Higher insulin, triglycerides, and blood pressure with greater trunk fat in Tanner 1 Chinese

Objective: The aims of this study were to investigate the body fat distribution pattern in prepubertal Chinese children and to investigate the relationship between central fat distribution and specific biomarkers of cardiovascular disease. Research Methods and Procedures: The study was conducted in an urban Mainland Chinese (Jinan, Shandong) sample of children using a cross‐sectional design. Pubertal status was determined by Tanner criteria. Measurements included weight, height, waist circumference, DXA measures of total body fat and trunk fat; fasting serum measures of glucose, insulin, triglyceride, cholesterol, high‐density lipoprotein‐cholesterol; and systolic and diastolic blood pressure. Multiple regression models were developed with the biomarkers of cardiovascular risk factor as the dependent variables, and adjustments were made for significant covariates, including sex, age, height, weight, waist circumference, total body fat, trunk fat, and interactions. Results: A total of 247 healthy prepubertal subjects were studied. After co‐varying for age, weight, height, and extremity fat (the sum of arm fat and leg fat), girls had greater trunk fat than boys (p < 0.0001, R² for model = 0.95). Insulin and triglyceride were positively related to central fat measured by DXA‐trunk fat (p < 0.05) but not related to the waist circumference. In the blood pressure model, waist circumference was a significant predictor of both systolic blood pressure and diastolic blood pressure, while DXA‐trunk fat was associated with diastolic blood pressure only. Significant interactions between sex and trunk fat, and sex and total fat, were found in relation to diastolic blood pressure. Discussion: In prepubertal Chinese children, greater trunk fat was significantly associated with higher insulin and triglyceride in boys and girls and was associated with higher diastolic blood pressure in boys only.     

Changes in blood lipids and blood pressure during adolescence.

A total of 625 adolescents from three general practices participated in a cross-sectional study of cardiovascular disease risk factors. The girls had higher serum total and high density lipoprotein (HDL) cholesterol concentrations than the boys, while the boys had higher serum triglyceride concentrations. Smoking (equally prevalent in both sexes) was associated with lower HDL cholesterol concentrations, particularly in boys, while in girls use of oral contraceptives was associated with higher total cholesterol and lower HDL cholesterol concentrations showed striking associations with age, height, and sexual maturation in boys, but not in girls. Triglyceride concentrations were associated with age in boys. Systolic blood pressure and serum urate concentrations were higher in boys and rose steeply with age, but no age association was seen for urate concentrations or systolic blood pressure in girls or for diastolic pressures in either sex. Girls, however, had higher diastolic pressures. There was a strong association between urate concentration and the other cardiovascular disease risk factors, especially HDL cholesterol. Adolescence is associated with considerable changes in cardiovascular disease risk factors, and there are striking sex differences in these changes.     

Do American born Japanese children still grow faster than native Japanese?

Growth patterns of Japanese schoolchildren in Hawaii, composed of 2,954 boys and 3,213 girls aged between 11 and 17, were compared with those comparable groups of Japanese schoolchildren in Japan based on the data published by the Japanese Ministry of Education. Growth characteristics studied were height, weight, and relative weight index, weight/(height). The Hawaii-Japanese boys were taller at early ages but the difference disappeared by age 16. Native Japanese girls were shorter than Hawaii-Japanese until age 13, but they overtook the latter by age 14, exceeding them in height after age 15. A similar pattern was found in weights of girls but the Hawaii-Japanese boys remained consistently heavier by 5.0 to 9.0 kg than native Japanese. The relative weight measure indicated that the Hawaii boys were more "obese" than native Japanese boys for the growth period studied; whereas the same tendency was maintained until age 15 in girls. These observations indicate a marked degree of convergence of the patterns of physical growth of the two populations, whose differences were unmistakably in favor of American born children in earlier studies. It is concluded that the convergence is due largely to the improved environmental conditions in Japan in recent years.     

