Body Composition and BMI Growth Charts in Children With Down Syndrome

Area of Science:

• Pediatrics
• Genetics
• Public Health

Background:

• New US Down syndrome (DS) BMI growth charts exist, but their effectiveness in detecting excess adiposity or cardiometabolic risk (CMR) is unconfirmed.
• Identifying children with DS who are at increased risk for CMR is crucial for timely intervention.

Purpose of the Study:

• To compare the utility of the Centers for Disease Control and Prevention (CDC) BMI 85th percentile and DS-specific BMI 85th percentile in identifying excess adiposity in children with DS.
• To evaluate these metrics against fat mass index (FMI) ≥80th percentile as a marker for increased CMR.

Main Methods:

• A cross-sectional study included 121 participants with DS (aged 10-20 years) and compared them with 7978 typically developing children from the Bone Mineral Density in Childhood Study (BMDCS).
• Sensitivity and specificity of the CDC BMI 85th percentile (in both groups) and DS-specific BMI 85th percentile (in the DS group) were calculated relative to FMI ≥80th percentile.

Main Results:

• The CDC BMI 85th percentile demonstrated high sensitivity (100%) and specificity (78.3%) for identifying excess adiposity in children with DS.
• In contrast, the DS-specific BMI 85th percentile showed lower sensitivity (62.3%) but perfect specificity (100%) in the DS group.
• The CDC BMI 85th percentile performed similarly in typically developing children (96.9% sensitivity, 87.4% specificity).

Conclusions:

• For children with DS aged 10 years and older, the CDC BMI growth chart 85th percentile is a more effective indicator of excess adiposity compared to DS-specific BMI charts.
• Additional research is necessary to fully understand the complex relationships between BMI, FMI, and CMR in individuals with Down syndrome.