| 1. |
- Holmgren, Anton, et al.
(författare)
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Detailed analyzes of the relation between childhood BMIand gain in height during puberty, separated into different Components
- 2016
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Ingår i: International Journal of Obesity. - 0307-0565 .- 1476-5497.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: We have previously found that childhood BMI is inversely related to pubertal height gain: overweight/obese children of both genders have less specific pubertal height gain. The QEPS-model (describing total growth in height as a combination of four mathematical functions), can be used for calculation of estimates of pubertal growth. Growth in height during puberty can be described as a combination of continuous ongoing growth, Q(ES), and a specific pubertal growth function, P. Objectives: To investigate the importance of when overweight/obesity starts during childhood in relation to subsequent growth in height during puberty; and to study the relationship between childhood BMI and pubertal growth functions from the QEPS-model in greater detail than previously presented. Material/Methods: The longitudinally followed GrowUpGothenburg 1990 birth cohort, with growth data from birth until adult height was analyzed, using the QEPS-model. Individual BMI-SDS values, from 3.5–8.0 years of age (n = 1901) were calculated for linear and subgroup analyses (normal /underweight, NwUw, overweight/obese, OwOb), based on the IOTF 2012 reference2. Relationships between childhood-BMI and total pubertal height gain were considered according to P-function and Q(ES)-function. Results: We found no significant difference in pubertal height gain depending on when in childhood the BMI-SDS peaked, in either sex. In general, the total pubertal growth in girls depended more on the continuous Q(ES)-function than P-function and this balance was shifted towards less P-function with higher BMI-SDS, especially for Ob girls (figure, left). NwUw boys had pubertal gain mostly from the P-function, for the Ow boys the pattern was more mixed and for Ob boys all had less P- than Q(ES)-function (figure, right). Conclusion: The results of the present study have shown that the reduced pubertal gain in height for OwOb children is not related to when during childhood the BMI peaked. For both genders, the pubertal gain shifted to less specific pubertal growth (P) and relatively more continuous growth (Q(ES)) with higher BMI-SDS.
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| 2. |
- Holmgren, Anton, et al.
(författare)
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Estimating secular changes in longitudinal growth patterns underlying adult height with the QEPS model: the Grow Up Gothenburg cohorts
- 2018
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Ingår i: Pediatric Research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 84:1, s. 41-49
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Over the past 150 years, humans have become taller, and puberty has begun earlier. It is unclear if these changes are continuing in Sweden, and how longitudinal growth patterns are involved. We aimed to evaluate the underlying changes in growth patterns from birth to adulthood by QEPS estimates in two Swedish cohorts born in 1974 and 1990. METHODS: Growth characteristics of the longitudinal 1974 and 1990-birth cohorts (n = 4181) were compared using the QEPS model together with adult heights. RESULTS: There was more rapid fetal/infancy growth in girls/boys born in 1990 compared to 1974, as shown by a faster Etimescale and they were heavier at birth. The laterborn were taller also in childhood as shown by a higher Q-function. Girls born in 1990 had earlier and more pronounced growth during puberty than girls born in 1974. Individuals in the 1990 cohort attained greater adult heights than those in the 1974 cohort; 6 mm taller for females and 10 mm for males. CONCLUSION: A positive change in adult height was attributed to more growth during childhood in both sexes and during puberty for girls. The QEPS model proved to be effective detecting small changes of growth patterns, between two longitudinal growth cohorts born only 16 years apart.
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| 3. |
- Holmgren, Anton, et al.
(författare)
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Higher childhood BMI is associated with less pubertal gain
- 2015
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Ingår i: Obesity Facts (The European Journal of Obesity). - : S. Karger AG. - 1662-4025 .- 1662-4033.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Our objective was to investigate the impact of body mass index (BMI) in childhood on the pattern of growth during puberty. Methods: The longitudinally followed Grow up 1990 Gothenburg birth cohort, with growth data from birth until adult height was analyzed, using the QEPS growth model (describing total height as a combination of four mathematical functions; Quadratic -Q, Exponential -E, Pubertal -P and Stop –S, Fig 1.), for calculation of estimates for pubertal growth (1). Individual BMI-SDS values, from 3.5–8 years of age (n = 1908) were calculated for linear and subgroup analyses (low/normal- nw, overweight – ow, obese– ob), based on the IOTF 2012 reference. Results: Ow/ob children already at birth were heavier and grew faster in height in the pre pubertal period compared to nw, due to an increased Q function. Ow/ob children of both genders had 3.4–4.3 months earlier puberty, reduced growth during puberty, boys and girls had 3 cm and 2 cm, respectively, less pubertal gain from the specific pubertal growth function (P) compared to their nw peers. We saw a negative dose-response effect of childhood BMI on pubertal gain, across the whole BMI spectrum (Fig 2–3.). The adult height was not related to BMI in childhood. Conclusion: For the first time, the result of the present study has shown that; the higher the BMI is in childhood, the less is the pubertal gain. Higher childhood BMI was also associated with increased pre pubertal growth due to an increased Q-function and the resulting adult height was similar for ow/ob and nw children. Reference 1.Holmgren A et al.: Horm. res. in paed. 2013;80(suppl. 1):177.
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| 4. |
- Holmgren, Anton, et al.
(författare)
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Pubertal height gain is inversely related to peak BMI in childhood.
