Physical Growth and Biological Maturation of Children and Adolescents: Proposed Reference Curves

2017 ◽  
Vol 70 (4) ◽  
pp. 329-337 ◽  
Author(s):  
Daniel Leite Portella ◽  
Miguel Arruda ◽  
Rossana Gómez-Campos ◽  
Giovanna Checkin Portella ◽  
Cynthia Lee Andruske ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Growth Patterns ◽  
Physical Growth ◽  
Chronological Age ◽  
Standing Height ◽  
Common Reference ◽  
Biological Maturation ◽  
Physical Maturation ◽  
Control And Prevention ◽  
Regional Curves

Background/Aim: The study of physical growth variables in terms of chronological age and biological maturation may provide a common reference point to reflect on the occurrence of body dimensions in and between individuals. The objectives of this study were as follows: (a) verify if the observed gender differences in the variables of physical growth by chronological age are confounded by physical maturation, (b) compare physical growth patterns with the reference of the Centers for Disease Control and Prevention (CDC)-2012, and (c) develop regional curves to assess physical growth in terms of biological maturation. Methods: Researchers studied 3,674 children and adolescents. Weight, standing height, and sitting height were measured. Biological maturation was determined by using the age of peak velocity growth. Body mass index (BMI) was calculated. Growth variables were compared with the CDC-2012 reference. Percentiles were calculated by the LMS method. The students differed in weight and BMI when compared to the reference individuals. The differences in weight, standing height, and BMI between both genders are more pronounced when they are aligned with biological age rather than chronological age. Conclusion: Weight and BMI differ from the reference. Furthermore, the assessment of the physical growth trajectory should be analyzed in terms of biological maturation. The proposed regional curves may be used in and applied to clinical and epidemiological contexts.

Association between a History of Inhibitors and Delays in Skeletal Maturation in Adolescents with Hemophilia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1022-1022 ◽  
Author(s):  
Sharyne M. Donfield ◽  
Alice Lail ◽  
Edward D. Gomperts ◽  
W. Keith Hoots ◽  
Erik Berntorp ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Bone Age ◽  
Physical Growth ◽  
Skeletal Maturation ◽  
Chronological Age ◽  
Growth Delay ◽  
Hiv Positive ◽  
P Values ◽  
History Of ◽  
Hiv Negative

Abstract The development of inhibitory antibodies to factor VIII or factor IX is the most serious complication of replacement therapy for people with hemophilia. Inhibitors decrease effectiveness of treatment, increasing risk of morbidity including bleeding frequency and arthropathy, and mortality. The current study examined the association between history of inhibitors and physical growth measured by skeletal maturation (bone age, BA) in participants enrolled in the longitudinal Hemophilia Growth and Development Study (HGDS). The HGDS is a population-based multicenter study of children and adolescents enrolled between 1989 and 1990. Participants not skeletally mature (n=306) were included in this investigation. Their mean age was 12, range 7–18 years. Seventy-five percent had severe hemophilia, 19% moderate, and 6% mild. Eighteen percent (n=54) had a history of inhibitors, with maximum lifetime Bethesda titers ranging from 1 to 2048. In general, HGDS participants received on-demand therapy prior to and during study follow-up. Skeletal maturation was determined centrally from x-rays of the hand-wrist according to the Fels method. Readers were masked to the clinical status of participants. Growth delay was defined as chronological age (age) minus BA and modelled using a longitudinal mixed effects polynomial model including age, race, HIV and inhibitor status, and their interactions. P-values were adjusted for multiple comparisons using Scheffe’s method. At every year evaluated (10 through 16), growth delay was greater among HIV-negative subjects with a history of inhibitors compared to HIV-negative subjects without inhibitors (p-values ranged from 0.042 to 0.12). The greatest differences, 9 to 10 months, were observed during the period of expected maximum growth velocity, 12 through 14 years of age (all p<0.05). At ages 15 and 16, subjects with inhibitors lagged approximately 9 months behind those without inhibitors in their skeletal maturation (p=0.067 and 0.12). The predicted BA of HIV-negative adolescents without inhibitors was quite similar to age during this period. At 12, 13, 14, 15 and 16 years, they were 11.9, 13.1, 14.3, 15.4, and 16.4 respectively. Previous investigations from the HGDS have reported delays in skeletal maturation associated with HIV. In this study, delays were greater among HIV-positive subjects with an inhibitor compared to HIV-positive subjects without an inhibitor at every age, but perhaps due to intervening effects of HIV, the differences were generally small (1 to 2 months) and not statistically significant. In conclusion, the differences in bone age relative to chronological age between the HIV-negative groups suggest that a history of inhibitors is associated with delays in onset of puberty. Further investigation of this association and other growth parameters is a priority. If confirmed, the observation has important clinical, epidemiologic and therapeutic implications for the children and adolescents most severely impacted by hemophilia.