Extreme levels of underweight and stunting among pre-adolescent children of low socioeconomic class from Madhyamgram and Barasat, West Bengal, India

A cross-sectional study on 1206 children (788 boys, 618 girls) aged 1-12 years, belonging to low socioeconomic status, of Barasat and Madhyamgram, West Bengal, India, was undertaken to investigate age and sex variations in height and weight. It also evaluated the levels of underweight and stunting among them. Anthropometric measurements included weight and height. Weight-for-age (WA) and height-for-age (HA) <-2 z-scores were used to evaluate underweight (UW) and stunting (ST), respectively, following the National Center for Health Statistics (NCHS) Guidelines. Results showed that boys aged 4 and 11 years were significantly heavier than girls of corresponding ages. Boys aged 7 years were significantly taller than girls of the same age. Significant (p < 0.001) age differences existed in mean weight and height in boys (weight: F = 336.762; height: F = 565.160) as well as girls (weight: F = 275.320; height = 498.715). Results also revealed that the mean z-scores of WA (WAZ) and HA (HAZ) were less than (negative values) those of NCHS for both sexes at all ages. The overall (age combined) rate of UW was 60.4% and 51.3%; while that of ST was 51.7% and 48.4%, in boys and girls, respectively. Based on World Health Organization classification of severity of malnutrition, the prevalence of UW and ST were very high (> or = 30%) in both sexes. In conclusion, this study demonstrated that the prevalence of UW and ST were very high among the subjects. Since the nutritional status of the subjects is not satisfactory, there is need for immediate supplementary nutrition.     

Associations of Blood Pressure with Body Composition among Afro-Caribbean Children in Barbados

Despite complex presentation of adult hypertension and a concomitant obesity epidemic, little is known about overweight in relation to blood pressure among Caribbean children. We examined blood pressure in relation to body size in a cross-sectional study of 573 Barbadian children aged 9–10 years (2010-2011).The United States normative blood pressure percentiles were used to identify children with high (≥ 95^th percentile) or high normal blood pressure (90^th – 95^th percentile). The World Health Organization body mass index cut-off points were used to assess weight status.

Major findings

Thirty percent of children were overweight/obese. Percentage fat mass differed between girls (20.4%) and boys (17.72%) (p< 0.05). Mean systolic blood pressure among girls was 106.11 (95% CI 105.05, 107.17) mmHg and 105.23 (104.09, 106.38) for boys. The percentages with high or high-normal mean systolic blood pressurewere14.38% (10.47, 18.29) for girls and 8.08% (4.74, 11.41) for boys. Height and body mass index were independent correlates of systolic and diastolic blood pressure. Mean systolic blood pressure was related to lean mass but not fat mass, while diastolic blood pressure was associated with fat mass index and overweight.

Principal conclusion

One third of 9-10 year old children in Barbados were overweight/obese and 12% had elevated mean systolic blood pressure. BP was related to body size. These findings signal potential adverse trends in weight gain and BP trends for children growing up in the context of a country that has recently undergone rapid economic transition.     

Prepubertal Asians have less limb skeletal muscle.

Skeletal muscle mass in prepubertal Asian children has not been examined previously. The aims of this study were to test the hypotheses that 1) prepubertal Asians have less appendicular skeletal muscle (ASM) mass compared with African-Americans and Caucasians, and 2) ASM is less in prepubertal Asian girls compared with Asian boys. ASM was estimated by using dual-energy X-ray absorptiometry in healthy prepubertal girls (n = 170) and boys (n = 166). The results showed that, after adjusting for age, height, and body weight, 1) Asian girls and boys had less amounts of ASM than African-Americans (P < 0.001); 2) Asian girls had less amounts of ASM than Caucasian girls (P = 0.004); 3) there was a trend towards less ASM in Asian compared with Caucasian boys (P = 0.07); 4) and Asian girls had significantly less ASM than Asian boys (P < 0.001). This study indicates that skeletal muscle mass as a fraction of body weight is smaller in Asian compared with African-American and Caucasian children.     