- 2017
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Ingår i: Pediatric research. - : Springer Science and Business Media LLC. - 1530-0447 .- 0031-3998. ; 81:3, s. 448-454
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChildhood BMI may influence subsequent growth in height as well as the timing of puberty. The aim of the present study was to investigate associations between BMI in childhood and subsequent height gain/pubertal growth.MethodsLongitudinal growth data were used (GrowUp1990 Gothenburg cohort, n=1901). The QEPS growth-model was used to characterize height gain in relation to the highest BMISDS value between 3.5 and 8 years of age. Children were defined as overweight/obese (OwOb) or normal weight/underweight (NwUw), using the 2012 International Obesity Task Force criteria.ResultsA negative association between childhood BMISDS and pubertal height gain was observed. Already at birth, OwOb children were heavier than NwUw children, and had a greater height velocity during childhood. Onset of puberty was 3.5/3.0 months earlier in OwOb girls/boys, and they had 2.3/3.1cm less pubertal height gain from the QEPS-models specific P-function than NwUw children. Adult height was not related to childhood BMI.ConclusionWe found that pubertal height gain was inversely related to peak BMI in childhood. Higher childhood BMISDS was associated with more growth before onset of puberty, earlier puberty and less pubertal height gain, resulting in similar adult heights for OwOb and NwUw children.
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| 5. |
- Holmgren, Anton, et al.
(författare)
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The Pubertal Gain in Height is Inversely Related to BMI in Childhood
- 2015
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Ingår i: Hormone Research in Paediatrics. ; 84:Supplement 1, s. 268-69
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Weight in childhood may influence the pubertal timing and pattern of growth. Objective: To investigate the impact of BMI in childhood on further growth, especially the specific pubertal pattern of growth. Method: The longitudinally followed GrowUpGothenburg1990 birth cohort, was analyzed using the QEPS growth model (Nierop et al. Horm Res in Ped.2013; 80(suppl 1):152–153) (describing total height as a combination of four mathematical functions; Quadratic – Q, Exponential – E, Pubertal – P and Stop – S). Individual BMISDS values, from 3.5–8 years of age were calculated for linear and subgroup analyses (low/normal – Lw/Nw, overweight/obese – Ow/Ob), based on the IOTF 2012 reference (Cole TJ, Lobstein T. Pediatric obesity. 2012; 7(4):284–94.). Results: Across the whole BMI range a negative dose-response effect of childhood BMI on pubertal gain (Pmax) was found. Already at birth Owob children were heavier, and they grew faster in height in the prepubertal period compared to Lw/Nw, as evidenced by an increased Q function. Owob children of both genders had earlier puberty (91–117 days), P = 0.0004, reduced growth during puberty, boys/girls 3.13/2.26 cm less pubertal gain P<0.0001, from the specific pubertal growth function (Pmax). The adult height was not related to BMI in childhood. Conclusion: The higher BMI in childhood, the faster the prepubertal growth, the earlier onset of puberty, the less pubertal gain. This was evident across the whole BMI-range, making weight status an important modifier of growth. Funding information: This work was supported by the Swedish Research Council (VR no 7509 and VR 2006-7777), VR/FORMAS/FORTE/VINNOVA (259-2012-38 and 2006-1624); EpiLife-TEENS research program, Pfizer AB, the Governmental Grants for University Hospital Research (ALF), the R&D Department, County of Halland, and the Foundation Växthuset for children.
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| 6. |
- Holmgren, Anton, et al.
(författare)
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The Specific Pubertal Height Gain is Higher in Boys as Well as in Children with Lower BMISDS
- 2016
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Ingår i: Hormone Research in Paediatrics. - 1663-2818 .- 1663-2826.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Growth in height during puberty can be described by the QEPS-model as a combination of continuous basal growth, QES, and a specific pubertal growth function, P. Objective and hypotheses: To study the relationship between childhood BMISDS and the prepubertal gain and pubertal gain related to growth functions from the QEPS-model. Method: The longitudinally followed GrowUpGothenburg 1990 birth cohort, was analyzed, by the QEPS-model. Individual maximal BMISDS values, from 3.5–8.0 years of age (n=1901) were calculated for linear and subgroup analyses, underweight (blue cross), normal (blue open circles), overweight (red open circles), obese (red circles). Results: For girls (Figure left), total pubertal gain (Tpubgain) depended more on QESgain during puberty. For boys, total pubertal gain depended more on specific Pgain (Figure right). With higher BMISDS this balance was shifted towards less Pgain for both girls and boys. Before puberty, children with higher BMISDS were taller, expressed as higher QESgain, with a linear correlation over the whole BMI–range (P<0.001for both girls/ boys). Conclusion: During puberty, girls grew more due to the QES than the P functions, with opposite findings in boys. For both boys and girls, there were less Pgain and more QES- gain with higher childhood BMISDS. Before puberty, children with higher BMISDS were taller.