scholarly journals Reference norms for evaluating maximum expiratory flow of children and adolescents of the Maule Region in Chile

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5157
Author(s):  
Marco Antonio Cossio-Bolaños ◽  
Cynthia Andruske ◽  
Miguel Arruda ◽  
Jose Sulla-Torres ◽  
Jaime Pacheco-Carrillo ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Peak Height ◽  
Biological Age ◽  
Height Velocity ◽  
Chronological Age ◽  
International Studies ◽  
Peak Height Velocity ◽  
Biological Maturation ◽  
Maximum Expiratory Flow ◽  
Expiratory Flow

Background The norms for evaluating the maximum expiratory flow (MEF) usually are developed according to chronological age and height. However, to date, little research has been conducted using reference values that take into account the temporal changes of biological maturation. The objectives of this study were to (a) compare the MEF with those of other international studies, (b) align the MEF values with chronological and biological age, and (c) propose reference standards for children and adolescents. Methods The sample studied consisted of 3,566 students of both sexes (1,933 males and 1,633 females) ranging in age from 5.0 to 17.9 years old. Weight, standing height, and sitting height were measured. Body mass index was calculated. Biological maturation was predicted by using age of peak height velocity growth (APHV). MEF (L/min) was obtained by using a forced expiratory manoeuvre. Percentiles were calculated using the LMS method. Results and Discussion Predicted APHV was at age 14.77 ± 0.78 years for males and for females at age 12.74 ± 1.0 years. Biological age was more useful than chronological age for assessing MEF in both sexes. Based on these findings, regional percentiles were created to diagnose and monitor the risk of asthma and the general expiratory status of paediatric populations.

scholarly journals Maximum Expiratory Flow of Children and Adolescents Living at Moderate Altitudes: Proposed Reference Values

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 264
Author(s):  
Marco Cossio-Bolaños ◽  
Rubén Vidal-Espinoza ◽  
Luis Felipe Castelli Correia de Campos ◽  
Luis Urzua-Alul ◽  
José Damián Fuentes-López ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Reference Values ◽  
Lower Limbs ◽  
Height Velocity ◽  
Chronological Age ◽  
International Studies ◽  
Peak Height Velocity ◽  
Geographical Regions ◽  
Maximum Expiratory Flow ◽  
Expiratory Flow

(1) Background: Spirometry is useful for diagnosing and monitoring many respiratory diseases. The objectives were: (a) compare maximum expiratory flow (MEF) values with those from international studies, (b) determine if MEF should be evaluated by chronological age and/or maturity, (c) develop reference norms for children, and adolescents. (2) Methods: A cross-sectional study was designed with 3900 subjects ages 6.0 and 17.9 years old. Weight, standing height, sitting height, and MEF were measured. Length of the lower limbs, body mass index (BMI), and age of peak height velocity growth (APHV) were calculated. (3) Results: Values for the curves (p50) for females of all ages from Spain and Italy were higher (92 to 382 (L/min)) than those for females from Arequipa (Peru). Curve values for males from Spain and Italy were greater [70 to 125 (L/min)] than the males studied. MEF values were similar to those of Chilean students ages 6 to 11. However, from 12 to 17 years old, values were lower in males (25 to 55 (L/min)) and in females (23.5 to 90 (L/min)). Correlations between chronological age and MEF in males were from (r = 0.68, R2 = 0.39) and in females from (r = 0.46, R2 = 0.21). Correlations between maturity (APHV) and MEF for males were from (r = 0.66, R2 = 0.44) and for females (r = 0.51, R2 = 0.26). Percentiles were calculated for chronological age and APHV. Conclusion: Differences occurred in MEF when compared with other geographical regions of the world. We determined that maturity may be a more effective indicator for analyzing MEF. Reference values were generated using chronological age and maturity.

scholarly journals 2765. Pediatric Mumps during the 2015–2017 Mumps Resurgence in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S975-S975
Author(s):  
Mariel Marlow ◽  
John Zhang ◽  
Nakia S Clemmons ◽  
Mona Marin ◽  
Manisha Patel ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Surveillance System ◽  
Pediatric Patients ◽  
Age Groups ◽  
Exposure Period ◽  
The United States ◽  
College Campuses ◽  
Control And Prevention ◽  
Low Rate

