Reproducibility of anthropometric measurements in children: a longitudinal study

The purpose of this study was to establish the reproducibility of a series of anthropometric measures performed twice during one week during a three year period in boys and girls. The subjects of this investigation were 39 children (21 boys and 18 girls), 9-10 year of age at the beginning of the study. Children were measured three times with one year interval. Children were classified by Tanner stage 1-2 during the first measurements, stage 1-3 during the second measurements and stage 1-4 during the third measurements. Body height and weight were measured and BMI calculated. All anthropometric parameters were measured according to the protocol recommended by the International Society for the Advancement of Kinanthropometry (Norton & Olds 1996). Nine skinfolds, 13 girths, eight lengths and eight breadths/lengths were measured. The reproducibility of body height (r = 0.995-0.999), body weight (r = 0.990-0.999) and BMI (r = 0.969-0.999) was very high in boys and girls. The intraclass correlations (ICC), technical errors (TE) and coefficients of variation (CV) were quite different depending on the measurement site of the skinfold thickness. It was surprising that the ICCs were highest and TEs and CVs were lowest during the second year of the measurement. The computed ICC was high, and TE and CV values were quite similar and relatively low in girth, length and breadth/length measurements. It was concluded that the reproducibility of girths, lengths and breadths/lengths in children is very high and the reproducibility of skinfolds is high. Specifically, the reproducibility is very high immediately before puberty in boys and girls.     

Waist circumference cutoff points in school-aged Chinese Han and Uygur children

Objective: To examine the distribution of age‐ and gender‐specific waist circumference (WC) and to identify optimal cutoffs for predicting cardiovascular (CV) risk factors in Chinese Han and Uygur children. Methods and Procedures: In total 4,224 Han and Uygur children aged 7–18 were randomly selected from schools in Urumqi city, China. WC, height, and weight were accurately measured in all subjects. Blood pressure, fasting lipids, glucose, and insulin were determined in 258 overweight/obese children and 370 age‐, gender‐, and ethnicity‐matched normal‐weight controls selected from the same study sample. LMS (lambda‐mu‐sigma) method was used to construct WC centile curves. Optimal WC cutoffs were determined by comparing the performance of five sets of WC cutoffs in predicting CV risk factors. Results: Han boys and girls had higher WC at all percentiles and ages except for girls over the age of 16. Uygur girls also showed a greater increase in WC corresponding with age (2.1 cm/year vs. 1.6 cm/year for the median) than Han girls. Compared with the other four sets of cutoffs, the 85th WC percentile showed the best combination of sensitivity (81.0%) and specificity (71.4%). The two sets of WC cutoffs constructed by allowing centile curves passing through the adult cutoffs for central adiposity using the fitted LMS curves provided poor sensitivities in predicting the presence of cluster of CV risk factors. Discussion: The growth pattern of WC varies with gender and ethnicity. The 85th percentile of WC is an appropriate cutoff for Chinese Han and Uygur children in the prediction of CV risks.     

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     

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.     

Estimating height from arm span measurement in Malawian children

Arm span and standing height were measured in 289 boys and 337 girls aged 6-15 years who were free from physical deformities which can affect stature or arm span. The arm span exceeded height in all age groups of boys and in older girls. At the age of 7, 11 and 12 years girls were significantly taller than the boys and had longer arm span while at the age of 15 years, the trend was opposite. The mean difference between the two anthropometric parameters for boys was 5.45 +/- 4.21 cm (t = 3.556, p < 0.001) and for girls was 4.94 +/- 4.96 cm (t = 3.542, p < 0.001). Correlation coefficient between height and arm span measurements for Malawian boys was 0.983 and for girls was 0.986. Height, arm span and height-arm span difference increased with age of children while height to arm span ratio decreased. The gender difference in height-arm span differences was only significant at the age of 15 years. Multiple regression and cross validation were performed. Height of Malawian children of both sexes can be estimated from equation: Height (cm) = 15.756 + (0.168 x age) + (0.839 x arm span) (SEE = 0.760, R2 = 0.988).     