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| 7. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Swedish references for weight, weight-for-height and body mass index: The GrowUp 1990 Gothenburg study
- 2021
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 110, s. 537-548
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Tidskriftsartikel (refereegranskat)abstract
- Aim To update the Swedish references for weight, weight-for-height and body mass index (BMI) considering the secular trend for height but not including that for weight. Methods Longitudinal measures of height and weight were obtained (0-18 years) from 1418 (698 girls) healthy children from the GrowUp 1990 Gothenburg cohort born at term to non-smoking mothers and Nordic parents. A total of 145 individuals with extreme BMI value vs GrowUp 1974 BMI SDS reference were excluded (0-2 years: +/- 4SDS, 2 < years: -3SDS, +2.3SDS). References were constructed using the LMS method. Results The updated weight reference became similar to the GrowUp 1974 Gothenburg reference: BMI increased rapidly up to lower levels in the 1990 cohort during infancy/early childhood, similar in both groups in late childhood/adolescence, despite lower values at +2SDS. Compared with the WHO weight standard, median and -2SDS weight values were higher for the 1990 cohort, whereas +2SDS values were lower, resulting in narrower normal range. Median values were greater and +/- 2SDS narrower for the 1990 vs the WHO weight-for-height reference. International Obesity Task force (IOTF) BMI lines for definitions for over- and underweight were added. Conclusion We present updated references for weight, weight-for-height and BMI, providing a healthy goal for weight development when monitoring growth within healthcare settings.
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| 8. |
- Chen, Yun, 1978, et al.
(författare)
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Childhood BMI trajectories predict cardiometabolic risk and perceived stress at age 13 years: the STARS cohort
- 2023
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Ingår i: Obesity. - 1930-7381 .- 1930-739X.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to examine BMI trajectories from birth throughout childhood, associations with health outcomes at age 13 years, and time frames during which early-life BMI influenced adolescent health. Methods: Participants (1902, 44% male) reported perceived stress and psychosomatic symptoms and were examined for waist circumference (WC), systolic blood pressure (SBP), pulse wave velocity, and white blood cell counts (WBC). BMI trajectory was analyzed using group-based trajectory modeling of retrospective data of weight/height from birth throughout childhood. The authors performed linear regression to assess associations between BMI trajectories and health outcomes at age 13 years, presented as estimated mean differences with 95% CI among trajectories. Results: Three BMI trajectories were identified: normal; moderate; and excessive gain. Adjusting for covariates, adolescents with excessive gain had higher WC (19.2 [95% CI: 18.4–20.0] cm), SBP (3.6 [95% CI: 2.4–4.4] mm Hg), WBC (0.7 [95% CI: 0.4–0.9] × 109/L), and stress (1.1 [95% CI: 0.2–1.9]) than adolescents with normal gain. Higher WC (6.4 [95% CI: 5.8–6.9] cm), SBP (1.8 [95% CI: 1.0–2.5] mm Hg), and stress (0.7 [95% CI: 0.1–1.2]) were found in adolescents with moderate versus normal gain. The association of early-life BMI with SBP started around age 6 years with the excessive gain group, which was earlier than in the normal and moderate gain groups, in which it started at age 12 years. Conclusions: An excessive gain BMI trajectory from birth predicts cardiometabolic risk and stress in 13-year-old individuals.
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| 9. |
- Holmgren, Anton, et al.
(författare)
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Gender Difference in Secular Trend in Sweden
- 2014
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Ingår i: Hormone Research in Paediatrics. 82 (suppl 1), s. 132. - : S. Karger AG. - 1663-2818 .- 1663-2826.
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Konferensbidrag (refereegranskat)abstract
- Background, objective and hypotheses: By using QEPS, a new mathematic growth model, different components of growth can be analyzed, comparing secular trends of prepubertal and pubertal growth in Swedish birth cohorts born 1974 and 1990. Materials and methods: Two birth cohorts followed to adult height (AH) born around 1974 (1691 boys; 1666 girls) and 1990 (1647 boys; 1501 girls) being healthy, Nordic and born term. A subpopulation of 1974 (1177 boys; 1168 girls) and 1990 (989 boys; 919 girls) with < 10 height measurements evenly distributed during growth phases, and high data quality was used for comparison. The different components of the QEPS-model: (Q)uadratic, (E)xponential, (P)ubertal, and (S)top function were estimated with corresponding maximum values at AH and tempo adjusting ‘time scale ratios’ of E and P. Multivariate regression analyses were used for explaining the variation of AH. Results: Both boys and girls born 1990 compared to those born 1974 had at birth an increased lengthSDS and weightSDS and during infancy a more rapid growth (shorter Etimescale). Boys -1990 had increased prepubertal growth (P= 0.0001 for Qmax, Qheightscale), their pubertal part of growth was not significantly changed. Their AHcm increased 1.3 from 180.4 to 181.7; the variation in AH was explained to 44% by mid parental height (MPH) and birth characteristics, to 72% by adding Qmax, to 75% by pubertal onset age and to 99% by Pmax. Girls -1990 had prepubertal growth increased (P=0.05 for Qmax, Qheightscale). Their pubertal gain was markedly increased (P=0.001 for Pmax; Pheightscale), and duration decreased whereas mean menarche age remained 12.8 years. AHcm increased 0.7 from 167.6 to 168.3. AH could be explained to 52% by MPH and birth characteristics, to 71% by adding Qmax, to 75% by pubertal onset, and to 99% by Pmax. Conclusion: In cohorts born 16-years apart; a secular trend with increased AHcm was found, 1.3 in boys, due to more prepubertal growth, 0.7 in girls, due to more pubertal growth, indicating gender specific underlying regulations.
