Abnormal anthopometric measurements and growth pattern in male AIS

Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
European Spine Journal (Impact Factor: 2.07). 08/2011; 21(1):77-83. DOI: 10.1007/s00586-011-1960-x
Source: PubMed


The progression of adolescent idiopathic scoliosis is closely correlated with longitudinal growth during puberty. A decreased incidence of curve progression has been found in male patients with adolescent idiopathic scoliosis compared with female patients with the condition. This finding implies that there might be a sexual dimorphism in the pubertal growth patterns of adolescent idiopathic scoliosis patients. Abnormal pubertal growth in female adolescent idiopathic scoliosis patients has been well characterized; however, the pubertal growth patterns of male adolescent idiopathic scoliosis patients have not been reported. We conducted a cross-sectional study of anthropometric measurements to compare the growth patterns of male patients with adolescent idiopathic scoliosis with those of healthy boys during puberty and explore the difference in the pubertal growth patterns of female and male patients with adolescent idiopathic scoliosis.
A total of 688 subjects were involved in the study, including 332 male adolescent idiopathic scoliosis patients and 356 age-matched healthy boys. The subjects were categorized according to their chronological ages. Their body weights, heights and arm spans were obtained using standard methods; the corrected body heights of the adolescent idiopathic scoliosis boys were determined using Bjour's equation. The inter-group differences in the anthropometric parameters were analyzed. Multivariate regression analysis was carried out in the adolescent idiopathic scoliosis patients to identify the anthropometric parameters that influence curve severity.
The corrected standing heights and arm spans of male adolescent idiopathic scoliosis patients were similar to those of the matched controls during puberty. However, the body weights of the adolescent idiopathic scoliosis patients who were more than 14 years old were significantly less than those of the control group. The body mass index of the adolescent idiopathic scoliosis patients between the ages of 15 and 17 were also significantly less than those of the control subjects. Moreover, a significantly higher incidence of underweight was found in adolescent idiopathic scoliosis patients (8.6%) than in the controls (3.4%). Upon multivariate regression analysis, body weight and chronological age were identified as independent predictors of curve magnitude in male adolescent idiopathic scoliosis patients. The male adolescent idiopathic scoliosis patients with variable curve patterns exhibited no significant differences in their anthropometric parameters.
The results showed abnormal pubertal growth in the male adolescent idiopathic scoliosis patients compared with their age- and gender-matched normal controls. Despite similar longitudinal growth, the male patients with adolescent idiopathic scoliosis exhibited significantly lower body weights and a higher incidence of underweight during the later stage of puberty compared with their normal controls. These abnormalities in the pubertal growth of male patients were different from those observed in female patients with adolescent idiopathic scoliosis. Body weight could be an important parameter for further longitudinal studies on the prognostication of curve progression in adolescent idiopathic scoliosis.

