Percentage Body Fat in Apparently Healthy School Children From Northern India.

Context: Increased prevalence of obesity in childhood and adolescence, defined by the use of body mass index (BMI), has drawn attention towards direct measurement of body fat Objective: To develop age-and sex-specific reference distribution of body fat in apparently healthy North-Indian children in the age group of 7-17 years and to assess agreement between obesity (defined by BMI) and excess body fat Design: Study subjects for this cross sectional study included1640 apparently healthy school children (825 boys; 815 girls) aged 7-17 years. Total body fat was measured by dual energy X-rays absorptiometry (DXA). The excess body fat by DXA was defined by two methods, prevalence matching and with the use of 85th and 95th centile cutoffs. Results: The mean ± SD, 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile values of percentage body fat (PBF) are presented. PBF was highly correlated with BMI in both boys and girls (all boys: r=0.76, P<0.0001; all girls r=0.81, P<0.0001). There was no significant difference noted in PBF between boys and girls at the age of 7-8 years. From 9 years onwards, girls had significantly higher PBF than boys. Moderate degree of agreement was observed between BMI and PBF by DXA by both methods. Conclusions: Smoothened reference distribution of PBF for North-Indian children and adolescents in Delhi are provided. Indian children accumulate more body fat during peri-pubertal years in comparison with US children.

Does Paget's disease exist in India?: A series of 21 patients.

OBJECTIVE: Paget's disease of bone has been described as a few case reports from India. The aim of the present study is to document the existence of Paget's disease (PD) in India. MATERIAL AND METHODS: We describe demography, clinical manifestations, biochemical and radiological profile and the treatment outcome of 21 patients of PD. RESULTS: Mean (+/-SD) age of these patients at presentation was 49.2 +/- 17.6 years and the male to female ratio was 2.5:1. Common clinical manifestations included backache, headache and bone pains. Others were fracture, joint pain, deafness, gait ataxia, visual impairment and difficulty in biting. Two patients presented with hydrocephalus and one had recurrent paraparesis. Fifteen (71.4%) patients had polyostotic and six (28.6%) had monoostotic Paget's disease. More commonly involved bones were skull and spine (61.9%) followed by pelvis (38.1%), femur (33.3%), tibia (9%) and ulna (9%). Mean (+/-SD) serum alkaline phosphatase at diagnosis was 1514 +/- 1168 IU/L and nine months after treatment with bisphosphonates decreased to 454 +/- 406 IU/ L(P<0.03). CONCLUSION: This illustrates that Paget's disease does exist in India and a high index of suspicion is required to clinch the diagnosis.

Growth charts suitable for evaluation of Indian children.

OBJECTIVE: To assess the suitability of recently published reference anthropometric data for evaluation of the growth of children in our region. SETTING: Referral Pediatric Endocrinology Clinic in tertiary level care hospital. SUBJECTS: 280 normal school children and 155 children referred for growth retardation to the clinic in 1993 and 1994. METHODS: Heights of school children were plotted on growth charts created from recently published reference growth data of children from high socioeconomic group families. The case records of 155 children referred for growth evaluation were retrospectively analyzed for (i) etiology of short stature, (ii) height percentile based on previously used Indian Council of Medical Research (ICMR) references, and (iii) height percentile and standard deviation scores based on the new references. RESULTS: 93% of school children fell above and 7% below the 5th centile of the new height references. Of the 129 clinic children diagnosed to have growth retardation, 128 fell below the 5th centile of the new references. However, 38 of these (29.5%) fell above the 5th centile of ICMR references. These included patients with pathological causes of short stature. Twenty four of 26 children labelled as having no growth problem fell above the 5th centile of new reference data. CONCLUSIONS: The 5th height centile of new reference data from high socioeconomic group children is an appropriate cut off below which to evaluate children for short stature in our region. It will allow earlier identification and treatment than the hitherto used ICMR percentiles, and yet is not expected to result in over investigation of normal children.