Referencias de índice de masa corporal. Precisión diagnóstica con área grasa braquial en escolares argentinos / Body mass index references. Diagnostic accuracy with the upper-arm fat area in Argentine schoolchildren

El índice de masa corporal (IMC) es una eficaz herramienta para detectar la sobrecarga ponderal en niños y adolescentes, asociado a la adiposidad corporal. Objetivo. Analizar la concordancia, sensibilidad y especificidad de tres referencias internacionales de IMC/edad (OMS, IOTF y CDC) para diagnosticar el exceso ponderal y conocer su precisión diagnóstica para identificar el exceso de adiposidad con relación al área grasa braquial (AGB) en población infanto juvenil de Argentina. Materiales y métodos. Se realizó un estudio multicéntrico, descriptivo-comparativo y transversal entre 2003 y 2008, en 22.658 niños y adolescentes argentinos de 4 a 13 años de edad. A partir del peso, talla, circunferencia del brazo y pliegue tricipital, se calcularon IMC y AGB. Se analizó la concordancia, sensibilidad y especificidad de referencias de IMC/edad (OMS, CDC, IOTF) y la precisión diagnóstica (curvas ROC) para identificar exceso de adiposidad, a partir del AGB, así como el punto de corte óptimo (PCO). Resultados. Las tres referencias tuvieron buena concordancia. La mayor sensibilidad correspondió a OMS y la mayor especificidad a IOTF. El área bajo la curva (ABC) fue mayor en Z-IMC/IOTF en varones y en Z-IMC/OMS en mujeres. Los PCO mostraron discrepancias, siendo mayores con OMS. Conclusión. Las tres referencias muestran similar precisión diagnóstica para detectar alta reserva calórica, con puntos de corte óptimo para las puntuaciones Z-IMC menores a 2 Z scores. Esto resulta relevante para la identificación de exceso de adiposidad en poblaciones, en relación con la implementación de políticas públicas de prevención de enfermedades crónicas no transmisibles(AU)

The body mass index (BMI) is an effective tool to detect weight overload in children and adolescents, associated with body adiposity. Objective. To analyze the concordance, sensitivity and specificity of three international BMI/age references (WHO, IOTF and CDC) to diagnose excess weight and to know their diagnostic accuracy to identify excess adiposity in relation to the brachial fat area (BFA) in Argentine child-youth population. Materials and methods. A multicenter, descriptive- comparative and cross-sectional study was carried out between 2003 and 2008 in 22.658 Argentine children and adolescents between aged 4 to 13 years. From the weight, height, arm circumference and tricipital fold, BMI and BFA were calculated. The concordance, sensitivity, and specificity of BMI / age references (WHO, IOTF, CDC,) were analyzed and the diagnostic precision (ROC curves) to identify excess adiposity, from the BFA, as well as the optimal cut-off point (OCP). Results. The three references had good agreement, the highest sensitivity corresponded to WHO and the highest specificity to IOTF. The area under the curve (AUC) was greater in Z-BMI/IOTF in men and in Z-BMI/WHO in women. The OCPs showed discrepancies, being higher with WHO. Conclusion. The three references show similar diagnostic accuracy to detect high caloric reserve, but with cut-off points for Z-BMI scores less than 2 Z scores. This is relevant for the identification of excess adiposity in populations in relation to the implementation of public policies for the prevention of chronic non-communicable diseases(AU)

Body composition in relation to nutritional status and socio-environmental conditions in schoolchildren living in the urban periphery of La Plata, Argentina

The aim of this study was to evaluate body composition in relation to nutritional status and socio-environmental conditions of residence in schoolchildren living in the urban periphery of La Plata, Argentina. Weight, height, arm circumference and tricipital and subscapular skinfolds were measured in 3,284 schoolchildren aged 4-12 years in the period 2014-2017. The National Health and Nutrition Examination Survey (NHANES) III reference was used to assess nutritional status, identifying the following categories: normal, underweight, stunting, wasting, overweight and obesity. Body composition was evaluated based on upper arm muscle area (UMA) and upper arm fat area (UFA). Deficit and excess UMA and UFA were also calculated. Central fat distribution was determined with the subscapular-tricipital index. Socio-environmental characteristics were surveyed using a structured questionnaire. The prevalence of nutritional status and body composition indicators were compared by sex using Chi square test. Socio-environmental data were analyzed using categorical Principal Component Analysis, discriminating into more favorable and unfavorable conditions. Nutritional status results were as follows: normal, 64.5%; stunting, 3.4%; underweight, 0.0%; wasting, 0.1%; overweight, 15.6% and obesity 16.4%. The nutritional status of children worsened as the socio-environmental condition of their families became more precarious. Long-term socio-environmental stress manifested as decreased muscle tissue in normal, stunted, overweight and obese children. The current results evidence the strong impact of poverty on child growth and development and at the same time enforce the need for continuous monitoring of children with hidden malnutrition(AU)