Abstract Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in children aged 1–4 years, 1,408 (29%) in children aged 5–10 years, 1,365 (28%) in adolescents aged 11–14 years, and 1,678 (34%) in adolescents aged 15–18 years. Most (3,548, 73%) cases did not travel outside the state during their exposure period; only 37 (1%) traveled outside the country. Cases in patients aged 1–4 years were more frequently non-outbreak associated (38%) than those in patients <1 years and 5–18 years (24% and 9%, respectively). Among 3,309 (68%) patients with known number of MMR doses received, 81% of those 5–18 years had ≥2 MMR doses, while 67% of those 1–4 years had ≥1 dose. Median time since last MMR dose for patients with 2 doses was 8 years (IQR: 4, 11 years). Four patients had meningitis and 1 had encephalitis; all were ≥10 years old and previously received 2 MMR doses. Of male mumps patients older than 10 years of age (2,113), 46 (2%) reported having orchitis; of these, 33 (72%) had 2 MMR doses. Sixty-four patients were hospitalized and there were no deaths. Conclusion About one-third of cases reported during the recent US mumps resurgence were in children and adolescents. The low rate of mumps complications compared with previous studies suggests mumps complications may not be adequately captured in national surveillance or identified by providers. Providers should remain vigilant that mumps can still occur among fully vaccinated pediatric patients, even those recently vaccinated. Disclosures All authors: No reported disclosures.

scholarly journals Increased body mass index percentile is associated with decreased epiphyseal tubercle size in asymptomatic children and adolescents with healthy hips

2020 ◽  
Vol 14 (3) ◽  
pp. 167-174
Author(s):  
Shayan Hosseinzadeh ◽  
Ata M. Kiapour ◽  
Daniel A. Maranho ◽  
Seyed Alireza Emami ◽  
Patricia Miller ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Children And Adolescents ◽  
Body Mass ◽  
Slipped Capital Femoral Epiphysis ◽  
Level Of Evidence ◽  
Age Related ◽  
Asymptomatic Children ◽  
Control And Prevention ◽  
Male Patients ◽  
3D Software

Purpose To investigate whether body mass index (BMI) percentile impacts the morphology of the capital femoral epiphysis in children and adolescents without hip disorders. Methods We assessed 68 subjects with healthy hips who underwent a pelvic CT for evaluation of appendicitis. There were 32 male patients (47%) and the mean age was 11.6 years (sd 2.3). The BMI (k/m2) was calculated for sex- and age-related percentiles according to the Centers for Disease Control and Prevention growth charts. CT images were segmented, and the epiphysis and metaphysis were reformatted using 3D software. We measured the epiphyseal tubercle (height, width and length), the metaphyseal fossa (depth, width and length) and the peripheral cupping of the epiphysis. All measurements were normalized to the diameter of the epiphysis. Pearson’s correlation analysis was used to assess the correlations between the variables measured and BMI percentile adjusted for age. Results Following adjustment to age, increased BMI correlated to decreased tubercle height (r =-0.34; 95% confidence interval (CI) -0.53 to -0.11; p = 0.005), decreased tubercle length (r = -0.32; 95%CI -0.52 to -0.09; p = 0.008) and decreased tubercle width (r = -0.3; 95% CI -0.5 to -0.07; p = 0.01). There was no correlation between BMI and metaphyseal fossa and epiphyseal cupping measurements. Conclusion The association between increased BMI percentile and decreased epiphyseal tubercle size, without changes of the metaphyseal fossa and peripheral cupping suggests another morphological change of the femur that may be associated with decreased growth plate resistance to shear stress. Further study is necessary to investigate whether the epiphyseal tubercle size plays a role in the pathogenesis of slipped capital femoral epiphysis in obese children and adolescents. Level of Evidence Level IV

scholarly journals Height-corrected low bone density associates with severe outcomes in sickle cell disease: SCCRIP cohort study results

2019 ◽  
Vol 3 (9) ◽  
pp. 1476-1488 ◽  
Author(s):  
Oyebimpe O. Adesina ◽  
James G. Gurney ◽  
Guolian Kang ◽  
Martha Villavicencio ◽  
Jason R. Hodges ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
African American ◽  
Cohort Study ◽  
Sickle Cell Disease ◽  
Children And Adolescents ◽  
Sickle Cell ◽  
Chronological Age ◽  
Cell Disease ◽  
Mineral Density ◽  
Z Scores

AbstractLow bone mineral density (BMD) disproportionately affects people with sickle cell disease (SCD). Growth faltering is common in SCD, but most BMD studies in pediatric SCD cohorts fail to adjust for short stature. We examined low BMD prevalence in 6- to 18-year-olds enrolled in the Sickle Cell Clinical Research and Intervention Program (SCCRIP), an ongoing multicenter life span SCD cohort study initiated in 2014. We calculated areal BMD for chronological age and height-adjusted areal BMD (Ht-aBMD) z scores for the SCCRIP cohort, using reference data from healthy African American children and adolescents enrolled in the Bone Mineral Density in Childhood Study. We defined low BMD as Ht-aBMD z scores less than or equal to –2 and evaluated its associations with demographic and clinical characteristics by using logistic regression analyses. Of the 306 children and adolescents in our study cohort (mean age, 12.5 years; 50% female; 64% HbSS/Sβ0-thalassemia genotype; 99% African American), 31% had low areal BMD for chronological age z scores and 18% had low Ht-aBMD z scores. In multivariate analyses, low Ht-aBMD z scores associated with adolescence (odds ratio [OR], 7.7; 95% confidence interval [CI], 1.94-30.20), hip osteonecrosis (OR, 4.0; 95% CI, 1.02-15.63), chronic pain (OR, 10.4; 95% CI, 1.51-71.24), and hemoglobin (OR, 0.74; 95% CI, 0.57-0.96). Despite adjusting for height, nearly 20% of this pediatric SCD cohort still had very low BMD. As the SCCRIP cohort matures, we plan to prospectively evaluate the longitudinal relationship between Ht-aBMD z scores and markers of SCD severity and morbidity.

