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      Resting energy expenditure and adiposity accretion among children with Down syndrome: a three year prospective study

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          Abstract

          Background

          Children with Down syndrome (DS) have a higher prevalence of obesity than other children. Whether this increased risk for obesity is due to a lower resting energy expenditure (REE) is controversial. Our study assessed whether 1) the REE of children with DS adjusted for fat free mass (FFM) was lower than that of sibling controls and 2) the changes in fat mass (FM) over three years were associated with FFM-adjusted baseline REE.

          Methods

          This study used cross-sectional and prospective cohort designs. Four annual measurement visits were conducted with 28 children with DS and 35 sibling controls aged 3–10y. REE and serum thyroxine (T4) were measured at baseline. Anthropometry, skinfold thicknesses measures, and, in a subsample, dual energy x-ray absorptiometry (DXA) were used at each visit to calculate FM.

          Results

          Children with DS had significantly lower REE adjusted for FFM (−78 kcal/day, 95% CI: −133 to −27, p=0.003). The difference remained significant after adjustment for FM, sex, and African ancestry (−49 kcal/day, 95% CI: −94 to −4, p=0.03). In the longitudinal analysis, the baseline REE adjusted for baseline FFM was not predictive of FM accretion over time (p=0.8).

          Conclusion

          Children with DS have lower REE than sibling controls, but REE was not associated with changes in FM over time. The results suggest that the lower REE of children with DS does not explain their increased risk for obesity.

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          Most cited references46

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          Down's syndrome

          The sequencing of chromosome 21 and the use of models of Down's syndrome in mice have allowed us to relate genes and sets of genes to the neuropathogenesis of this syndrome, and to better understand its phenotype. Research in prenatal screening and diagnosis aims to find methods to identify fetuses with Down's syndrome, and reduce or eliminate the need for amniocentesis. Other areas of active research and clinical interest include the association of Down's syndrome with coeliac disease and Alzheimer's disease, and improved median age of death. Medical management of the syndrome requires an organised approach of assessment, monitoring, prevention, and vigilance. Improvements in quality of life of individuals with Down's syndrome have resulted from improvements in medical care, identification and treatment of psychiatric disorders (such as depression, disruptive behaviour disorders, and autism), and early educational interventions with support in typical educational settings. Approaches and outcomes differ throughout the world.
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            Health supervision for children with Down syndrome.

            These guidelines are designed to assist the pediatrician in caring for the child in whom a diagnosis of Down syndrome has been confirmed by chromosome analysis. Although a pediatrician's initial contact with the child is usually during infancy, occasionally the pregnant woman who has been given a prenatal diagnosis of Down syndrome will be referred for review of the condition and the genetic counseling provided. Therefore, this report offers guidance for this situation as well.
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              Determination of body composition of children from skinfold measurements.

              C. Brook (1971)
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                Author and article information

                Contributors
                Journal
                8804070
                3570
                Eur J Clin Nutr
                Eur J Clin Nutr
                European journal of clinical nutrition
                0954-3007
                1476-5640
                11 August 2013
                31 July 2013
                October 2013
                01 April 2014
                : 67
                : 10
                : 1087-1091
                Affiliations
                The Children's Hospital of Philadelphia
                The Children's Hospital of Philadelphia
                Perelman School of Medicine at the University of Pennsylvania
                The Children's Hospital of Philadelphia
                Perelman School of Medicine at the University of Pennsylvania
                The Children's Hospital of Philadelphia
                Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania
                The Children's Hospital of Philadelphia
                Perelman School of Medicine at the University of Pennsylvania
                Exponent, Inc.
                Author notes
                Reprints not available. Correspondence should be directed to Douglas L. Hill, PhD, Department of Pediatrics, The Children’s Hospital of Philadelphia, 3535 Market Street, Room 1589, Philadelphia, PA 19104. Phone: (267) 426-0986. Fax: (215) 590-0604. hilld@ 123456email.chop.edu
                Article
                NIHMS498310
                10.1038/ejcn.2013.137
                3790863
                23900244
                831b7086-ce45-4c35-853b-ba39b06e1875

                Users may view, print, copy, download and text and data- mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms

                History
                Funding
                Funded by: National Center for Research Resources : NCRR
                Award ID: K23 RR016073 || RR
                Categories
                Article

                Nutrition & Dietetics
                obesity,fat free mass,fat mass
                Nutrition & Dietetics
                obesity, fat free mass, fat mass

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