儿童最大有氧活动能力的发展特征

本文报告了我国４６３名１０－１９岁儿童青少年的最大有氧活动能力的发展特征。在青春早期,男女童的最大吸氧量绝对值均随年龄增长而增加,男童由１．７５升／分增至３．１０升／分,女童由１．４４升／分增至２．０７升／分,女童增长较少;以后女童即稳定于这一水平,男童仍略有增长。按身高及按最大心率计标的相对值与其有相似的特征。按体重和瘦体重计算的相对值,在男女童都未见随年龄增长的规律。男童ＶＯ２ｍａｘ绝对值及各     

Blood pressure during exercise in healthy children

During maximal dynamic exercise the blood pressure (BP) was measured in 497 healthy 9- to 18-year-old children. Systolic BP increased more in the postpubertal groups than in the prepubertal ones. It was also higher in the boys than in the girls of the same age. This was due to a higher work load in boys than girls. Twenty-two subjects had a systolic BP of 200 mmHg or more during the exercise. Only 2 had a resting systolic BP exceeding the mean by 2 standard deviations or more. Three postpubertal boys reached a systolic BP of 240 mmHg at heart rate 170. None had an elevated resting BP. It may be concluded that it cannot be predicted on the basis of the resting BP whether or not an individual is going to have an excessive increase in systolic BP during exercise. The increase in systolic BP to dangerous levels, e.g. 240 mmHg or more, during exercise can only be excluded by means of an individual exercise test.     

Growth pattern of the Kamars--a primitive tribe of Chhattisgarh,India

A cross sectional study of the physical growth status was made on 655 Kamar children (341 boys and 314 girls), aged 5 to 18 years, in the Raipur district of Chhattisgarh. The study aimed to find out the growth pattern of the Kamar children, which is considered to be a primitive tribe of Chhattisgarh, India and was compared with another Indian tribe and the official data for all India (ICMR). Anthropometric measurements included height, weight, sitting height, biacromial diameter, biilliocrystal diameter, upper arm circumference, calf circumference and measurements of the triceps and subscapular skinfolds. All anthropometric measurements except skinfold thickness exhibit uniform increase with age in both sexes. However, when height and weight of the Kamar boys and girls were compared with the data for other tribes and for all India, the Kamar children (both boys and girls) indicated lower weight and height and the difference showed to be significant, for almost all ages. Kamar boys showed higher anthropometric values than girls in almost all measurements except in biilliocrystal diameter and in measured skinfolds. Poor socio-economic status of this primitive tribe may be one of the reasons for this poor growth pattern. However, in-depth study is necessary in order to arrive at any basic conclusions and to recommend any policy and interventions.     

Growth attainments of well-off chandigarh children: A mixed longitudinal study

Distance and velocity pattern of growth for body weight and height of 134 well-off Chandigarh boys aged 9–17 years, and 109 girls aged 9 to 16 years were studied following a mixedlongitudinal growth study design. For both body weight and height pattern-wise, Chandigarh boys showed close similarity with their American counterparts up to about 13 years of age, while girls did so till 12 years. Where after, Chandigarh children remained lighter and shorter than those of American origin and this differential may be explained on racial grounds rather than nutritional ones since all children included in this study remained free from dietary and other health related constraints. Marginally, higher height growth attainments noticed in Chandigarh children in contrast to their other Indian counterparts during initial years of adolescence shows that Chandigarh children are in process of expressing their genetic growth potential to its full which has not yet been fully achieved. The rate (velocity) of weight and height growth in Chandigarh children remained substatially lower than their sex-matched British counterparts throught the period of study. PHV in boys measured 6.4 cm/yr. and 5.4 cm/yr. in girls. It was attained at the age of 11.5 years in girls and 12.5 years in boys. Peak weight velocity in boys averaged 3.7 kg/yr., while it measured 4.6 kg/yr. in girls. In girls (11.5 yr.), PWV too was attained earlier than boys (13.5 yr.) by two years. The shorter height and lighter weight growth attainments noticed in Chandigarh children in contrast to their Western counterparts may be attributed to slower and lesser magnitude peak growth velocities recorded in Chandigarh children. The use of values presented has been recommended to monitor and assess growth attainments of Indian children residing in the Union Territory of Chandigarh.     

