictors of disturbed bone turnover in anorexia nervosa. A case–control study. Eur J Clin Nutr 57:1262–1267PubMedCrossRef Weinbrenner T, Zittrmann A, Gouni-Berthold I, Stehle P, Berthold HK (2003) Body mass index and disease duration are predictors of disturbed bone turnover in anorexia nervosa. A case–control study. Eur J Clin Nutr 57:1262–1267PubMedCrossRef
28.
go back to reference Zipfel S, Zipfel S, Seibel MJ, Lone B, Beaumont PK, Kasperk C, Herzg W (2001) Osteoporosis in eating disorders: a follow-up study of patients with anorexia nervosa and bulimia nervosa. J Clin Endocrinol Metab 86:5227–5233PubMedCrossRef Zipfel S, Zipfel S, Seibel MJ, Lone B, Beaumont PK, Kasperk C, Herzg W (2001) Osteoporosis in eating disorders: a follow-up study of patients with anorexia nervosa and bulimia nervosa. J Clin Endocrinol Metab 86:5227–5233PubMedCrossRef
29.
go back to reference Lee WTK, Cheung CSK, Tse YK, Guo X, Qin L, Ho S, Lau J, Cheng JCY (2005) Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period. Osteoporos Int 16:1024–1035PubMedCrossRef Lee WTK, Cheung CSK, Tse YK, Guo X, Qin L, Ho S, Lau J, Cheng JCY (2005) Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period. Osteoporos Int 16:1024–1035PubMedCrossRef
30.
go back to reference Cheng JCY, Guo X, Sher AH (1999) A persistent osteopenia in adolescent idiopathic scoliosis: a longitudinal study. Spine 24(12):1218PubMedCrossRef Cheng JCY, Guo X, Sher AH (1999) A persistent osteopenia in adolescent idiopathic scoliosis: a longitudinal study. Spine 24(12):1218PubMedCrossRef
Metadata
Title
Body composition in adolescent idiopathic scoliosis
Authors
Manuel Ramírez
Juana Martínez-Llorens
Juan Francisco Sanchez
Joan Bagó
Antoni Molina
Joaquim Gea
Enric Cáceres
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 2/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2465-y

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