El objetivo del trabajo fue analizar la composición corporal en relación al estado nutricional y las condiciones socio-ambientales de niños residentes en la periferia urbana de La Plata, Argentina. Sobre 3284 escolares de 4 a 12 años se evaluaron peso, talla, perímetro braquial y pliegues tricipital y subescapular, durante los años 2014-2017. Se determinaron, utilizando la referencia NHANES III, las categorías de estado nutricional Normal; Bajo Peso/Edad; Baja Talla/Edad; Bajo IMC/Edad; Sobrepeso y Obesidad, y para composición corporal, se calcularon las áreas muscular y grasa (UMA y UFA) y se estimaron los déficits y excesos de tejido muscular y graso. La adiposidad centralizada fue estimada con el índice subescapular-tricipital. Las características socio-ambientales se evaluaron mediante encuesta estructurada. Las prevalencias del estado nutricional y de los indicadores de composición corporal fueron estimados y comparados por sexos, mediante pruebas de Chi2. Los datos socio-ambientales se analizaron empleando Análisis de Componentes Principales categóricos y se discriminaron dos grupos: con condiciones más favorables y con condiciones desfavorables. Los resultados indicaron: 64.5% Normal, 3.4% Baja Talla/Edad, 0.0% Bajo Peso/Edad; 0.1% Bajo IMC/Edad; 15.6% Sobrepeso; 16.4% Obesidad. El estado nutricional de los niños empeoró cuando la calidad socio-ambiental de sus familias se hizo más precaria. Debido al estrés socio-ambiental continuo, los niños tuvieron disminución del tejido muscular, incluyendo aquellos con estado nutricional Normal, Baja Talla/Edad, Sobrepeso y Obesidad. Los resultados alcanzados evidencian la impronta que deja la pobreza e impone urgentemente el monitoreo continuo de niños "con desnutrición oculta"(AU)

The Pattern of Weight Gain and Change of Peripheral Serum Lipid Profiles in Idiopathic Epileptic Children Treated with Valproate / 대한소아신경학회지

PURPOSE: This study was performed to investigate the change of weight and body composition, and lipid profiles in the idiopathic epileptic children treated with valproate. METHODS: We measured the weight, height, left arm circumference, left triceps skinfold thickness of 30 idiopathic epileptic children treated with valproate before, at 1 month and 4 months of treatment. We also analyzed the serum lipid profiles of the patients before and at 4 months of treatment. We analyzed the change of Body Mass Index (BMI), Arm Muscle Area(AMA), Arm Fat Area(AFA), and the serum lipid profiles. Two-way analysis of variance, chi-square test and paired-t test were used for statistical analysis. RESULTS: There was no statistically significant change in BMI, AFA, AMA of the patients. But the weight of 13(44.3%) children increased greater than 10% with valproate treatment. AMA were not changed, but AFA were significantly increased, 791.2+/-209.6 mm2 before treatment, 858.1+/-246.6 mm2 at 1 month, 1051.7+/-393.2 mm2 at 4 months, in 13 patients, whose weight gain were greater than 10%(P<0.05). There was no change in cholesterols, low density lipoproteins, high density lipoproteins of the 30 children. CONCLUSION: The increase of the weight in the children treated with valproate resulted from the increase body fat. So the weight gain may be a risk factor of obesity

Change in Nutritional Status of Elementary School Children

PURPOSE: The purpose of this study is to compare the present nutritional status with that of previous surveys done in Korea and other advance countries. METHODS: We measured the arm circumference and triceps skinfold thickness of 1,009 students of Hanyang Elementary School. We analyzed the arm muscle area and arm fat area. We analyzed the lomgitudinal height and weight of 6th grade children. We used an obesity index to estimate the prevalence of obesity. RESULTS: The mean height increased to 4.2-6.6cm in boys, 3.7-6.3cm in girls and the mean weight increased to 3.7-9.7kg in boys, 3.2-8.2kg in girls. The median of arm circumference increased to 7-44mm in boys, 8-36mm in girls. The median of triceps skinfold thickness increased to 1.7-7.8mm in boys, 2.3-6.4mm in girls. The mean of arm muscle area increased to 1.0-7.4cm2 in boys, 0.2-5.4cm2 in girls. The mean of arm fat area increased to 2.4-9.6cm2 in boys, 3.0-8.9cm2 in girls. The prevalence of obesity was 27% in boys and 24% in girls. CONCLUSION: Current data revealed marked increase in arm circumference, triceps skinfold thickness, arm muscle area and arm fat area than those of previous standard data established in Korea, 1984, approaching 1981 U.S standards. The increase in arm fat area and increased prevalence of obesity suggest an increased intake of calorie with relative deficiency in physical activity.

