title: Natural evolution of weight status in Duchenne muscular dystrophy: a retrospective audit.
abstract: The life expectancy of patients with Duchenne muscular dystrophy (DMD) has increased. A cross-sectional study of DMD patients showed that 54 % of 13-year-old patients are obese and that 54 % of 18-year-old patients are underweight. We aimed to describe the natural evolution of weight status in DMD. This retrospective multi-centre audit collected body-weight measurements for seventy DMD patients born before 1992. The body-weight:age ratio (W:A) was used to evaluate weight status in reference to the Griffiths and Edwards chart. At the age of 13 years, 73 % were obese and 4 % were underweight. At maximal follow-up (age 15-26 years, mean 18·3 (sd 2·3) years), 47 % were obese and 34 % were underweight. Obesity at the age of 13 years was associated with later obesity, whereas normal weight status and underweight in 13-year-old patients predicted later underweight. A W:A ≥ 151 % in 13-year-old patients predicted later obesity, and a W:A ≤ 126·5 % predicted later underweight. Our audit provides the first longitudinal information about the spontaneous outcome of weight status in DMD. Patients (13 years old) with a W:A ≥ 151 % were more likely to become obese in late adolescence, but obesity prevented later underweight. These data suggest that mild obesity in 13-year-old DMD patients (W:A between 120 and 150 %) should not be discouraged because it prevents later underweight.
authors.affiliation: Service de Gastroentérologie, Hépatologie et Nutrition Pédiatrique, Hôpital Jeanne de Flandre, Centre Hospitalier Régional et Universitaire, Lille, France. leonie.martigne@chru-lille.fr
authors.forename: Léonie
authors.initials: L
authors.lastname: Martigne
authors.forename: Julia
authors.initials: J
authors.lastname: Salleron
authors.forename: Michèle
authors.initials: M
authors.lastname: Mayer
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Cuisset
authors.forename: Alain
authors.initials: A
authors.lastname: Carpentier
authors.forename: Véronique
authors.initials: V
authors.lastname: Neve
authors.forename: Vincent
authors.initials: V
authors.lastname: Tiffreau
authors.forename: Dominique
authors.initials: D
authors.lastname: Guimber
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gottrand
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D044342:Malnutrition / Q000150:complications / Q000503:physiopathology; D008485:Medical Audit; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000503:physiopathology*; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies; D055815:Young Adult