title: Assessment of body composition in children with cerebral palsy: a cross-sectional study in Norway.
abstract: OBJECTIVE
  The assessment of growth and body composition is challenging in children with cerebral palsy (CP). The aim of this study was to compare clinical assessments of body composition with measurements obtained using dual-energy X-ray absorptiometry (DXA) in this population.
  
  
  METHODS
  Knee height, weight, and triceps and subscapular skinfold thickness (SFT) were measured in 47 children with CP (age range 8-18y; 18 females, 29 males). Height was estimated from knee height, and used to calculate body mass index (BMI). Using SFT measurements, body fat percentage was calculated by standard ('Slaughter') and CP-modified ('Gurka') equations and compared with results obtained using DXA.
  
  
  RESULTS
  Children with severe gross motor function impairments (Gross Motor Function Classification System [GMFCS] level III or IV) exhibited stunted growth and had higher fat percentages and lower lean body mass than children classified in GMFCS level I or II. In 10 children classified as 'thin' according to their BMI (five of whom were assigned thinness grade of 2 or lower), percentage of body fat, as determined by DXA, was normal or high. The Slaughter equations significantly underestimated body fat percentages, whereas the precision of the CP-modified Gurka equations was excellent.
  
  
  CONCLUSIONS
  In this study, children with CP and severe motor impairments displayed stunted growth, but were not undernourished. Relying solely upon BMIs may be misleading in children with CP. Therefore, clinicians should be encouraged to measure SFT and to calculate body fat percentages using the CP-modified version of the Slaughter equation.
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Pediatrics, St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Ane-Kristine
authors.initials: AK
authors.lastname: Finbråten
authors.affiliation: Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Catia
authors.initials: C
authors.lastname: Martins
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.|The Cerebral Palsy Register of Norway, Habilitation Center, Vestfold Hospital Trust, Tønsberg, Norway.
authors.forename: Guro Lillemoen
authors.initials: GL
authors.lastname: Andersen
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Jon
authors.initials: J
authors.lastname: Skranes
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.|Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Bente
authors.initials: B
authors.lastname: Brannsether
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.|Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
authors.forename: Pétur Benedikt
authors.initials: PB
authors.lastname: Júlíusson
authors.affiliation: Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Endocrinology, St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Unni
authors.initials: U
authors.lastname: Syversen
authors.affiliation: Department of Pediatrics, Division of Developmental Pediatrics, Kluge Children's Rehabilitation Center and Research Institute, University of Virginia, Charlottesville, VA, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Stevenson
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Torstein
authors.initials: T
authors.lastname: Vik
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D012885:Skinfold Thickness