Reduced body protein in children with spastic quadriplegic cerebral palsy.
BACKGROUND
No studies have directly measured body protein or validated skinfold-thickness anthropometry and dual-energy X-ray absorptiometry (DXA) to assess body protein in children with spastic quadriplegic cerebral palsy (SQCP).


OBJECTIVE
We aimed to measure and evaluate body protein and to determine whether skinfold-thickness anthropometry and DXA can predict body protein in children with SQCP.


METHODS
This was a cross-sectional study of 59 children (22 girls, 37 boys) aged 3.9-19.5 y with SQCP. The children underwent measurements of anthropometric indexes, lean tissue mass by DXA (LTM(DXA)), and total body protein by neutron activation analysis (TBP(NAA)). In addition, TBP was estimated from both skinfold-thickness anthropometry (TBP(SKIN)) and DXA (TBP(DXA)). The agreement of TBP(SKIN) and TBP(DXA) was tested against TBP(NAA) by using Bland and Altman plot analysis.


RESULTS
Height and weight SD scores (x +/- SD: -3.1 +/- 1.6 and -4.8 +/- 5.3, respectively) were significantly lower than reference data in the children with SQCP (P < 0.001). TBP(NAA) for age and height was low in the children with SQCP (P < 0.001): 56.1 +/- 17.3% and 81.5 +/- 15.7%, respectively, of the values predicted from control data. TBP(SKIN) and TBP(DXA) were both highly correlated with TBP(NAA): r = 0.90, P < 0.001, and r = 0.91, P < 0.001, respectively. Despite these significant correlations, agreement analyses showed wide variation of up to 33.3% of the mean for both methods.


CONCLUSIONS
Body protein in children with SQCP is significantly reduced for age and height. Skinfold anthropometry and DXA show wide variation in estimation of body protein compared with NAA in this group of children.
Arrowsmith
Fiona E
FE
Department of Gastroenterology, The Children's Hospital at Westmead, Westmead, Australia.
Allen
Jane R
JR
Gaskin
Kevin J
KJ
Gruca
Margie A
MA
Clarke
Samantha L
SL
Briody
Julie N
JN
Howman-Giles
Robert B
RB
Somerville
Helen
H
O'Loughlin
Edward V
EV
D015502:Absorptiometry, Photon / Q000379:methods*; D000293:Adolescent; D000328:Adult; D001823:Body Composition; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000378:metabolism / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000378:metabolism; D009501:Neutron Activation Analysis / Q000379:methods*; D011506:Proteins / Q000378:metabolism*; D011782:Quadriplegia / Q000378:metabolism / Q000503:physiopathology*; D012885:Skinfold Thickness
D011506:Proteins