儿童身高生长追踪研究

以北京市106名儿童为样本 ,为研究各年龄生长速度的集中趋势、变异状况以及与生长速度有关的参数 ,追踪观察这些儿童自6、7岁至 18岁时共12年的身高变化 ,并做有关参数分析。报告了各年龄组身高生长速度的均值及标准差 ,该组儿童身高生长突增开始年龄 (男10.73±1 .12岁 ,女 9.00± 1.18岁 )及速度 (男4.51± 0.65cm/年 ,女 4.95± 0.79cm/年 ) ;身高生长高峰发生年龄 (男 1 3.0 7±1.08岁 ,女11.32± 1.32岁 )及速度高峰值 (男10 .01± 1.59cm/年 ,女8.13± 1.03cm/年 ) ;以及生长突增结束年龄 (男16.18± 1.02岁 ,女 13.96± 1.09岁 )。分析了最终身高与生长突增有关指标的相关关系。     

Causes of precocious puberty in children referred for evaluation in hospital conditions

INTRODUCTION: Symptoms of precocious puberty (PP) in children always arouse anxiety in their parents. Many children with PP are being hospitalized for the detailed diagnostic work-up. The aim of our study was to analyze the frequency of the variants of PP in children referred to our department. MATERIAL: Retrospective analysis of 119 children (103 girls and 16 boys) referred for hospitalization in the years 2003-2005 due to signs of precocious puberty was performed. RESULTS: Premature thelarche, benign variant of puberty, was diagnosed in 62 (53%) girls, in the mean age of 3.39 (+/- 2.33) years. Their mean height was within 0.7 +/- 1.1 SD. Premature pubarche was diagnosed 30 (25%) children--22 girls and 8 boys in the mean age was 7.24 (+/- 0.81) years. Their mean height was 1.3 +/- 1.0 SD and was significantly higher than normal (p < 0.0001). Premature menarche was diagnosed in 8 (7%) girls in the mean age 4.81 +/-2.26 years. Mean height in this group was normal for age (0.9+/-0.8 SD). PP was diagnosed in 19 (16%) children (11 girls and 8 boys) in the mean age 5.91 +/- 1.63 years. Mean height in this group was 1.6 +/- 0.7 SD, and was significantly higher than the mean for age (p<0.0005). GnRH-dependent type was present in 15 children, diagnosed as idiopathic in 9 girls and 1 boy. In 5 children (4 boys and 1 girl) pathology of central nervous system was found. In 4 children GnRH-independent precocious puberty was diagnosed--in 3 caused by congenital adrenal hyperplasia and in 1 boy by tumour of testis (leydigioma). CONCLUSIONS: Girls with precocious thelarche without growth acceleration present the benign variant of puberty and need clinical follow up only. Boys with clinical signs of precocious puberty should be carefully evaluated to rule out the organic cause.     

Clinical standards for growth velocity in height of Belgian boys and girls,aged 2 to 18 years

The present paper presents the first clinical standards for growth velocity in height of Belgian boys and girls, based on purely longitudinal data. Growth charts are provided with centiles of height for age, along with the growth velocity curves of the typical early, average and late maturing child in the population. These new growth velocity standards provide centile lines which allow to judge whether a child's growth velocity over a one-year interval lies within the limits of normal variation for his age, irrespective of his stage of maturation. They also provide information about variability in the individual patterns of growth velocity in the population and can, as such, also be used to evaluate the normality of a child's pattern in growth velocity over a longer period of time. Age at peak velocity occured in 95% of the children within an age range of about 4 years. The average age at peak height velocity at puberty was 14.0 years (S.D.=1.0) in boys and 11.6 years (S.D.=0.9) in girls. Peak height velocity was in the average 9.1 cm/year (S.D.=1.4) in boys and 7.5 cm/year (S.D.=1.1) in girls. The representativity of these new standards with respect to the actual Belgian population was tested by comparison with recent cross-sectional data, collected on a large number of subjects. These new charts will find useful applications in longitudinal health screening surveys, and in clinical follow-up studies, where interest lies in the examination of a child's growth retardation in relation to some disease, or catch-up growth, as a response to subsequent medical treatment.     

Growth hormone treatment in short Japanese children born small for gestational age

Recent reports have shown that high-dose growth hormone (GH) treatment in short children born with small for gestational age (SGA) resulted in a pronounced acceleration of linear growth. We describe the results of multicenter trials of recombinant human GH (rhGH) treatment in short SGA children in Japan. Two clinical studies were performed and the results were combined. Study 1 comprised 104 SGA children and study 2 comprised 61 SGA children. The patients were divided into three groups: group 1 consisted of 20 patients (13 boys and 7 girls) who received rhGH 25 microg/kg per day six or seven times per week in the first year and 50 microg/kg per day in the second year and thereafter; group 2 consisted of 48 patients (28 boys, 20 girls) who received rhGH 45/50 microg/kg per day; group 3 consisted of 44 patients (28 boys, 16 girls) who received 90/100 microg/kg per day. The mean increments in height SDS were 0.46, 0.67 and 0.94 SD in boys and 0.49, 0.79 and 0.93 SD in girls in groups 1, 2 and 3, respectively. The mean increment in height SDS at 2 years in group 3 was significantly greater than that in group 1, but it was not significantly different from that in group 2 in boys and girls. Our data demonstrated that high-dose GH administration significantly improved height velocity and height SDS in short SGA children. Additional studies are necessary to optimize a long-term GH treatment regimen and combined luteinizing hormone releasing hormone analog treatment for final height. Careful observation is also necessary to assess the metabolic effects of high-dose GH, especially on carbohydrate metabolism.     

