Bone Abstracts

Background: Based on our recent data, nutritional status disturbances (both under- and overweight) can be associated with the severity of scoliotic curve. Objectives: The study objective was to compare two methods for the assessment of nutritional status (routine BMI calculation vs body composition analysis by bioelectrical impedance analyzer (BIA)) in the group of pediatric patients with idiopathic scoliosis (IS).

Methods: 317 patients (240 girls/77 boys) in mean age of 14.11±2.79 years, with IS were qualified into the study. Scoliotic curve was assessed by Cobb’s angle and angle vertebra rotation (AVR). Height, weight, waist and hip circumferences were measured and BMI, BMI z-score, waist/height ratio (WHtR) and waist/hip ratio (WHR) were calculated in the entire group. Body composition parameters as: fat mass (FAT), fat-free mass (FMM), predicted muscle mass (PMM) and total body water (TBW) were evaluated using bioelectrical impedance analyzer. Nutritional status was classified by centile charts for BMI as underweight, normal weight, overweight, obesity and for FAT% as underfat, lean, overfat, adiposity.

Results: Nutritional status assessed by BMI has been associated with the 21.1% of misclassification, comparing with BIA. There were important differences between percent of underweight vs underfat patients (13.9% vs 9.5% respectively), overweight vs overfat (5.4% vs 7.9% respectively) and obesity vs adiposity (2.8% vs 5.0% respectively). There was no significant correlation between BMI and scoliosis severity in the subgroups classified by standard measurement. However BMI z-score correlated significantly with either, Cobb’s angle and AVR in every BMI classified subgroups. There were also significant correlation between body composition parameters (BIA) and vertebral deformity only in the normal BMI group. After the correction to the FAT%, finally 252 (78.9%) of children were properly classified, and in this group of IS patients statistical analysis showed strong (P<0.001) significant correlation between either, Cobb’s angle and AVR vs every (standard and bioelectrical) anthropometrical parameters.

Conclusions: i) Nutritional status classification by BMI assessment overestimates the underweight and lead to the underestimation of both overweight and obesity in patients with IS. ii) Bioelectrical impedance analysis is a useful tool for the proper nutritional status assessment in pediatric population with IS. iii) Properly assessed nutritional status is significantly associated with the severity of scoliotic curve assessed by Cobb’s angle and AVR.

Disclosure: The authors declared no competing interests.