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Available from: Liu Zhen, Jun 01, 2015
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    • "Of note, most authors agree that curves with a thoracic apex are characterized by the highest prevalence of progression, ranging 58–100 % [43–45]. Furthermore, compared with female AIS patients, male patients revealed a lower tendency towards curve progression [41]. "
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    ABSTRACT: Purpose Knowledge on the normative growth of the spine is critical in the prenatal detection of its abnormalities. We aimed to study the size of T6 vertebra in human fetuses with the crown-rump length of 115–265 mm. Materials and methods Using the methods of computed tomography (Biograph mCT), digital image analysis (Osirix 3.9) and statistics, the normative growth of the T6 vertebral body and the three ossification centers of T6 vertebra in 55 spontaneously aborted human fetuses (27 males, 28 females) aged 17–30 weeks were studied. Results Neither male–female nor right–left significant differences were found. The height, transverse, and sagittal diameters of the T6 vertebral body followed natural logarithmic functions as y = −4.972 + 2.732 × ln(age) ± 0.253 (R2 = 0.72), y = −14.862 + 6.426 × ln(age) ± 0.456 (R2 = 0.82), and y = −10.990 + 4.982 × ln(age) ± 0.278 (R2 = 0.89), respectively. Its cross-sectional area (CSA) rose proportionately as y = −19.909 + 1.664 × age ± 2.033 (R2 = 0.89), whereas its volumetric growth followed the four-degree polynomial function y = 19.158 + 0.0002 × age4 ± 7.942 (R2 = 0.93). The T6 body ossification center grew logarithmically in both transverse and sagittal diameters as y = −14.784 + 6.115 × ln(age) ± 0.458 (R2 = 0.81) and y = −12.065 + 5.019 × ln(age) ± 0.315 (R2 = 0.87), and proportionately in both CSA and volume like y = −15.591 + 1.200 × age ± 1.470 (R2 = 0.90) and y = −22.120 + 1.663 × age ± 1.869 (R2 = 0.91), respectively. The ossification center-to-vertebral body volume ratio was gradually decreasing with age. On the right and left, the neural ossification centers revealed the following models: y = −15.188 + 6.332 × ln(age) ± 0.629 (R2 = 0.72) and y = −15.991 + 6.600 × ln(age) ± 0.629 (R2 = 0.74) for length, y = −6.716 + 2.814 × ln(age) ± 0.362 (R2 = 0.61) and y = −7.058 + 2.976 × ln(age) ± 0.323 (R2 = 0.67) for width, y = −5.665 + 0.591 × age ± 1.251 (R2 = 0.86) and y = −11.281 + 0.853 × age ± 1.653 (R2 = 0.78) for CSA, and y = −9.279 + 0.849 × age ± 2.302 (R2 = 0.65) and y = −16.117 + 1.155 × age ± 1.832 (R2 = 0.84) for volume, respectively. Conclusions Neither sex nor laterality differences are found in the morphometric parameters of evolving T6 vertebra and its three ossification centers. The growth dynamics of the T6 vertebral body follow logarithmically for its height, and both sagittal and transverse diameters, linearly for its CSA, and four-degree polynomially for its volume. The three ossification centers of T6 vertebra increase logarithmically in both transverse and sagittal diameters, and linearly in both CSA and volume. The age-specific reference intervals for evolving T6 vertebra present the normative values of potential relevance in the diagnosis of congenital spinal defects.
    Anatomia Clinica 03/2013; 35(10). DOI:10.1007/s00276-013-1107-3 · 1.05 Impact Factor
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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. 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/m(2) (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.
    European Spine Journal 08/2012; 22(2). DOI:10.1007/s00586-012-2465-y · 2.07 Impact Factor
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    ABSTRACT: Background: Body composition changes during childhood and adolescence. It is markedly different in children with idiopathic scoliosis (IS). This study was carried out to assess the nutritional status of patients with IS based on standard anthropometric indices and bioimpedance measurements (BIA). Material and methods: 59 patients with IS (45 girls/ 14 boys) at a mean age of 13.37 ± 2.67 years were qualified into the study. Scoliotic curves were assessed radiographically by measuring Cobb's angle and apical vertebral rotation (AVR, standing A-P view). Height, weight, waist and hip circumferences were measured and the body mass index (BMI), BMI Z-score, waist/height ratio (WHtR) and waist/hip ratio (WHR) were calculated for each participant. A bioelectrical impedance analyzer was used to assess body composition in every child. Results: 64.4% of the children in the study had normal weight, while 23.7% of them were underweight and 11.9% overweight or obese. More patients in the juvenile IS group were underweight and fewer were overweight compared with the adolescent IS (AIS) group. Normal nutritional status was found significantly more frequently in girls. Body composition correlated significantly with scoliotic curve severity in the study group. Higher correlation coefficients were seen in overweight and obese patients, but significance was reached only for predicted muscle mass. WHtR correlated significantly with curve severity in the entire group, in AIS patients and in girls. Scoliotic curve severity also correlated significantly with the degree, as measured by the BMI Z-score, of both overweight (positively) and underweight (negatively). Conclusions: 1. Overweight and obesity appear to have a similar prevalence in scoliotic adolescents and in the general pediatric population. 2. Scoliotic curve severity appears to be related to body composition parameters, especially in overweight and obese patients. 3. Adipose tissue distribution measured by WHtR seems to be significantly related to the clinical grade of IS. 4. Further investigations concerning the nutritional status of children and adolescents with IS are recommended.
    08/2012; 14(4):351-62. DOI:10.5604/15093492.1005093
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