Growth curves of children with Down syndrome.

Growth curves of 105 children with Down syndrome (50 boys and 55 girls) were established. At birth height, weight and head circumference of Down syndrome children were lower than these parameters in controls. This delay remained stable until puberty. For weight there was no clear-cut pubertal growth spurt. For stature, the prepubertal growth spurt occurred earlier (at the age of 11 years in boys and 9 1/2 years in girls) than in controls but was less marked. As a result, Down syndrome patients had a short stature with a quite normal weight. These reference curves, available since prenatal diagnosis of Down syndrome is performed routinely, are helpful for monitoring normal and abnormal development in Down syndrome patients.     

Aerobic work capacity of mentally retarded boys and girls in junior high schools.

The maximal oxygen uptake (Vo2 max) and ergometer load at a heart rate of 170 beats/min (PWC170) were determined in mentally retarded children (74 boys and 53 girls) of ages 12-15, whose IQ ranged from 36 to 91, and the results were compared with those for normal children. Mentally retarded boys and girls showed significantly inferior body height and weight, but no significant difference was found in skinfold thickness. The mean value of PWC170 for boys and girls was 14.34 kpm/kg/min and 11.31 kpm/kg/min, respectively, significantly less than that of the normal group. The mentally retarded boys had mean VO2 max per unit body weight of 42.4 ml/kg/min, which was significantly less than the 51.2 ml/kg/min of normal boys. The mentally retarded girls had a mean of 33.1 ml/kg/min which was also less than the 41.3 ml/kg/min of normal girls. The correlation coefficient between body weight and PWC170 (kpm/min) was 0.711 and 0.720 for boys and girls, respectively, while that between body weight and VO2 max (liter/min) was 0.641 for boys and 0.656 for girls. No significant correlation was found between IQ and PWC170 (kpm/kg/min) nor between IQ and VO2 max (ml/kg/min) both for boys and for girls. Similarly, no significant correlation was found between mental age and the VO2 max value (ml/kg/min).     

Prevalence of overweight and obesity among the affluent adolescent school children of Amritsar, Punjab

In the present study, an attempt has been made to assess the prevalence of overweight and obesity in adolescent children (between 10-15 years of age) of the affluent families of Amritsar district of Punjab, a state in rapid economic and epidemiological transition. A total of 640 children (323 boys and 317girls) were measured for height and weight. Overweight and obesity were assessed using age and sex-specific body mass index (BMI) cut-off points. 9.91% boys and 11.99% girls were overweight, and 4.95% boys and 6.31% girls were obese. The prevalence of overweight and obesity among the affluent children in Amritsar was as high or higher as in some industrialized countries.     

Weight Status in Childhood as a Predictor of Becoming Overweight or Hypertensive in Early Adulthood**

Objective: To assess the extent to which weight status in childhood or adolescence predicts becoming overweight or hypertensive by young adulthood. Research Methods and Procedures: We conducted a prospective study of 314 children, who were 8 to 15 years old at baseline, and were followed up 8 to 12 years later. Weight, height, and blood pressure were measured by trained research staff. Incident overweight was defined as BMI ≥ 25 kg/m² among participants who had not been overweight as children. Results: More male subjects (48.3%) than female subjects (23.5%) became overweight or obese between their first childhood visit and the young adult follow‐up (p < 0.001). Being in the upper one half of the normal weight range (i.e., BMI between the 50th and 84th percentiles for age and gender in childhood) was a good predictor of becoming overweight as a young adult. Compared with children with a BMI <50th percentile, girls and boys between the 50th and 74th percentiles of BMI were ～5 times more likely [boys, odds ratio (OR) = 5.3, p = 0.002; girls, OR = 4.8, p = 0.07] and those with a BMI between the 75th and 84th percentiles were up to 20 times more likely (boys, OR = 4.3, p = 0.02; girls, OR = 20.2, p = 0.001) to become overweight. The incidence of high blood pressure was greater among the male subjects (12.3% vs. 1.9%). Compared with boys who had childhood BMI below the 75th percentile, boys between the 75th and 85th percentiles of BMI as children were four times more likely (OR = 3.6) and those at above the 85th percentile were five times more likely (OR = 5.1) to become hypertensive. Discussion: High normal weight status in childhood predicted becoming overweight or obese as an adult. Also, among the boys, elevated BMI in childhood predicted risk of hypertension in young adulthood.     