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| 10. |
- Wennergren, Mattias, 1993, et al.
(författare)
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Swedish Child Health Services Register: a quality register for child health services and children's well-being.
- 2023
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Ingår i: BMJ paediatrics open. - : BMJ. - 2399-9772. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Swedish child health services (CHS) is a free-of-charge healthcare system that reaches almost all children under the age of 6. The aim for the CHS is to improve children's physical, psychological and social health by promoting health and development, preventing illness and detecting emerging problems early in the child's life. The services are defined in a national programme divided into three parts: universal interventions, targeted interventions and indicated interventions.The Swedish Child Health Services Register (BHVQ) is a national Quality Register developed in 2013. The register extracts data from the child's health record and automatically presents current data in real time. At present, the register includes 21 variables.We aim to describe data available in the BHVQ and the completeness of data in BHVQ across variables.Child-specific data were exported from the register, and data for children born in the regions were retrieved from Statistics Sweden to calculate coverage.The register includes over 110000 children born between 2011 and 2022 from 221 child healthcare centres in eight of Sweden's 21 regions. In seven of the eight regions, 100% of centres report data.The completeness of data differs between participating regions and birth cohorts. The average coverage for children born in 2021 is 71%.The BHVQ is a valuable resource for evaluating Child Health Services nationally, with high coverage for the youngest children. As a result of continuous improvement of the services, the possibility to follow the development of children's health in Sweden is possible through the register. When fully expanded, the register will be a natural and essential part of developing preventive services, improving healthcare for children below 6years of age and a tool for developing evidence-based child health interventions.
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| 11. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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A new Swedish reference for total and prepubertal height.
- 2020
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 109:4, s. 754-763
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to develop up-to-date references with standard deviation scores (SDS) for prepubertal and total height.Longitudinal length/height measures from 1572 healthy children (51.5% boys) born at term in 1989-1991 to non-smoking mothers and Nordic parents were obtained from the GrowUp 1990 Gothenburg cohort. A total height SDS reference from birth to adult height was constructed from Quadratic-Exponential-Pubertal-Stop (QEPS) function estimated heights based on individual growth curves. A prepubertal height SDS reference, showing growth trajectory in the absence of puberty, was constructed using the QE functions.The total height reference showed taller prepubertal mean heights (for boys 1-2cm; for girls 0.5-1.0cm) with a narrower normal within ±2SDS range versus the GrowUp 1974 Gothenburg reference. Adult height was increased by +0.9cm for females (168.6cm) and by +1.6cm for males (182.0cm). Height in children growing at -2SDS (the cutoff used for referrals) differed up to 2cm versus the GrowUp 1974 Gothenburg reference, 3cm versus Swedish 1981 references and World Health Organization (WHO) 0-5 years standard, and 6-8cm versus the WHO 5-19 years reference.Up-to-date total and prepubertal height references offer promise of improved growth monitoring compared with the references used in Sweden today.
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| 12. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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A new type of pubertal height reference based on growth aligned for onset of pubertal growth
- 2020
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Ingår i: Journal of Pediatric Endocrinology & Metabolism. - : Walter de Gruyter GmbH. - 0334-018X .- 2191-0251. ; 33:9, s. 1173-1182
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Growth references of today traditionally describe growth in relation to chronological age. Despite the broad variation in age of pubertal maturation, references related to biological age are lacking. To fill this knowledge gap, we aimed to develop a new type of pubertal height reference for improved growth evaluation during puberty, considering individual variation in pubertal timing. Methods: Longitudinal length/height measures were obtained from birth to adult height in 1,572 healthy Swedish children (763 girls) born at term similar to 1990 to nonsmoking mothers and Nordic parents, a subgroup of GrowUp(1990) Gothenburg cohort. A total height reference was constructed from Quadratic-Exponential-Puberty-Stop (QEPS)-function-estimated heights from individual height curves that had been aligned for time/age at onset of pubertal growth (5% of P-function growth). References that separated growth into specific pubertal height(SDS ) P-function growth) and basic height(SDS) (QES-function growth) were also generated. Results: References (cm and SDS) are presented for total height, and height subdivided into that specific to puberty and to basic growth arising independently of puberty. The usefulness of the new pubertal growth reference was explored by identifying differences in the underlying growth functions that translate into differences in pubertal height gain for children of varying body mass, height, and with different pubertal timings. Conclusions: A new type of height reference allowing alignment of individual growth curves, based on the timing of the pubertal growth spurt was developed using QEPS-model functions. This represents a paradigm shift in pubertal growth research and growth monitoring during the adolescent period.
