Evaluation of nutritional status of children and adolescents with idiopathic scoliosis - A pilot study

Katedra i Klinika Rehabilitacji, Śląski Uniwersytet Medyczny w Katowicach.
Ortopedia, traumatologia, rehabilitacja 08/2012; 14(4):351-62. DOI: 10.5604/15093492.1005093
Source: PubMed


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.

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).

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.

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    • "A longitudinal study of the development of flat feet in preschool age showed during later years its greater prevalence in younger, obese boys who were also characterized by greater laxity of joints (Tobias et al., 2013; Chen et al., 2012). The nutritional status characterized by z-score of BMI correlated significantly with the seriousness of scoliosis in 13.37 year old subjects (Matusik et al., 2012). Pains of the lower part of the back were found in 10–18 years old subjects caused mainly by the characteristics of the physical activity level and BMI (Akdag et al., 2011). "
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    ABSTRACT: The main aim of this article is the review of selected longitudinal studies (lasting from several months up to fourteen years in the same groups) investigating body fat indicators in relationship to physical activity, exercise and fitness levels in normal weight, obese children and adolescents from preschool age. Special attention was focused on complex simultaneous observations which included body composition, cardiorespiratory efficiency, motor abilities, and dietary intake in their mutual relationhips, also with regard to secular changes along the last fifty years up to the present. Musculoskeletal problems related to excess fatness were also considered.
    Full-text · Article · Oct 2014 · Journal of King Saud University - Science
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    • "In Katowice, Poland, Matusik et al.[164] evaluated nutritional status of children and adolescents with idiopathic scoliosis, early onset (n = 25) and late onset (n = 34). Overweight and obesity had the same prevalence as the normal population, Nutritional abnormalities were more common in boys. "
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    ABSTRACT: This paper aims to integrate into current understanding of AIS causation, etiopathogenetic information presented at two Meetings during 2012 namely, the International Research Society of Spinal Deformities (IRSSD) and the Scoliosis Research Society (SRS). The ultimate hope is to prevent the occurrence or progression of the spinal deformity of AIS with non-invasive treatment, possibly medical. This might be attained by personalised polymechanistic preventive therapy targeting the appropriate etiology and/or etiopathogenetic pathways, to avoid fusion and maintain spinal mobility. Although considerable progress had been made in the past two decades in understanding the etiopathogenesis of adolescent idiopathic scoliosis (AIS), it still lacks an agreed theory of etiopathogenesis. One problem may be that AIS results not from one cause, but several that interact with various genetic predisposing factors. There is a view there are two other pathogenic processes for idiopathic scoliosis namely, initiating (or inducing), and those that cause curve progression. Twin studies and observations of family aggregation have revealed significant genetic contributions to idiopathic scoliosis, that place AIS among other common disease or complex traits with a high heritability interpreted by the genetic variant hypothesis of disease. We summarize etiopathogenetic knowledge of AIS as theories of pathogenesis including recent multiple concepts, and blood tests for AIS based on predictive biomarkers and genetic variants that signify disease risk. There is increasing evidence for the possibility of an underlying neurological disorder for AIS, research which holds promise. Like brain research, most AIS workers focus on their own corner and there is a need for greater integration of research effort. Epigenetics, a relatively recent field, evaluates factors concerned with gene expression in relation to environment, disease, normal development and aging, with a complex regulation across the genome during the first decade of life. Research on the role of environmental factors, epigenetics and chronic non-communicable diseases (NCDs) including adiposity, after a slow start, has exploded in the last decade. Not so for AIS research and the environment where, except for monozygotic twin studies, there are only sporadic reports to suggest that environmental factors are at work in etiology. Here, we examine epigenetic concepts as they may relate to human development, normal life history phases and AIS pathogenesis. Although AIS is not regarded as an NCD, like them, it is associated with whole organism metabolic phenomena, including lower body mass index, lower circulating leptin levels and other systemic disorders. Some epigenetic research applied to Silver-Russell syndrome and adiposity is examined, from which suggestions are made for consideration of AIS epigenetic research, cross-sectional and longitudinal. The word scoliogeny is suggested to include etiology, pathogenesis and pathomechanism.
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