Difference between Methods for Estimation of Basal Metabolic Rate and Body Composition in Pediatric Patients with Osteogenesis Imperfecta

Abstract

Background/Aims: Osteogenesis Imperfecta (OI) is a bone disease characterized by bone fragility, deformities, and multiple fractures. The aim of this study was to compare the different methods of measuring the basal metabolic rate (BMR) and body composition (BC) in pediatric patients with OI. Methods: This cross-sectional study included 52 individuals with a median age of 9 (5.25–12.7) years. BMR was calculated by bioelectrical impedance analyses (BIA), predictive values according to age from the World Health Organization (WHO), a kcal/cm formula, and indirect calorimetry (IC). BC was assessed using the anthropometric calculation of percentage body fat (%BF) and lean mass (kg), BIA, and dual-energy X-ray absorptiometry (DEXA). Agreement among the methods was assessed using the Bland-Altman technique. Results: IC estimates of BMR were greater than BIA and lower than values obtained using the WHO and kcal/cm methods. Better agreement was observed using the WHO values for mild forms of OI and the kcal/cm formula for moderate-to-severe forms. For BC, DEXA estimates of %BF were higher and the lean mass was lower than the values obtained using BIA and anthropometry. Neither method agreed with the DEXA method results. Conclusions: Significant differences exist among the various methods used for measuring BMR and BC with regard to phenotypic differences between OI types.

Calcium intake improvement after nutritional intervention in paediatric patients with osteogenesis imperfecta

“… have reported that BMI is not the best method for evaluating the body composition of these patients because BMI is a body height‐related measure and can be influenced by height loss as a result of leg deformities or scoliosis. Our previously published study showed a difference between the methods used to evaluate the body composition . Several studies have reported an association between OI and a higher BMI and being overweight .…”

“…and can be influenced by height loss as a result of leg deformities or scoliosis. Our previously published study showed a difference between the methods used to evaluate the body composition (14) . Several studies have reported an association between OI and a higher BMI and being overweight (7,9,19,20) .…”

“…BMI was calculated and nutritional status was classified in accordance with the WHO (2006, 2007) . The BMR was evaluated via indirect calorimetry and the data were published previously .…”

Osteogenesis Imperfecta: Diagnostic Feature

“…/2018/ ТОМ 15/ № 3 рослости [2]. Типичными внескелетными проявлениями болезни являются невысокий рост, голубые склеры, несовершенный дентиногенез, прогрессирующее сниже-ние слуха, поражение соединительной ткани связочного аппарата [3].…”

Evaluation of Body Composition in Paediatric Osteogenesis Imperfecta

“…Dual-energy X-ray absorptiometry (DXA) uses ionising radiation from two sources that traverse the body and measure absorption by the bone, giving a clear evaluation of BMD which remains the gold standard [8] . This also allows a convenient means of assessing lean mass (LM), which consists of water, muscle, connective tissue and internal organs; and fat mass (FM), which is fat tissue; and is accessible to the majority of paediatric bone services [9,10] . Although used interchangeably and as a surrogate marker, LM is critically different to muscle mass.…”