ESPE Abstracts (2018) 89 WG7.1

Advanced Anthropometrics in Pediatric Endocrinology: Utility and Difficulty

Jean De Schepper

UZ Brussel, Brussels, Belgium

Anthropometrics is an important part of pediatrics and public health. Its non-invasiveness, simplicity and low cost makes anthropometry attractive for several purposes. It is a valuable method for the screening or assessment of growth disorders, as well as under- and over-nutrition. Furthermore, specific anthropometric measures can be used as indicators of general fitness or cardiovascular risk factors (insulin resistance and dyslipidemia) in (obese) children, as well as markers for asthma severity, pulmonary function or sleep associated respiratory problems in (asthmatic or obese) children. However, attention for accurate measurements and availability of reliable references values are prerequisites for its use in clinical practice. Recently, European reference values of skinfold thickness, sum of skinfolds, waist and neck circumference, and the waist-to-height ratio have been developed. Furthermore, regular practice and respecting standard conditions (in the morning and fasting) and standardized measuring techniques increase their reliability. Measurements of body (head, neck, upper arm, waist and hip) circumferences, (biiliacal, biacromial) diameters and (truncal, leg) segments as well as of (tricipital, subscapular) skinfold thickness characterize either the body frame, body proportion or body composition. For the assessment of total body fat, sum of skinfold thicknesses and neck circumference (NC) can be used, whereas for the determination abdominal fat, waist circumference (WC) or waist-to-height ratio can be determined. The latter measurements have been recommended to improve the assessment of cardio-metabolic risk, even in young children. Body proportion determination may contribute to a better insight into the growth pattern of several genetic disorders, especially when affecting skeletal growth, such as Turner syndrome, Kabuki syndrome and Klinefelter syndrome. The evaluation of a morphogram of the body has been found very helpful in the detection of the typical changes in Turner syndrome, showing the greatest deficit in leg length and greatest excess in chest circumference, whereas in Klinefelter syndrome disproportionally long legs during childhood are present. In addition, segmental body measurements might be also helpful in evaluating the risk of associated diseases or the effect of growth promoting therapies. In Turner syndrome equal of greater increase in leg length SDS has been found to be a good marker of GH sensitivity. On the other hand, excessive GH dosing is known to increase feet length excessively in several growth disorders. In conclusion, anthropometric methods can be used with efficiency for several clinical purposes, if accurate and reliable measurements are performed by dedicated nurses or doctors.

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