Physical Activity,Obesity, and Cardiovascular Risk Factors in Children. The Belgian Luxembourg Child Study II

GUILLAUME, MICHÈLE, LEIF LAPIDUS, PER BJÖRNTORP, ANDRE LAMBERT. Physical activity, obesity, and cardiovascular risk factors in children. The Belgian Luxembourg Child Study II. Physical activity was measured in relation to cardiovascular (CV) risk factors in a randomly selected population of 1028 children from Province de Luxembourg in Belgium, a mainly rural area with a high prevalence of such risk factors among adults and children. Physical activity was estimated as participation in sport activities, a major indicator of leisure-time physical activity in schoolchildren, and physical inactivity was estimated as frequency and duration of television (TV) watching. Boys participated more frequently in sport activities than girls did (p=0. 001). A majority of the children watched TV daily. After age adjustment, bodyweight (girls, p<0. 012; boys, p<0. 027) and, in boys, body mass index (BMI) (p<0. 039) were related to days per week of TV watching. No significant relationships with other CV risk factors remained after adjustments for BMI. In analyses of independent contributions of age, TV watching, and sports activity on CV risk factors, age showed highly significant relationships. In boys, TV showed relationships with BMI (P<0. 04) and (borderline) with systolic blood pressure, independent of age and sports activity, whereas the latter was significantly related to subscapular skinfold (p<0. 04) and (borderline) with triceps skinfold and cholesterol. In girls, no significant independent contributions to risk factor associations were found. The father's education was directly associated with sports activities, whereas the mother being a housewife showed negative relationships to physical activity and positive to TV watching in their children, suggesting socioeconomic influence on the activity patterns of children. Furthermore, registrations suggested less physical activity in the most rural part of the area. It is concluded that children in this mainly rural area watch TV frequently. In boys, physical inactivity, measured both as TV watching and as registrations of sports activities, contributes independently to body fat mass. In girls, no contribution or weaker contributions of physical inactivity were found. This suggests that contributory factors leading to obesity might be different in girls and boys.     

Impact of war on growth patterns in school children in Croatia

The objective of this paper is to present the growth patterns of school children in Osijek--the city which was exposed to severe attacks during the aggression on Croatia. The mean height and weight of Osijek schoolchildren aged 7 to 18 and the menarcheal age in girls in academic year 1995/96 were compared to the analogous data collected in 1980/81. The secular changes in height were heterogeneous. In older age groups from 12 in girls and 13 in boys, the mean height in 1995/96 increased markedly, whereas from 9 to 11 or 12, changes were undulating. In the youngest groups--at the age of 7 in both genders, and at 8 in boys, negative changes were observed. Markedly smaller height in this cohort was still pronounced in 1999/2000 when these children reached the age of 11. However, one year later (2000/01), at the age of 12, boys and girls caught up with their peers in the previous generations. These children during the war were approximately at the age of 2.5 to 4, a period when growth patterns are highly sensitive to adverse environmental influences. It might be possible that the emotional stress caused by a change of environment and separation from home, contributed to the deceleration of growth rate, i.e. the smaller height in a large part of childhood.     

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.     

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.     

Cortical bone loss and measurements of the second metacarpal bone: II. Hypodense bone in postwar Guamanian children

Hand-wrist radiographs from 326 Guamanian children (180 boys and 146 girls) were evaluated for total width, medullary width, length, and combined cortical thickness of the second metacarpal. Bone measurements as well as standing height and weight were compared to similar published data from U.S. mainland black, white, and Mexican-American children. The results demonstrated that the second metacarpal bones of Guamanian boys and girls of all age groups (5–17 years) have a narrower width and shorter length with less combined cortical thickness than any of the other groups. Guamanian children also weighed less and were of shorter stature than their black, white, or Mexican-American counterparts. These results agree closely with those comparisons between Guamanian and U.S. mainland white adults published earlier. It is not possible from the present data to ascertain whether these differences were due to genetic variability or nutritional deficiency.     

Longitudinal analysis of adolescent growth of ladino and Mayan school children in Guatemala: effects of environment and sex.