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| 13. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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New Reference for Height in Swedish Boys and Girls
- 2014
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Ingår i: Hormone Research in Paediatrics. 82 (suppl 1), s. 256. 53rd Annual Meeting of the European Society for Paediatric Endocrinology (ESPE). Dublin, Ireland, September 18-20, 2014. Hormone Research in Paediatrics.. - : S. Karger AG. - 1663-2818 .- 1663-2826.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The actual Swedish growth references are based on a cohort born 1974. Objective and hypotheses: Due to secular changes there is need for new height references. Method: Material: Height measurements from birth to adult height (AH) in a cohort of healthy, Nordic and born full term 1990, 20.796 from 1647 boys, 19.202 from 1501 girls were used (ALL) and compared to both a subgroup with puberty close to mean (PHV G0.25 years) of 3.726 heights from 259 boys; 3.759 from 271 girls, and a subgroup (AM) with O10 height measurements evenly distributed (15.324 in 989 boys; 14.381 in 919 girls), and of high data quality. The 1974 cohort, with similar subgrouping, were used for comparison. Methods: For construction of height curves the LMS method was applied with LMS parameters based directly on the data: the power in the Box-Cox transformation (L), the median (M), and the generalized coefficient of variation (S). The GAMLSS R-package with a special LMS program was used, giving L, M, S and optional kurtosis as functions of age. Results: Height reference curves, with mean, G1, G2 SDS were obtained for 1990 of the ALL vs the AM material with similar results whereas the close puberty material showed the same mean but more narrow G1, G2 SDS during adolescence. When the different 1990 references were compared to 1974 references, the corresponding 1974 differences were found. The new references takes into account that the 1990 cohort had a more rapid infancy growth, increased prepubertal growth, especially in boys, increased pubertal gain, only in girls, and increased AH in both genders.
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| 14. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Novel type of references for BMI aligned for onset of puberty - using the QEPS growth model
- 2022
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Ingår i: Bmc Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Despite inter-individual variations in pubertal timing, growth references are conventionally constructed relative to chronological age (C-age). Thus, they are based on reference populations containing a mix of prepubertal and pubertal individuals, making them of limited use for detecting abnormal growth during adolescence. Recently we developed new types of height and weight references, with growth aligned to age at onset of the pubertal growth spurt (P-age). Here, we aim to develop a corresponding reference for pubertal BMI. Methods The QEPS-height and weight models were used to define a corresponding QEPS-BMI model. QEPS-BMI was modified by the same individual, constitutional weight-height-factor (WHF) as computed for QEPS-weight. QEPS-BMI functions were computed with QEPS weight and height functions fitted on longitudinal measurements from 1418 individuals (698 girls) from GrowUp(1990)Gothenburg cohort. These individual BMI functions were used to develop BMI references aligned for height at AgeP5; when 5% of specific puberty-related (P-function) height had been attained. Pubertal timing, stature at pubertal onset, and childhood BMI, were investigated in subgroups of children from the cohort GrowUp(1974)Gothenburg using the new references. Results References (median, standard deviation score (SDS)) were generated for total BMI (QEPS-functions), for ongoing prepubertal growth (QE-function) vs C-age, and for total BMI and separated into BMI specific to puberty (P-function) and BMI gain from ongoing basic growth (QES-functions), allowing individual growth to be aligned based on P-age. Growth in basic BMI was greater than average for children categorized as tall and/or with high-BMI at puberty-start. In children categorized as short at puberty-start, P-function-related-BMI was greater than average. Conclusions Use of these new pubertal BMI references will make it possible for the first time to consider individual variations owing to pubertal timing when evaluating BMI. This will improve the detection of abnormal changes in body composition when used in combination with pubertal height and weight references also abnormal growth. Other benefits in the clinic will include improved growth monitoring during treatment for children who are overweight/obese or underweight. Furthermore, in research settings these new references represent a novel tool for exploring human growth.
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| 15. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Novel type of references for weight aligned for onset of puberty - using the QEPS growth model
- 2021
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Ingår i: Bmc Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Growth references are traditionally constructed relative to chronological age, despite inter-individual variations in pubertal timing. A new type of height reference was recently developed allowing growth to be aligned based on onset of pubertal height growth. We here aim to develop a corresponding reference for pubertal weight. Methods To model QEPS-weight, 3595 subjects (1779 girls) from GrowUp(1974)Gothenburg and GrowUp(1990)Gothenburg were used. The QEPS-height-model was transformed to a corresponding QEPS-weight-model; thereafter, QEPS-weight was modified by an individual, constitutional weight-height-factor. Longitudinal weight and length/height measurements from 1418 individuals (698 girls) from GrowUp(1990)Gothenburg were then used to create weight references aligned for height at pubertal onset (the age at 5% of P-function growth, AgeP5). GrowUp(1974)Gothenburg subgroups based on pubertal timing, stature at pubertal onset, and childhood body composition were assessed using the references. Results References (median, SDS) for total weight (QEPS-functions), weight specific to puberty (P-function), and weight gain in the absence of specific pubertal growth (basic weight, QES-functions), allowing alignment of individual growth based on age at pubertal onset. For both sexes, basic weight was greater than average for late maturing, tall and high-BMI subgroups. The P-function-related weight was greater than average in short and lower than average in tall children, in those with high BMI, and in girls but not boys with low BMI. Conclusions New pubertal weight references allow individual variations in pubertal timing to be taken into consideration when evaluating growth. When used together with the comparable pubertal height reference, this will improve growth monitoring in clinical practice for identifying abnormal growth and serve as a valuable research tool providing insight into human growth.
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| 16. |
- Andersson, Björn, 1939, et al.