Growth, bone maturation and height prediction after three years of therapy with the slow release GnRH-agonist Decapeptyl-Depot in children with central precocious puberty.

More than 100 patients with central precocious puberty are participating in this international multicenter study using monthly i.m. injections of the slow-release GnRH agonist Decapeptyl-Depot. In 15 patients, Decapeptyl-Depot treatment could be discontinued after 2 years of therapy. Gonadal suppression was promptly reversible in all of them, as shown by prepubertal low gonadotrophin- and sex steroid levels. Of the remaining 90 patients, 40 have been treated for more than 3 years, including 33 girls and 7 boys. Plasma levels of LH, FSH, estradiol and testosterone dropped to the prepubertal range after one month of Decapeptyl-Depot and remained there for the whole period of therapy. At start of therapy, mean chronologic age of these 40 children was 6.6 +/- 1.4 (SD) years, mean bone age 10.2 +/- 1.9 years. Mean predicted adult height increased in the boys from 173.6 +/- 13.8 (SD) cm at start of therapy to 184.6 +/- 17.0 cm after 3 years. Predicted adult height increased in girls from 158.0 +/- 12.2 to 161.0 +/- 7.5 cm. Undue side effects were not seen, long term tolerance was good. It is concluded that Decapeptyl-Depot injected i.m. every 4 weeks suppresses the pituitary-gonadal axis in children with central precocious puberty without clinical or biochemical escapes, and leads to an increase in predicted adult height by more than 3 cm in all boys and in 53% of the girls after three years of treatment.     

Height, weight, and lines of arrested growth in young Guatemalan children

A cross-sectional study of height, weight and skeletal maturity as judged from radiographs of hand and wrist, of 1,412 children under seven years of age (694 boys and 718 girls) living in rural Guatemala was performed. Height and weight were compared to standards prepared by the Institute of Nutrition of Central America and Panama (INCAP). Skeletal age was assessed by the Tanner-Whitehouse and the Greulich and Pyle methods. All x-rays were read by the senior author. The children surveyed were significantly shorter and lighter than well noruished Guatemalan children. Differences were evident by age six months and at a maximum by age five years. Both methods showed skeletal age to lag behind chronological age so that the Guatemalan rural children mature at slower rates than either the British children or the Ohio, U.S.A., children, from whom the two sets of standards were developed. Children of both sexes with radio-opaque transverse lines at the metaphysis showed a consistent tendency to be shorter than children without such lines. Boys but not girls showed similar trends for weight. In general, the data are consistent with the view that the physical development in boys is more severely retarded by an adverse environment than that of girls.     

Zinc,copper, selenium,and glutathione peroxidase in blood of 11-yr-old dunedin,New Zealand children

Blood was obtained from 564 11-yr-old children who had participated since birth in a multidisciplinary health and development study. Serum zinc concentration did not differ between the boys and the girls (mean±SD: 91=17 μg/100 mL,n=453). Five-6% of serum zinc values were low; although there was a weak correlation with height, none of the boys with low values were below the 10th percentile for height for this group. Serum copper concentration (112±24 μg/100 mL,n=454) was unrelated to sex, height, weight, body mass index, socioeconomic status (SES), or iron status. Blood selenium concentration (49±10 ng/mL,n=564) was lower than previously reported for Dunedin children; it was higher in children in the lower SES categories. The data represent normal values for healthy, 11-yr-old NZ children.     

