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. 2010;33(4):410-9.
doi: 10.1080/10790268.2010.11689720.

Obesity and myelomeningocele: anthropometric measures

David B Shurtleff  1 , William Otis Walker, Sharon Duguay, Do Peterson, Diana Cardenas
Affiliations

Obesity and myelomeningocele: anthropometric measures

David B Shurtleff et al. J Spinal Cord Med. 2010.

Abstract

Objective: To evaluate the appropriate use of arm span measurements as a substitute for height/linear length to evaluate obesity in people with myelomeningocele by comparing calculated body mass indices (BMIs) with recently published BMI graphs by the Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics standards (NCHS) published in 2000.

Study design: Retrospective analysis of collected data on patients seen in the University of Washington Birth Defects Clinic from July 1, 1965, through June 1, 2008. Observations included degree of paralysis, presence of scoliosis, height (linear length), weight, and arm span. We compared published CDC/NCHS BMIs with our data using both height and arm span in place of height/linear length. There were 14,701 measures collected during 4968 visits from 709 patients. Mean values were calculated using age, gender, and lesion level as independent variables.

Results: Comparison of BMI means of patients with myelomeningocele suggests that our observations using arm span and height are comparable with the CDC/NCHS BMI means using height for the 2 least paralyzed groups but not for those groups with paralysis from high-level lesions that are more likely to exhibit lower extremity deformities or scoliosis.

Conclusions: Published CDC/NCHS graphs, with their percentiles, are appropriate for estimating normal growth by BMI for children born with myelomeningocele when arm span is substituted for length if severe body differences due to high-level paralysis are taken into consideration.

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Figures

Figure 1–3
Figure 1–3
Plots of the percent mean differences (⁃) between arm span (—) minus height (–○–) divided by height for females and males in each of the lesion level groups by age.
Figure 4–6
Figure 4–6
Plots of body mass index (BMI) calculated by both arm span (♦) and height (▵) for each of the lesion level groups by sex and age are superimposed on Centers for Disease Control and Prevention/National Center for Health Statistics BMI percentile graphs. The background BMI graphs for the lesion level 1 male and female groups (Figure 4) have the percentiles lowered because of lost lean body mass, as explained in the text.
Figure 7
Figure 7
Plots of body mass index calculated both by using height (–•–) and arm span (–♦–) before and after beginning participation in sports and immediately before and after spinal fusion for scoliosis. (a) The patients' plots against unaltered Centers for Disease Control and Prevention/National Center for Health Statistics (CDC/NCHS) percentile graphs; (b) the patients' plots against CDC/NCHS percentile graphs that have been lowered by approximately 50% of body mass index for age.
See this image and copyright information in PMC

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