ESPE Abstracts

We analyzed the effect of having different BMI and BMI SDS, if any, on linear growth (HtSDS) in a cohort of prepubertal children (n = 102) in different BMI categories. In addition, we studied the effect of weight changes on linear growth in a randomly selected group of underweight children after nutritional rehabilitation (NR).

Subjects and Methods: All prepubertal children between 1 and 9 years presented to the general pediatric clinic because of abnormal weight gain (decreased or increased) which is not related to any acute or chronic illness were included in this cross-sectional study. Physical exam and routine lab tests (CBC, renal and liver functions, ESR, thyroid function) did not show any abnormality. Anthropometric measurements included weight, height, HtSDS, BMI, and BMI SDS. Children BMI SDS were categorized into 4 groups: Group 1: BMISDS < -2, group 2: BMISDS <-1 but >-2, group 3 BMISDS > -1 but < 2, group 4 BMISDS > 2. We evaluated the effect of weight changes on linear growth in a randomly selected group of underweight children who received NR ( n = 51) for a year.

Results: HTSDS in children of groups 1 and 2 (underweight and at risk of underweight children) was significantly lower than HTSDS of groups 3 and 4 (normal and overweight children). HTSDS in children of group 4 was significantly higher than the HTSDS of children in group 3.

After NR 60% of underweight children increased their BMISDS and 43% increased their HtSDS. Children who had weight gain >7g/d over the whole period of follow-up (average normal weight gain for the average age and gender is 6.5g/d) ( n =14) increased their BMISDS and HtSDS significantly after versus before NR, whereas, BMISDS and HtSDS did not increase significantly in the group of children who had weight gain < 7 g/day. 28 children out of 51 improved their BMISDS after nutritional rehabilitation (group A) and 23 did not (Group B). Group A had higher weight gain per day (8.6 +/- 5.8 g/day) versus group B (3.3 +/- 2.2 g/d). Height growth velocity was significantly higher in Group B (7.4 +/- 3.6 cm/yr) vs A (5.7 +/- 2.8 cm/yr). A significant correlation between BMISDS and HtSDS (r = 0.72, P <0.001).

Conclusion: It appears that calculating the weight gain per day, BMISDS and HtSDS are clinically useful to detect the effect of weight gain on linear growth and monitor nutritional management.