Harpenden stadiometer

Age at clinic assessment and sex were recorded. Other demographic and lifestyle data were ascertained from questionnaire data; socioeconomic position was assigned by paternal occupation, education was classified as in full-time education or not, alcohol consumption was assessed as the number of drinks containing alcohol consumed on a typical day, smoking was categorized as never, ever but not current, or current. Weight and height were measured while the subjects were wearing light clothing and no shoes. Weight was measured to the nearest 0.1 kg by using scales (Tanita Europe BV, Amsterdam, the Netherlands). Height was measured to the nearest 0.1 cm by using a Harpenden stadiometer (Holtain, Ltd, Crymych, United Kingdom). Body mass index (BMI) was calculated as weight (kg)/height² (m²).

Total body DXA scans were performed on participants at five follow-ups (9-, 11-, 13-, 15- and 17-years) using a Lunar Prodigy scanner (Lunar Radiation Corp, Madison, WI, USA) with paediatric scanning software (GE Healthcare Biosciences Corp., Piscataway, NJ, USA). Scans were excluded if any anomalies were present (e.g. missing parts of limbs, movement artefacts). Further details of the measures, including reproducibility, are described elsewhere (38 (link)). DXA measures investigated included total body (excluding skull) BMD (g/cm²), and its components, bone mineral content (BMC, g) and bone area (BA, cm²). Total body (excluding skull) measures are preferred for paediatric evaluations of bone health as the variation during skeletal development is lower than the commonly used femoral neck or lumbar spine measurements in adults, therefore increasing reproducibility (39 (link)).
Height was measured to the nearest 0.1 cm using a Harpenden Stadiometer (Holtain Ltd. Crymych, UK). Weight was measured to the nearest 0.1 kg using the Tanita Body Fat Analyser (Tanita UK Ltd., Uxbridge).

Baseline characteristics of the patients, including age, sex, treatment duration, and leukemia classification, were collected. Anthropometric parameters, including height, weight, and BMI, were obtained and assessed at following time points: (1) leukemia diagnosis (LD), (2) TC, and (3) 12 months following TC. Height was measured to the nearest centimeter using a regularly calibrated stadiometer (Harpenden Stadiometer, Holtain®, UK). Weight was determined using a digital scale (Simple Weighing Scale, Cas®, Korea). All anthropometric data were converted to age- and sex-matched standard deviation scores (SDS), using the national growth chart (13 (link)). An increase or decrease in height, weight, and BMI, between the assessment points, was expressed as Δ. During the treatment, GC dosing was supervised by pediatric hemato-oncologists according to the protocol, and accumulated doses were converted to prednisolone equivalents, expressed as milligrams per body surface area.

The same experienced author measured body mass, height, sitting height, and four skinfolds (triceps, suprailiac, abdominal, and thigh). Body mass was measured to nearest 0.1 kg with a scale (model 770, SECA, Hanover, MD, USA). Height was measured to nearest 0.1 cm with a Harpenden stadiometer (model 98.603, Holtain Ltd., Crosswell, UK). Body mass index was calculated from height and body mass. Skinfolds were measured to nearest mm with a Lange caliper (Beta Technology, Ann Arbor, MI, USA). Percentage of body fat was estimated using sum of skinfolds (r = 0.77–0.88 with hydrostatic weighting [23 (link)]). Each measurement was taken three times and median was used for further analysis. Players wore light clothing and shoes were removed.

Children’s anthropometrics and body composition were measured by well-trained staff at a median age of 5.9 years (95 % range 5.7–6.5) in a dedicated research center in the Sophia Children’s Hospital in Rotterdam. Height was determined in standing position to the nearest millimeter without shoes with a Harpenden stadiometer (Holtain Limited, Dyfed, U.K.). Weight was measured using a mechanical personal scale (SECA, Almere, the Netherlands) and body mass index (BMI) was calculated (body weight (kg)/height (m)²).
Total body, android, and gynoid fat mass were measured using a Dual-energy X-ray absorptiometry (DXA) scanner (iDXA, GE-Lunar, 2008, Madison, WI, USA), which analyzed fat, lean and bone mass of the total body and specific regions using enCORE software v.13.6. We calculated fat mass index (FMI) [fat mass (kg)/height (m)²] and fat-free mass index (FFMI) [fat-free mass (kg)/height (m)²] [21 (link)]. As secondary outcome measures we also examined android/gynoid ratio (android fat mass divided by gynoid fat mass); and body fat percentage (BF %) (fat mass as percentage of total body weight). We calculated age- and sex-specific SD scores for all outcomes based on the total Generation R Study sample with body composition measurements available the age of 6 years (n = 6491).