Obesity and Myelomeningocele: Anthropometric Measures

Shurtleff, David B.; Walker, William O.; Duguay, Sharon; Peterson, Do; Cardenas, Diana D.

doi:10.1080/10790268.2010.11689720

Cited by 22 publications

(24 citation statements)

References 36 publications

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“…Half (52-68%) have had a romantic relationship 131, although this rate is lower than in typically developing young adults 164, 169. The lowest level of life satisfaction is in the areas of romantic relationships, employment, and financial independence 131.…”

Section: Quality Of Lifementioning

confidence: 99%

Spina bifida

Copp

Adzick

Chitty

et al. 2015

Nat Rev Dis Primers

549

432

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Spina bifida is a birth defect in which the vertebral column is open (bifid), often with spinal cord involvement. Clinically most significant is myelomeningocele (MMC; open spina bifida) in which the spinal neural tube fails to close during embryonic development. The exposed neural tissue degenerates in utero, resulting in neurological deficit that varies with level of the lesion. Occurring in around 1 per 1000 births worldwide, MMC is one of the commonest congenital malformations, yet its causation is largely unknown. The genetic component of MMC is estimated at 60-70% but few genes have yet been identified, despite much information from mouse models. Non-genetic risk factors include reduced folate intake, maternal anticonvulsant therapy, diabetes mellitus and obesity. Primary prevention by peri-conceptional folic acid has been demonstrated in clinical trials, leading to food fortification programmes in many countries. Prenatal diagnosis is by ultrasound enabling termination of pregnancy. Individuals who survive to birth have their lesions closed surgically, with subsequent management of associated defects, including the Chiari II malformation, hydrocephalus, and urological and orthopaedic sequelae. Fetal surgical repair of MMC has been associated with improved early neurological outcome compared with postnatal operation. MMC affects quality of life during childhood, adolescence, and into adulthood, posing a challenge for individuals, families and society as a whole.

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Section: Quality Of Lifementioning

confidence: 99%

Spina bifida

Copp

Adzick

Chitty

et al. 2015

Nat Rev Dis Primers

549

432

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“…9 Several studies have analyzed the use of more adequate cut-off points and different measures 5 with varying results. One of the nutritional challenges seen in patients with myelomeningocele is detecting the most adequate indicator to diagnose obesity.…”

Section: Original Articlementioning

confidence: 99%

Body composition and energy expenditure in a population of children and adolescents with myelomeningocele

Caminiti

Sauré

Weglinski

et al. 2018

Arch Argent Pediatr

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Introduction.Myelomeningocele is a congenital defect that occurs when the neural tube fails to close completely. It causes body composition alterations and a high prevalence of obesity. It is difficult to detect the most adequate indicator for a nutritional diagnosis due to the impossibility of recording accurate anthropometric measurements. Objective. To describe body composition, resting energy expenditure and metabolic disorders in a population of patients with myelomeningocele managed at "Hospital Garrahan" by comparing obese patients with myelomeningocele and a control population with multifactorial obesity. Population and methods. An anthropometry, an impedance analysis, skinfold equations, arm circumference equations, indirect calorimetry, and biochemical determinations were done to all patients with myelomeningocele between June 2013 and April 2014, once the informed consent had been signed. Results. 131 patients aged 0.7-18.6 years were assessed; they were classified according to their body mass index Z-score into low weight (15%), normal weight (42%), overweight (12%), and obese (31%). A high correlation (r: 20.74) was observed between the fat mass % measured by impedance analysis versus that estimated using skinfolds. Patients with a high fat mass % had a higher body mass index Z-score than those with a normal fat mass % (1.07 versus -0.27, p: 0.0001) although both values were within normal parameters. A lower resting energy expenditure was observed among obese patients with myelomeningocele than predicted and in comparison with multifactorial obese controls. Conclusions. A high percentage of overweight/ obesity was found in the population with myelomeningocele. Skinfold equations would be more adequate to detect obesity. Obese patients with myelomeningocele had a lower resting energy expenditure than predicted and in comparison with controls. Energy indication should be customized.

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“…11 Body mass index (BMI) can be difficult to evaluate in patients with MMC because of the scoliosis, the presence of contracture in the lower extremities and their altered dimensions and growth delay. 38,39 Previous studies from general paediatric populations have reported that maternal dietary folate intake during pregnancy positively correlates with BMD of the child. 40 …”

Section: Environmental Factorsmentioning

confidence: 99%

Osteoporosis in paediatric patients with spina bifida

Marreiros

Loff

Calado

2012

The Journal of Spinal Cord Medicine

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The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. Objective: To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Methods: Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results: Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB.

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Obesity and Myelomeningocele: Anthropometric Measures

Cited by 22 publications

References 36 publications

Spina bifida

Spina bifida

Body composition and energy expenditure in a population of children and adolescents with myelomeningocele

Osteoporosis in paediatric patients with spina bifida

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