Opoku H, Yirerong T, Osei-Onwona B, Boachie-Adjei O. The Use of Arm Span as a Substitute for Height in Calculating Body Mass Index (BMI) for Spine Deformity Patients.
Spine Deform 2019;
6:220-225. [PMID:
29735129 DOI:
10.1016/j.jspd.2017.09.052]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/16/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE
To compare arm span and height in body mass index (BMI) calculation in patients with spinal curvature and investigate their impact on interpretation of BMI.
STUDY DESIGN
Prospective case-control cohorts.
SUMMARY OF BACKGROUND DATA
The BMI value is based on weight to height ratio. Spine deformity patients experience height loss and its use in calculating BMI is likely to produce errors. A surrogate for height should therefore be sought in BMI determination.
METHODS
Ninety-three spine deformity patients were matched with 64 normal children. Anthropometric values (height, arm span, and weight) and spinal curve were obtained. BMIs using arm span and height were calculated, and statistical analysis performed to assess the relationship between BMI/height and BMI/arm span in both groups as well as the relationship between these values and Arm Span to Height difference (Delta AH).
RESULTS
There were 46 males and 47 females, the average age was 15.5 years in Group 1 versus 33 males and 31 females, average age 14.8 years in Group 2. Major scoliosis in Group 1 averaged 125.7° (21° to 252°). The extreme curves show vertebral transposition, with overlapping segments making it more than 180°. A logistic regression showed that there was linearity in BMI scores (R2 = 0.97) for both arm span and height (R2 = 0.94) in group 2 patients. For group 1 patients there was a significant difference in the BMI values when comparing BMI/arm span versus BMI/height (p < .0001). Mean BMI values using height was overstated by 2.8 (18.6%). The threshold at which BMI score must be calculated using arm span as opposed to the height (Delta AH) was determined to be 3 cm.
CONCLUSIONS
Spine deformity patients experience height loss, which can impact their true BMI values thereby giving an erroneous impression of their nutritional status. The arm span should be used in patients with Delta AH >3 cm to properly assess nutritional status.
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