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Anthropometric measurements to identify undernutrition in children with cerebral palsy

Ibrahim Duran1, Kyriakos Martakis2,3, Mirko Rehberg2

  • 1Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, University of Cologne, Cologne, Germany.

Developmental Medicine and Child Neurology
|March 31, 2019
PubMed

Insights

Anthropometric indicators like Body Mass Index (BMI) show high specificity but low sensitivity for detecting undernutrition in children with cerebral palsy (CP). Height z-scores are inappropriate for this assessment in CP populations.

Area of Science:

  • Pediatrics
  • Clinical Nutrition
  • Biostatistics

Background:

  • Cerebral palsy (CP) often presents with undernutrition, impacting patient outcomes.
  • Accurate identification of undernutrition is crucial for timely intervention in children with CP.
  • Existing anthropometric indicators may have limitations in this specific population.

Purpose of the Study:

  • To evaluate the diagnostic performance of common anthropometric indicators for identifying undernutrition in children with cerebral palsy (CP).
  • To compare the sensitivity and specificity of Body Mass Index (BMI) and height-for-age z-scores against dual-energy X-ray absorptiometry (DXA) determined body fat percentage.

Main Methods:

  • A monocentric retrospective analysis of prospectively collected data from children and adolescents with CP undergoing rehabilitation.
  • Undernutrition was defined by a dual-energy X-ray absorptiometry (DXA) determined body fat percentage z-score ≤ -2.0.
  • Evaluated World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Robert Koch Institut (RKI) cut-off values for BMI and height for age.

Main Results:

  • 329 children with CP (mean age 12 years 4 months) were analyzed.
  • BMI cut-offs demonstrated high specificity but low sensitivity: WHO (0.897), CDC (0.819), RKI (0.732).
  • Height-for-age z-scores showed lower sensitivity (0.263) and specificity (0.668), indicating poor diagnostic performance.

Conclusions:

  • Standard BMI cut-offs have high specificity but insufficient sensitivity to reliably detect undernutrition in children with CP.
  • Height-for-age z-scores are not appropriate for predicting undernutrition in this population.
  • BMI may overestimate undernutrition compared to DXA in children with CP.
Abstract

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