The rate of growth in height and the timing of adolescent growth events are analyzed for two samples of Guatemalan children. One sample includes Mayan school children, 33 boys and 12 girls between the ages of 5.00 to 17.99 years, living under poor conditions for growth and development. The second sample includes ladino children, 78 boys and 85 girls of the same age range, living under favorable conditions for growth. The Preece-Baines model I function is used to estimate mean values for rates and timing of childhood and adolescent growth events for the two groups. Significant statistical contrasts (t-tests) of these means show Mayan boys reach the age of "take-off" (TO; the onset of the adolescent growth spurt) 1.45 years later, achieve peak height velocity (PHV) 1.68 years later, and continue growing for about 2.0 years longer than do the ladino boys. Despite the Mayan boys' increased duration for growth they grow significantly more slowly than the ladinos. Mayan boys are 6.60 cm shorter than ladinos at the age of TO and are estimated to be 7.71 cm shorter than the ladinos at adulthood. Mayan girls reach the age of TO 0.93 years later than do the ladina girls, but the two groups do not differ in the age at PHV or the age at adulthood. The mean height of Mayan girls is significantly less than that of ladinas at the age of TO (6.5 cm), and this difference increases to an estimated 11.14 cm at adulthood. Possible causes of these ethnic and sex-related differences in amounts and rates of growth are discussed in relation to hypotheses about the genetic and environmental determinants of human development.     

中国汉族儿童生长的长期趋势

本文报告了中国北京、天津、济南、哈尔滨、沈阳、长春、上海、南京、杭州、武汉、广州及成都等12个城市汉族7—18岁儿童生长的长期趋势。 50年代至今,汉族儿童生长的长期趋势是明显的,30年来同年龄儿童身高每10年增长2.66(男)、2.40(女)厘米,体重每10年增长1.64(男)、1.14(女)公斤,近10年来的增长最为显著。生长突增高峰年龄大都提前1—2年。北京、上海、南京、广州、杭州等五所城市自30年代至今,生长长期趋势也是明显的,半个世纪来,每10年增长值,男童身高为1.12—2.66厘米,体重为0.56—1.29公斤,女童身高为1.42—2.67厘米,体重为0.65—1.18公斤。     

Autonomic Regulation of Heart Rate and Distinctive Features of Oculomotor Activity in Eight- to Nine-Year-Old Boys and Girls during the Reading of Texts of Different Complexities

Distinctive features of autonomic regulation of the heart rate and spatiotemporal parameters of eye movements during the reading of texts of different complexities levels from a computer screen have been analyzed in girls and boys eight to nine years of age. Sex-related differences in heart rate variability (HRV) pattern were already observed in the resting state, since parasympathetic effects were stronger in boys than in girls. Parasympathetic activity decreased in boys who were reading texts of different complexities. The most pronounced decrease was observed during the reading of the first (simple) text. The changes in girls were mostly due to an increase in sympathetic activity and were less pronounced than in boys. Oculomotor activity analysis revealed differences in reading process strategy: reading was more fragmented (discrete) in the girls and more integrated in the boys. However, reading skills were not fully developed in children of eight to nine years of age, since “syllabized” reading was observed in girls and boys alike.     

Energy gain and energy gap in normal-weight children: longitudinal data of the KOPS

Population-based prevention of overweight needs evidence-based goals consistent with our present knowledge about energy gap (i.e., daily imbalance between energy intake and energy expenditure resulting in overweight). Longitudinal data of normal-weight children (1,029 girls and 1,028 boys; Kiel Obesity Prevention Study, KOPS) were used to calculate energy gain (i.e., increase in fat mass (FM) and fat-free mass (FFM)) in normal-weight children staying normal weight (persistent children) or becoming overweight (incident children). Taking into account weight gain in proportion to height gain (normal development) energy gap was calculated from increases in FM and FFM exceeding normal development. Children were divided into two groups and were followed from age 6 to 10 (group A) and 10 to 14 years (group B). FM and FFM were measured. Medians of 4-year BMI- (kg/m(2))/weight changes (kg) were +1.8/+13.2 (A) and +3.0/+18.7 (B) in girls, and +1.6/+12.8 (A) and +2.6/21.7 (B) in boys. Corresponding data for FM/FFM (kg) were +3.1/+10.2 (A) and +5.1/12.7 (B) in girls, and +2.3/10.8 (A) and +3.0/18.6 (B) in boys. The 4-year-incidence of overweight (%) were 9.4 (A) and 5.4 (B) in girls, and 11.0 (A) and 3.8 (B) in boys, respectively. Mean energy gains (kcal/day) were 26.8 (A) and 46.4 (B) in girls, and 22.1 (A) and 32.5 (B) in boys. The 90th percentile of energy gap (kcal/day) in incident children were 58.1 (A) and 72.0 (B) in girls and 46.0 (A) and 53.2 (B) in boys. To prevent overweight in children energy gap should not exceed 46-72 kcal/day.