The Association of Serum IGF-I, Growth Velocity, Fat Area and Muscle Area after Growth Hormone Treatment in Growth Hormone Deficient Children

PURPOSE: Growth hormone, which is used in growth hormone deficiency, promote anabolic and lipolytic effect through IGF-I on skeletal, muscle, and fat tissue. And so, we studied the association of serum IGF-I, growth velocity, fat area and muscle area after growth hormone treatment in growth hormone deficient children. METHODS: At the department of Pediatrics, Hanyang University Hospital, we measured serum IGF-I, growth velocity, fat area and muscle area before and after growth hormone therapy from 10 patients who were diagnosed as growth hormone deficiency after pharmrcological stimulation tests. We measured IGF-I levels by the radioimmuno assay using Nichol's kit (Nichols Co, USA), circumference and thickness by tapeline and caliper (Holtain Ltd, U.K.), height by Harpenden stadiometer. RESULTS: 1) The mean IGF-I levels of before and after 3, 6, 9 and 12 months growth hormone treatment were 72.9, 274.8, 228.7, 287.6, 210.3ng/mL, respectively. 2) The mean growth velocity of before and after 3, 6, 9 and 12 months growth hormone treatment were 4.2, 10.79, 11.3, 8.1, 7.4cm/year, respectively 3) The mean arm circumference of before and after 3, 6, 9 and 12 months growth hormone treatment were 20, 19.7, 19.5, 21.7 and 21cm respectively, and the mean arm skin thickness of before and after 3, 6, 9 and 12 months growth hormone treatment were 14.3, 11.8, 10.5, 12.9 and 13.6mm, respectively. 4) The mean abdominal circumference of before and after 3, 6, 9 and 12 months growth hormone treatment were 66.9, 61.7, 58.2, 68.1 and 65.7cm respectively, and the mean abdominal skin thickness of before and after 3, 6, 9 and 12 months growth hormone treatment were 16.4, 11.2, 9.9, 14.8 and 16.6mm, respectively. 5) The mean arm muscle area of before and after 3, 6, 9 and 12 months growth hormone treatment were 19.6, 20.6, 21.2, 25.1 and 22.6cm2 respectively, and the mean arm fat area of before and after 3, 6, 9 and 12 months growth hormone treatment were 12.9, 10.9, 9.7, 9.9 and 13.4cm2, respectively. CONCLUSIONS: After growth hormone therapy in growth hormone deficient children, as IGF-I increase, growth velocity and arm muscle area increased but arm fat area decreased. Thus this study provides for anabolic and lipolytic activity of growth hormone through IGF-I.

The Association of Serum IGF-I, Growth Velocity, Fat Area and Muscle Area after Growth Hormone Treatment in Growth Hormone Deficient Children

PURPOSE: Growth hormone, which is used in growth hormone deficiency, promote anabolic and lipolytic effect through IGF-I on skeletal, muscle, and fat tissue. And so, we studied the association of serum IGF-I, growth velocity, fat area and muscle area after growth hormone treatment in growth hormone deficient children. METHODS: At the department of Pediatrics, Hanyang University Hospital, we measured serum IGF-I, growth velocity, fat area and muscle area before and after growth hormone therapy from 10 patients who were diagnosed as growth hormone deficiency after pharmrcological stimulation tests. We measured IGF-I levels by the radioimmuno assay using Nichol's kit (Nichols Co, USA), circumference and thickness by tapeline and caliper (Holtain Ltd, U.K.), height by Harpenden stadiometer. RESULTS: 1) The mean IGF-I levels of before and after 3, 6, 9 and 12 months growth hormone treatment were 72.9, 274.8, 228.7, 287.6, 210.3ng/mL, respectively. 2) The mean growth velocity of before and after 3, 6, 9 and 12 months growth hormone treatment were 4.2, 10.79, 11.3, 8.1, 7.4cm/year, respectively 3) The mean arm circumference of before and after 3, 6, 9 and 12 months growth hormone treatment were 20, 19.7, 19.5, 21.7 and 21cm respectively, and the mean arm skin thickness of before and after 3, 6, 9 and 12 months growth hormone treatment were 14.3, 11.8, 10.5, 12.9 and 13.6mm, respectively. 4) The mean abdominal circumference of before and after 3, 6, 9 and 12 months growth hormone treatment were 66.9, 61.7, 58.2, 68.1 and 65.7cm respectively, and the mean abdominal skin thickness of before and after 3, 6, 9 and 12 months growth hormone treatment were 16.4, 11.2, 9.9, 14.8 and 16.6mm, respectively. 5) The mean arm muscle area of before and after 3, 6, 9 and 12 months growth hormone treatment were 19.6, 20.6, 21.2, 25.1 and 22.6cm2 respectively, and the mean arm fat area of before and after 3, 6, 9 and 12 months growth hormone treatment were 12.9, 10.9, 9.7, 9.9 and 13.4cm2, respectively. CONCLUSIONS: After growth hormone therapy in growth hormone deficient children, as IGF-I increase, growth velocity and arm muscle area increased but arm fat area decreased. Thus this study provides for anabolic and lipolytic activity of growth hormone through IGF-I.

A STUDY ON THE STANDARDS FOR UPPER ARM MUSCLE CIRCUMFERENCE AND OTHER ANTHROPOMETRIC PARAMETERS / 营养学报

Anthropometric evaluations of the upper limb have become valuable in the assessment of nutritional status of fat and protein. The standards for TSF (triceps skinfold thickness), T + S (sum of triceps and subscapular skinfold thicknesses), F(upper arm fat area), AMC (upper arm muscle circumference) and M(upper arm muscle area) which can be used on male adults tentatively are presented by survey in 1532 healthy males aged from 18 to 34 years.