scholarly journals Characterisation and correlates of stunting among Malaysian children and adolescents aged 6–19 years

2019 ◽  
Vol 4 ◽  
Author(s):  
Uttara Partap ◽  
Elizabeth H. Young ◽  
Pascale Allotey ◽  
Manjinder S. Sandhu ◽  
Daniel D. Reidpath
Keyword(s):  
Children And Adolescents ◽  
Normal Weight ◽  
World Health ◽  
Sensitivity Analyses ◽  
Protective Effects ◽  
Older Children ◽  
Normal Height ◽  
Cross Sectional ◽  
Control And Prevention ◽  
Health Organization

AbstractBackgroundDespite emerging evidence regarding the reversibility of stunting at older ages, most stunting research continues to focus on children below 5 years of age. We aimed to assess stunting prevalence and examine the sociodemographic distribution of stunting risk among older children and adolescents in a Malaysian population.MethodsWe used cross-sectional data on 6759 children and adolescents aged 6–19 years living in Segamat, Malaysia. We compared prevalence estimates for stunting defined using the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) references, using Cohen's κ coefficient. Associations between sociodemographic indices and stunting risk were examined using mixed-effects Poisson regression with robust standard errors.ResultsThe classification of children and adolescents as stunted or normal height differed considerably between the two references (CDC v. WHO; κ for agreement: 0.73), but prevalence of stunting was high regardless of reference (crude prevalence: CDC 29.2%; WHO: 19.1%). Stunting risk was approximately 19% higher among underweight v. normal weight children and adolescents (p = 0.030) and 21% lower among overweight children and adolescents (p = 0.001), and decreased strongly with improved household drinking water sources [risk ratio (RR) for water piped into house: 0.35, 95% confidence interval (95% CI) 0.30–0.41, p < 0.001). Protective effects were also observed for improved sanitation facilities (RR for flush toilet: 0.41, 95% CI 0.19–0.88, p = 0.023). Associations were not materially affected in multiple sensitivity analyses.ConclusionsOur findings justify a framework for strategies addressing stunting across childhood, and highlight the need for consensus on a single definition of stunting in older children and adolescents to streamline monitoring efforts.

scholarly journals Age, maturation and serum lipid parameters: findings from the German Health Survey for Children and Adolescents

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anja Schienkiewitz ◽  
Julia Truthmann ◽  
Andrea Ernert ◽  
Susanna Wiegand ◽  
Karl Otfried Schwab ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Sexual Maturation ◽  
Serum Lipid ◽  
Serum Lipids ◽  
Physical Growth ◽  
Pubertal Stage ◽  
Cross Sectional ◽  
Pubertal Stages ◽  
The Impact ◽  
Lipid Parameters

Abstract Background Recommendations on preventive lipid screening among children and adolescents remain controversial. The aim of the study was to assess age and puberty-related changes in serum lipids, including total cholesterol (TC), and high-density (HDL-C) and non-high-density lipoprotein cholesterol (Non-HDL-C). Methods Using cross-sectional data from the National Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS 2003–2006; N = 13,676; 1–17 years), changes in distributions of serum lipids were visualized according to sex, age and maturation. Youth aged 10–17 years were classified as prepubescent, early/mid-puberty, and mature/advanced puberty. Multiple linear regressions were used to quantify the impact of pubertal stage on serum lipid levels, adjusted for potential confounding factors. Results Among children 1–9 years mean serum lipid measures increased with age, with higher mean TC and Non-HDL-C among girls than boys. Among children 10–17 years, advanced pubertal stage was independently related to lower lipid measures. Adjusted mean TC, HDL-C and Non-HDL-C was 19.4, 5.9 and 13.6 mg/dL lower among mature/advanced puberty compared to prepubescent boys and 11.0, 4.0 and 7.0 mg/dL lower in mature/advanced puberty compared to prepubescent girls. Conclusions Lipid concentrations undergo considerable and sex-specific changes during physical growth and sexual maturation and significantly differ between pubertal stages. Screening recommendations need to consider the fluctuations of serum lipids during growth and sexual maturation.

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