BMI and Waist Circumference; Cross-Sectional and Prospective Associations with Blood Pressure and Cholesterol in 12-Year-Olds

Objective

Childhood and adolescent overweight, defined by body mass index (BMI) are associated with an increased risk of cardiovascular disease in later life. Abdominal adiposity may be more important in associations with cardiovascular diseases but waist circumference (WC) has been rarely studied in children. We studied associations between BMI and WC and blood pressure (BP) and cholesterol in 12-year-old children and prospectively changes in BMI or WC status between age 8 and 12 years and BP and cholesterol at age 12.

Study Design

Weight, height, WC, BP and cholesterol concentrations were measured in 1432 children at age 12 years. Linear regression was used to study the associations between high BMI and large WC (>90^th percentile) and BP and cholesterol.

Results

Systolic BP was 4.9 mmHg higher (95% (CI 2.5, 7.2) in girls and 4.2 mmHg (95%CI 1.9, 6.5) in boys with a high BMI. Large WC was also associated with higher systolic BP in girls (3.7 mmHg (95%CI 1.3, 6.1)) and boys (3.5 mmHg (95%CI 1.2, 5.8)). Diastolic BP and cholesterol concentrations were significantly positively (HDL cholesterol negatively) associated with high BMI and large WC, too. Normal weight children with a history of overweight did not have higher blood pressure levels or adverse cholesterol concentrations than children that were normal weight at both ages.

Conclusion

A high BMI and large WC were associated with higher BP levels and adverse cholesterol concentrations. WC should be taken into account when examining cardiovascular risk factors in children.     

Growth charts for Croatian school children and secular trends in past twenty years

The aim of this study was to construct new Croatian growth charts for body height and weight of boys and girls aged 6.5 to 18.5 years and to investigate differences between our and pre-existing studies. Analysis was based on a multistage stratified sample representative for school children aged 6.5 to 18.5, 6046 boys and 5656 girls. Growth reference was constructed using LMS method. Present results demonstrated an increment of body height and weight during the last two decades. Highest increase of body height is in boys aged 13-14 years 6.5 cm, in girls aged 12 years is 5.0 cm. Highest increase of body weight is in 16 year age group of boys 8.7 kg and in 11-12 year age group of girls 5.2 kg. In conclusion, regarding presence of secular trend because previously used growth charts in Croatia are obsolete.     

Sex difference in the effect of puberty on the relationship between fat mass and bone mass in 926 healthy subjects, 6 to 18 years old

Objective: Understanding factors influencing bone mineral accrual is critical to optimize peak bone mass during childhood. The epidemic of pediatric obesity and reported higher incident of fracture risk in obese children led us to study the influence of fat mass on bone mineral content (BMC) in children. Research Methods and Procedures: Height; weight; pubertal stage; and BMC, non‐bone fat‐free mass (nbFFM), and fat mass (FM) by DXA were obtained in a multiethnic group of healthy children (444 girls/482 boys; 6 to 18 years old) recruited in the New York metropolitan area. Regression techniques were used to explore the relationship between BMC and FM, with age, height, nbFFM, pubertal stage, sex, and ethnicity as covariates. Results: Because there were significant sex interactions, separate regression analyses were performed for girls and boys. Although ln(nbFFM) was the greatest predictor of ln(BMC), ln(FM) was also a significant predictor in prepubertal boys and all girls but not in pubertal boys. This effect was independent of ethnicity. Discussion: FM was a determinant of BMC in all girls but in only prepubertal boys. Our study confirms nbFFM as the greatest predictor of BMC but is the first to find a sex difference in the effect of puberty on the relationship of FM to BMC. Our results suggest that, in two individuals of the same sex and weight, the one with greater fat mass will have lower BMC, especially pubertal boys. The implications of these findings for achievement of optimal peak bone mass in a pediatric population with an unprecedented incidence of overweight and “overfat” status remain to be seen.