COVID-19 Pandemisi Sırasında Çocuklarda Sarkopenik Obezite Riskinin Değerlendirilmesi: El kavrama kuvveti -BMI Oranı

Abstract

Amaç: Bu çalışma, COVID-19 pandemisi sırasında 6-10 yaş arasındaki Türk çocuklarında sarkopenik obezite sıklığını incelemeyi ve tanısal yöntemleri karşılaştırmayı amaçlamaktadır. Yöntem: : Bu çalışmaya toplam 431 sağlıklı çocuk (230 kız, 201 erkek) dahil edildi. Boy, kilo ve beden kitle indeksi (BKİ) gibi çeşitli antropometrik ölçümler alındı. Ayrıca, vücut bileşimi, yağ kütlesi, iskelet kas kütlesi ve kas-yağ oranını (KYO) belirlemek için biyoelektrik empedans analizi (BİA) kullanılarak değerlendirildi. Ek olarak, kavrama gücü ölçüldü ve kavrama gücü/BKİ oranı belirlendi. Sarkopenik obeziteyi tanımlamak için McCarthy'nin yöntemi kullanılarak KYO eşik değerleri belirlendi. ROC eğrileri ile, kavrama gücü/BKİ oranının sarkopenik obezite riskini belirlemek için uygulandı. Bulgular: Kız çocuklarında sarkopenik obezite sıklığı %8,7, erkek çocuklarda %10,4 olarak bulundu. Kas/yağ oranı (KYO) ile karşılaştırıldığında, kavrama gücü/BKİ indeksi oranının sarkopenik obezite riskini saptamada önemli duyarlılık gösterdiği görüldü. 6-8 yaş grubundaki erkek ve kız çocuklarında kavrama gücü/BKİ oranı ile KYO arasındaki korelasyon zayıf (erkeklerde r=0,363, kızlarda r=0,458, p<0,001) iken, 9-10 yaş grubundaki erkek ve kız çocuklarında bu ilişki güçlü bulundu (Erkeklerde r=0,628, p<0,001; kızlarda r=0,612, p<0,001). 6-8 yaş grubu kız çocuklarında KYO’nın 3. kuintilde BKİ ile belirlenen kesme değeri ≤0,81, 9-10 yaş grubu kız çocuklarında ise ≤0,78 olarak saptandı. 6-8 yaş grubu erkek çocuklarında kesme değeri ≤0,96, 9-10 yaş grubu erkek çocuklarında ise ≤0,61 olarak bulundu. Kavrama gücü/BKİ oranı, sarkopenik obezite riskini tanımlamak için optimal kesme değerleri belirlemede başarıyla kullanıldı. Yaşa göre düzeltilmiş ikili regresyon modelinde, kız çocukları için OR (%95 GA): 11,833 (3,353-41,757) p<0,001; erkek çocuklar için OR ( %95 GA): 11,705 (3,318-41,290) p<0,001 olarak hesaplandı. Sonuç: Bu araştırma, COVID-19 pandemisinin çocuk sağlığı üzerindeki etkilerini aydınlatmaktadır. Özellikle sokağa çıkma yasakları ve okul kapanmaları nedeniyle egzersiz fırsatlarının azalması ve bu dönemde beslenme alışkanlıklarındaki değişiklikler, çocukların vücut kompozisyonunu olumsuz etkilemiş olabilir. Çocuklarda vücut kompozisyonu göstergelerini tahmin etmek için BIA kullanılması bu çalışmada değerli bilgiler sunmaktadır. Çalışma, sarkopenik obezite riskini belirlemek için kavrama gücü/BKİ oranının dikkate alınması gerektiğini önermektedir ve kavrama gücü/BKİ çocuk vakalarda bir tarama ölçüsü olarak kullanılabilir.

Keywords

• Biyoelektrik İmpedans Analizi (BİA)
• COVID-19 Pandemisi
• Çocuklar
• Sarkopenik Obezite
• Vücut Kompozisyonu

Assessing Sarcopenic Obesity Risk in Children During the COVID-19 Pandemic: Grip-to-BMI Ratio

Abstract

Aim: The present investigation aimed to examine the prevalence of sarcopenic obesity in Turkish children aged 6-10 years during the COVID-19 pandemic, while also conducting a comparison of diagnostic methods. Methods: A total of 431 healthy children (230 females, 201 males) were recruited for this study. Various anthropometric measurements, including height, weight, and body mass index (BMI), were collected. Furthermore, body composition was assessed through the utilization of bioelectrical impedance analysis (BIA) to ascertain fat mass, skeletal muscle mass, and the muscle-to-fat ratio (MFR). Additionally, grip strength was measured to determine the grip strength-to-BMI ratio. McCarthy's framework was employed to define sarcopenic obesity based on MFR cut-offs. Receiver operating characteristic curves were implemented to evaluate the efficacy of the grip strength-to-BMI ratio in identifying the risk of sarcopenic obesity. Results: The prevalence of sarcopenic obesity was found to be 8.7% in females and 10.4% in males. In comparison to the MFR, the grip strength-to-BMI ratio exhibited considerable sensitivity in detecting the risk of sarcopenic obesity. The correlation between the ratio of grip strength to BMI and the muscle-to-fat ratio (MFR) was found to be weak among boys and girls aged 6-8 years (r=0.363, r=0.458, p<0.001), while it was strong among boys and girls aged 9-10 years (boys: r=0.628, p<0.001; girls: r=0.612, p<0.001). For girls aged 6-8 years, the cut-off value for the MFR in the 3rd quintile, as determined by the BMI, was found to be ≤0.81, while for girls aged 9-10 years, it was ≤0.78. For boys aged 6-8 years, the cut-off value was ≤0.96, and for boys aged 9-10 years, it was ≤0.61. The grip strength-to-BMI ratio was successfully used to establish optimal cut-off points for defining the risk of sarcopenic obesity. In the age-adjusted binary regression model, the odds ratio (OR) for girls was: 11,833 %95 CI (3,353-41,757) p<0,001, while for boys, it was OR 11,705, CI (3,318-41,290) with p<0.001. Conclusion: The research sheds light on the effects of the COVID-19 pandemic on child wellness. Specifically, reduced opportunities for exercise due to lockdowns and school closures, coupled with potential changes in nutrition during this period, could have negatively impacted body composition in children. By applying BIA to estimate body composition indicators amongst a sample of young participants, the study provides valuable insights. It suggests the grip-BMI ratio warrants consideration as a screening metric to identify at-risk pediatric demographics.

Keywords

• Bioelectrical impedance analysis (BIA)
• COVID-19 Pandemic
• Children
• Sarcopenic Obesity
• Body composition

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