Evaluation of body composition in paediatric Osteogenesis Imperfecta

Gilani, M., Shepherd, S., Nichols, B., Gerasimidis, K. , Wong, S. C. and Mason, A. (2022) Evaluation of body composition in paediatric Osteogenesis Imperfecta. Journal of Clinical Densitometry, 25(1), pp. 81-88. (doi: 10.1016/j.jocd.2021.01.012) (PMID:33582031)

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Abstract

Osteogenesis Imperfecta (OI) is a skeletal disorder characterised by a predisposition to recurrent fractures and bone deformities. Clinically OI is defined by features such as short stature, however, less is known regarding body composition. Assess body composition, both lean mass and fat mass, in a paediatric OI population. Children with OI attending the Bone service at the Royal Hospital for Children Glasgow were included; who had a dual-energy x-ray absorptiometry (DXA) scan performed 2015-2018. Height and body-mass-index (BMI) were converted to standard-deviation scores (SDS) using UK population references. DXA-derived lean mass and fat mass were used to generate lean-mass-index (LMI) and fat-mass-index (FMI) by dividing the covariates by height squared. LMI and FMI were converted to age-and-gender-adjusted SDS using DXA data from 198 local healthy children. Thirty-eight children (20 males) with median age 11.95 (range: 4.8, 18.3) years were included. Median height SDS was -1.08 (-3.64, 1.62) and was significantly lower than the healthy population (p<0.0001). Median BMI SDS was -0.10 (-2.31, 2.95), and not significantly different from the healthy population (p = 0.53). Median LMI SDS was -2.52 (-6.94, 0.77), and significantly lower than healthy controls (p<0.0001); 61% (23/38) had an SDS below -2.0. Median FMI SDS was 0.69 (-0.45, 2.72), significantly higher than healthy controls (p < 0.0001). BMI SDS cut-offs of -0.15 and 1.33, from ROC analysis, identified children with LMI SDS <-2, with a positive predictive value of 95% and a negative predictive value of 70%; and FMI SDS >2 with a positive predictive value of 44% and a negative predictive value of 100%. A contemporary population of children with ranging severities of OI present with significant reduction in height and lean mass, and relatively high fat mass. Standard BMI SDS cut-offs for identifying children with malnutrition and obesity have poor prognostic validity in OI.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Shepherd, Dr Sheila and Wong, Dr Jarod and Nichols, Mr Ben and Mason, Dr Avril and Gerasimidis, Professor Konstantinos
Authors: Gilani, M., Shepherd, S., Nichols, B., Gerasimidis, K., Wong, S. C., and Mason, A.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Clinical Densitometry
Publisher:Elsevier
ISSN:1094-6950
ISSN (Online):1559-0747
Published Online:30 January 2021
Copyright Holders:Copyright © 2021 Elsevier
First Published:First published in Journal of Clinical Densitometry 25(1): 81-88
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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