(författare)
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Seasonal variations in vitamin D in relation to growth in short prepubertal children before and during first year growth hormone treatment
- 2015
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Ingår i: Journal of Endocrinological Investigation. - : Springer Science and Business Media LLC. - 0391-4097 .- 1720-8386. ; 38:12, s. 1309-1317
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This study investigated the relationship between seasonal variations in 25-hydroxyvitamin D (25(OH) D) levels and growth in prepubertal children during both the pretreatment year and the first year of GH treatment. Methods The study included 249 short prepubertal children with a broad range of GH secretion, GH(max) during a 24 h profile median 23; range 1-127 mU/L, 191 boys (mean age +/- SD, 8.6 +/- 2.6 years), 58 girls (7.5 +/- 1.9 years) receiving GH treatment (mean 43 mu g/kg/day; range 17-99 mu g/kg/day). Serum 25(OH) D was measured using an automated IDS-iSYS immunoassay. Results 25(OH) D levels showed seasonal variation, and decreased significantly during GH treatment. 25(OH) D levels at start and first year reduction in 25(OH) D, correlated (-) with the first year growth response during treatment. The degree of GH secretion capacity within our study population of mainly non-GH deficient children and 25(OH) D sufficient (67 +/- 29 nmol/L) had no influence on 25(OH) D levels. Growth during GH treatment were independent of seasonal variations in 25(OH) D. Multiple regression analysis showed that 25(OH) D levels at treatment start, together with auxological data and IGF-binding protein-3(SDS), explained 61 % of the variation in first year gain in height(SDS). Conclusion 25(OH) D levels were associated with first year growth response to GH and may be a useful contribution to future growth prediction models.
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| 17. |
- Gelander, Lars, 1956
(författare)
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Children's growth: a health indicator and a diagnostic tool
- 2006
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Ingår i: Acta Paediatr. - : Wiley. - 0803-5253. ; 95:5, s. 517-8
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Tidskriftsartikel (refereegranskat)abstract
- The publication of Werner and Bodin in Acta Paediatrica should inspire countries to use the growth of children as an indicator of health. The development of databases that cover all measurements of all children that have contact with healthcare and medical care will provide new knowledge in this area. Such databases will give us the opportunity to explore health in different areas of the country and to evaluate community projects in order to prevent obesity. CONCLUSION: Growth charts that are used to identify sick children or children that have other causes for growth disturbances must reflect how a healthy child should grow. If such prescriptive growth charts are computerized together with regional databases, they will provide necessary growth data for descriptive health surveys.
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| 18. |
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| 19. |
- Holmgren, Anton, et al.
(författare)
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Insight into human pubertal growth by applying the QEPS growth model.
- 2017
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Ingår i: BMC pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 17:107
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Tidskriftsartikel (refereegranskat)abstract
- Computerized mathematical models describing absolute and relative individual growth during puberty in both cm and standard deviation (SD)-scores are lacking. The present study aimed to fill this gap, by applying the QEPS-model that delineates mathematically the specific pubertal functions of the total growth curve.Study population used was the individual growth curves of the longitudinally followed cohort GrowUp1974 Gothenburg (n=2280). The QEPS-model describes total height as (T)otal-function: a combination of four shape-invariant growth functions, modified by time-scale and height-scale parameters: a (Q)uadratic-function for the continuous growth from fetal life to adulthood; a negative (E)xponential-function adds the rapid, declining fetal/infancy growth; a (P)ubertal-function the specific pubertal growth spurt; a (S)top-function the declining growth until adult height. A constructed variable, MathSelect, was developed for assessing data-quality. CIs and SD-scores for growth estimates were calculated for each individual. QEPS-model estimates used for pubertal growth; from the T-function: onset of puberty as minimal height velocity (AgeT ONSET ); mid-puberty as peak height velocity (AgeT PHV ); end of puberty as height velocity decreased to 1cm/year (AgeT END ); duration of different intervals and gain (AgeT ONSET-END and Tpubgain); from the P-function: onset of puberty, estimated as growth at 1% or 5% (AgeP1 , AgeP5); mid-puberty as 50% (AgeP50) and PHV (AgeP PHV ); end of pubertal growth at 95 or 99% (AgeP95, AgeP99); duration of different intervals and pubertal gain (Ppubgain; P max ); from the QES-function: gain (QESpubgain) . RESULTS: Application of these mathematical estimates for onset, middle and end of puberty of P-function, QES-function, and T-function during puberty showed: the later the onset of puberty, the greater the adult height; pubertal gain due to the P-function growth was independent of age at onset of puberty; boys had higher total gain during puberty due to P-function growth than to QES-function growth; for girls it was reversed.QEPS is the first growth model to provide individualized estimates of both the specific pubertal growth function and the total growth during puberty, with accompanying SD-scores and Cis for each individual. These QEPS-derived estimates enable more in-depth analysis of different aspects of pubertal growth than previously possible.
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| 20. |
- Holmgren, Anton, et al.
(författare)
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New puberty growth model for estimation of age for peak height velocity ompared with a manual method.
