title: Body composition of patients with Duchenne muscular dystrophy: the Greek experience.
abstract: Greece ranks among the first countries suffering from the obesity epidemic globally. The aim of the study was to evaluate body composition in Greek patients with Duchenne muscular dystrophy (DMD). We hypothesized that able-bodied patients would not differ from controls, in terms of adiposity, based on clinical observations during everyday practice.
  
  
  METHODS
  Cross-sectional study of steroid-dependent DMD subjects, who underwent dual-energy X-ray absorptiometry and laboratory metabolic bone profile evaluation. Forty-two patients and thirty-one controls were studied. Overall, DMD subjects were shorter (height Z-score = -1.4, p = 0.01). Their bone mineral density (BMD) was low (lumbar spine BMD Z-score = -1.2, p < 0.01, subcranial total body BMD Z-score = -1.8, p < 0.01). Lean tissue mass (LTM) was also decreased (LTM Z-score = -2.2, p < 0.01). The above findings were more pronounced in adolescence. Regarding adiposity, increased fat mass (FM) was found only in pubertal DMD patients (FM Z-score = 1.4, p < 0.01), whereas prepubertal, able-bodied patients did not differ from controls, thus confirming the initial hypothesis. Finally, 65 % of DMD subjects had increased bone resorption markers and 57 % had suboptimal vitamin D levels. The importance of using native population as controls for body composition analysis is highlighted. In Greece, abnormal body composition in DMD patients is more striking when loss of ambulation occurs and not during the prepubertal period, due to the concurrent presence of obesity in the pediatric population. Thus, adolescents with this neuromuscular disorder should be targeted toward prompt lifestyle interventions.
authors.affiliation: Department of Bone and Mineral Metabolism, Institute of Child Health, "Agia Sophia" Children's Hospital, 115 27, Goudi, Athens, Greece. doulgeraki@yahoo.com.
authors.forename: Artemis E
authors.initials: AE
authors.lastname: Doulgeraki
authors.affiliation: Department of Bone and Mineral Metabolism, Institute of Child Health, "Agia Sophia" Children's Hospital, 115 27, Goudi, Athens, Greece.
authors.forename: Helen I
authors.initials: HI
authors.lastname: Athanasopoulou
authors.affiliation: Neuromuscular Unit, "Agia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Marina S
authors.initials: MS
authors.lastname: Katsalouli
authors.affiliation: Department of Bone and Mineral Metabolism, Institute of Child Health, "Agia Sophia" Children's Hospital, 115 27, Goudi, Athens, Greece.
authors.forename: Glykeria M
authors.initials: GM
authors.lastname: Petrocheilou
authors.affiliation: Department of Orthopedics, "Penteli" Children's Hospital, Athens, Greece.
authors.forename: Ioanna N
authors.initials: IN
authors.lastname: Paspati
authors.affiliation: Department of Statistics, Institute of Child Health, "Agia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Ioannis K
authors.initials: IK
authors.lastname: Monopolis
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition; D015519:Bone Density; D002648:Child; D003430:Cross-Sectional Studies; D015444:Exercise; D006115:Greece; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne
keywords: Adiposity; Bone; Metabolism; Obesity; Sarcopenia; Wheelchair