- 2013
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Ingår i: Hormone Research in Paediatrics. 9th Joint Meeting of Paediatric Endocrinology. 19-22 september 2013. Milan, Italien.. - : S. Karger AG. - 1663-2818 .- 1663-2826.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: There is a lack of methods describing pubertal growth in a computerized way. Objective and hypotheses: To compare a mathematical model, describing pubertal growth, for age at start P5%, mid P50% and end P95% of pubertal growth and total curve peak height velocity (TPHV) to compare with manually identified PHV. Methods: From a new growth model (QEPs Quadratic Exponential Puberty stop) we used the P(uberty) function for estimating PO (5% of P(AUC), mid puberty as P50% and PE (95% of P(AUC)). The calculated PHV from total growth curve (TPHV) was compared with the manually identified PHV (against a ICP based grid) . The Swedish growth reference, born 1974 (n=3655 of which 2622) was selected. Results: For the 1320 boys mean (SD) of ageP50% was 13.82 (0.96), ageTPHV 13.67 (0.97) and age at PHV 13.85 (1.00). For the 1302 girls mean (SD) of ageP50% was 12.08 (0.97), ageTPH 11.81 (0.99) and age at PHV 11.93 (0.95). PO, as P5% for boys was 11.77 (1.00) and for girls 9.80 (1.04). PE, as P95% for boys was 16.16 (0.99) and for girls 14.70 (0.97) giving a mean duration for boys of 4.8 years and 4.9 years for girls. The mean age difference between PHV and TPHV was for boys 0.18 (0.38) and for girls 0.11 (0.48). The mean difference between PHV and P50% was for boys 0.03 (0.38) and for girls -0.15 (0.48). Conclusions: This new puberty growth model gives computerized information of start, mid and end of pubertal growth as well as the age at TPHV. This makes possible a better evaluation of influence of hormones, disease and environment on timing of amount of pubertal growth.
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| 21. |
- Johnston, L. B., et al.
(författare)
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Association between insulin-like growth factor I (IGF-I) polymorphisms, circulating IGF-I, and pre- and postnatal growth in two European small for gestational age populations
- 2003
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Ingår i: J Clin Endocrinol Metab. ; 88:10, s. 4805-10
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to assess the association of IGF-I and birth size by studying small for gestational age (SGA) subphenotypes and undertaking more detailed analysis of IGF-I genetic markers. SGA subjects from Haguenau, France (n = 113), and Gothenburg, Sweden (n = 174), were studied. The Swedish subjects were subphenotyped according to postnatal growth (114 short SGA and 60 SGA catch-up). IGF-I dinucleotide repeat and single nucleotide polymorphism (SNP) markers were studied, and haplotypes were generated in the Swedish short SGA group by identity of state. Association analysis was undertaken using the Monte Carlo method of association analysis of multiallelic markers for dinucleotide repeat markers, by exact chi(2) analysis for SNPs and by ANOVA for serum IGF-I levels. IGF-I genotype was associated with the SGA phenotype, in particular with symmetrical SGA and low birth weight, and with IGF-I levels in SGA subjects. Association with postnatal growth was different in the two populations, which may reflect the power of the smaller subphenotype groups. Haplotype analysis in the Swedish short SGA subjects showed that the region of association lay between the promoter and intron 2 of the IGF-I gene. These studies validate the association of the IGF-I gene with birth size and refine the region of association in Swedish short SGA subjects.
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| 22. |
- Klingberg, Gunilla, 1960, et al.
(författare)
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Morphological appearance and chemical composition of enamel in primary teeth from patients with 22q11 deletion syndrome.
- 2005
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 113:4, s. 303-11
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Tidskriftsartikel (refereegranskat)abstract
- Patients with 22q11 deletion syndrome have many and complex medical problems, including hypocalcemia and/or hypoparathyroidism. Odontological findings include enamel aberrations in both dentitions. In order to describe enamel morphology, chemical composition in primary teeth, and to investigate the relationship between medical history and morphological appearance, dental enamel was investigated in 38 exfoliated primary teeth from 15 children and adolescents. Morphology was studied by the use of a polarized light microscope, microradiography, scanning electron microscopy, X-ray microanalysis, and secondary ion mass spectrometry. The morphological findings were compared with medical history. The teeth showed, in principle, a normal morphological appearance with regard to prism structure. A high frequency of aberrations, such as hypomineralization, hypoplasia and extra incremental lines, were found. The majority of the aberrations were found around the neonatal line. There was a relationship between high numbers of medical problems in the patients and enamel deviations. The result supports the hypothesis of under-reporting of both hypocalcemia and hypoparathyroidism in patients with 22q11 deletion syndrome.
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| 23. |
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| 24. |
- Löfqvist, Chatarina, 1964, et al.
(författare)
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Reference Values for Insulin-Like Growth Factor-Binding Protein-3 (IGFBP-3) and the Ratio of Insulin-Like Growth Factor-I to IGFBP-3 throughout Childhood and Adolescence
- 2005
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Ingår i: J Clin Endocrinol Metab. - : The Endocrine Society. ; 90:3, s. 1420-1427
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Tidskriftsartikel (refereegranskat)abstract
- To facilitate the diagnosis of GH deficiency and monitor GH therapy, we constructed two reference models to allow comparison of serum IGF binding protein (IGFBP)-3 concentrations and IGF-I to IGFBP-3 ratios among children throughout childhood and adolescence. This report presents equations for determining the sd score of IGFBP-3 and IGF-I to IGFBP-3 measurements for individual patients. The data set contains serum values from 468 healthy children and adolescents (232 males, 236 females; ages 1.1-18.3 yr) whose height, weight, and body mass index were within +/- 3 sd of means. Puberty was classified according to breast development (B) and testicular volume into pre-, early, mid-, and late puberty. The values of IGFBP-3 and IGF-I to IGFBP-3 ratios were log transformed, and multiple linear regression analysis was used to identify models for converting serum concentrations into sd scores. The models include the variables of age, gender, and puberty and take into account the interactions among these variables. The best linear models explain 42% of the variation in serum IGFBP-3 concentrations and 50% of the variation in serum IGF-I to IGFBP-3 concentrations. The relationship between age and log(IGFBP-3) was positive for boys in pre-, early, and midpuberty. In late puberty, values were higher than earlier in puberty, and there was a negative relationship with age. For girls the relationship between age and log(IGFBP-3) also was positive in pre- and early puberty, with larger effect for girls older than 8 yr. Values for girls in midpuberty were relatively constant, and in late puberty values were higher than earlier in puberty, and there was a negative relationship with age. The relationship between age and log(IGF-I to IGFBP-3 ratio) was positive for boys in pre-, early, and early midpuberty (volume = 9-14 ml). In late midpuberty (volume = 15-19 ml), the relationship between age and IGF-I to IGFBP-3 ratio was negative. In late puberty, values were relatively constant and higher than earlier in puberty. For girls in prepuberty, the relationship with age was positive, with a larger effect in girls older than 8 yr. In early puberty, the girls' values were relatively constant. In early midpuberty (B = 3), log(IGF-I to IGFBP-3 ratio) values were higher for girls than boys of the same age. In late midpuberty (B = 4), the relationship with age was negative, and in late puberty values were relatively constant and higher than earlier in puberty.
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| 25. |
- Nierop, Andreas FM, 1954, et al.
(författare)
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Modelling individual longitudinal human growth from fetal to adult life - QEPS I
- 2016
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Ingår i: Journal of Theoretical Biology. - : Elsevier BV. - 0022-5193. ; 406, s. 143-165
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Tidskriftsartikel (refereegranskat)abstract
- Background: Only one mathematical model to date describes human growth and its different phases from fetal life until adult height. Aim: To develop a model describing growth from fetal life to adult height taking maturation/biological tempo into consideration. Methods: Subjects: The model was developed based on longitudinal mean height values obtained from published growth references for a cohort of 3650 healthy Swedish children followed from birth circa 1974 until adult height combined with birth-length for circa 400 000 healthy infants born 1990-1995. Results: The QEPS-model for individual growth was constructed with a combination of four basic shape invariant growth functions: a quadratic Q-function and a negative exponential E-function, both started during fetal life, 8 months before birth; the E-function levelled off after birth, whereas the Q-function continued until end of growth. A specific nonlinear pubertal P-function started at onset of puberty, and a stop S-function ended growth according to both the Q-function continuing during puberty and the specific P-function. For each function, an individual height-scale parameter was defined, and for the E and P-functions, a time-scale parameter; giving six modifying parameters in total. In addition standardized proportional scores were used for biological interpretations. The QEPS-model was used to fit and generate mathematical functions suitable to describe the growth of the healthy population of Swedish children; thereafter, the model was modified using four height scale parameters to model individual height in cm, and two time-scale parameters to adjust for the individual tempo of growth. Individual confidence intervals were calculated for all parameters. Conclusions: A new shape-invariant growth model, QEPS, was developed, that requires only four basic growth functions to describe the total pattern of growth in height from fetal life to adult height, with addition of height- and time-scale parameters describing individual growth. The model can describe a wide variety of growth curves. Moreover, it is the first model to provide confidence intervals which enable us to describe the precision/quality of individual parameters.
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| 26. |
- Nierop, Andreas FM, 1954, et al.
(författare)
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QEPS- a new mathematical model describing individual human growth.
- 2013
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Ingår i: Hormone Research in Paediatrics. 9th Joint Meeting of Paediatric Endocrinology, ESPE-PES-APEG-APPES-ASPAE-JSPE-SLEP. Milan, Italy. September 19-22, 2013. - : S. Karger AG. - 1663-2826.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Longitudinal spontaneous human growth from fetal period to adult height often shows systematic nonparallel growth in SD-scores.Systematic modeling of nonparallel growth in SD-scores is lacking. Objective and hypotheses: To develop a new model describing the growth from fetal life to adult height. To model individual growth changes in SDscores, with a limited number of parameters and to quantify the occurrence of nonparallel growth. Method: Longitudinal height is modeled on the cohort from the Swedish growth reference (born 1974, n=3650). The growth values can be described as a sum of four growth functions: Quadratic(Q), Exponential(E), Pubertal(P)and Stopping(S). Key individual parameters of the model expressed in height in cm are translated in corresponding parameters expressed in height SD-scores, addressing different growth periods. The model is tested on 712 girls and 727 boys from a cohort born 1990. Systematic nonparallel growth in SD-scores is classified by non-overlapping 90% confidence intervals in SD-scores. Result: In the prepubertal period 13% (14%) of the girls(boys) had nonparallel growth in SD-scores before 2 years of age and 19% (20%) after 2 years. For the pubertal period we adjusted the SD-scores for the individual timing of puberty and still found 29% (25%) of the girls (boys) having pubertal nonparallel growth. Evaluating over the total growth period 62% (60%) of the girls (boys) had nonparallel growth. Conclusion: The proposed QEPS model can concisely describe a wide variety of growth curves in SD-scores of healthy individuals. More than half of the individuals appear to have systematic nonparallel growth in SD-scores.
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