Sampling Schemes for Studying Growth of Children

Efficiency of linked cross-sectional scheme has been compared with pure longitudinal schemes for generalised estimation of norm relaxing the condition of constancy of variances. The relevant theory of estimation has been developed and the expression for the optimum estimators alongwith their variances have been derived. The percentage gain in efficiency has been calculated. It has been observed that for higher values of Q, percentage gain in efficiency of proposed scheme over cross-sectional is very high.     

Growth Hormone Secretion in Growth-retarded Asthmatic Children

The serum growth hormone response to Bovril was studied in 12 growth-retarded children with severe asthma, and was found to be normal. Eight children who were receiving corticosteroids had been small for their age before starting steroid treatment. It is concluded that there is no case for treating growth-retarded asthmatic children with growth hormone.     

重组人生长激素治疗生长激素缺乏症的疗效观察

目的：正确评价重组人生长激素（rhGH）治疗儿童生长激素缺乏症（GHD）的疗效。方法：GHD患儿47例,给予rhGH0．1U／（kg．d）,疗程3个月,并对其疗效进行观察。结果：身高（height）由（122±17．67）cm增至（125．32±17．50）cm,生长速率（growthrate）由〈4cm／年增加到（10．40±3．74）cm／年。血清碱性磷酸酶（AKP）由（207±48．11）IU／L增至（261±45．29）IU／L。I型前胶原羧基端伸展肽（PICP）由（97．80±14．94）ng／ml增至（119．50±24．10）ng／ml值。肌酐（Cr）由（40．20±8．28）umol／L变为（36．50±8．33）umol／L值。结论：rhGH是治疗GHD有效的药物。     

Linked Cross Sectional Schemes for Estimating Growth of Children

For estimation of growth, the efficiency of linked cross sectional scheme has been compared with pure longitudinal and cross sectional schemes. The relevant estimation theory has been developed and the expressions for the optimum estimators alongwith their variances have been derived. It has been observed that for estimation of growth, the linked cross-sectional scheme has been observed to be less efficient as compared to pure longitudinal scheme but more efficient than pure cross-sectional scheme.     

Association of Daily Growth Hormone Injection Adherence and Height Among Children With Growth Hormone Deficiency

ObjectiveRecombinant human growth hormone (somatropin) is recommended for children with growth hormone deficiency (GHD) to normalize adult height. Prior research has indicated an association between adherence to somatropin and height velocity. Further research is needed using real-world data to quantify this relationship; hence the objective of this study was to investigate the association between adherence to somatropin and change in height among children with GHD.MethodsThis retrospective cohort study included patients in the IQVIA PharMetrics Plus and Ambulatory Electronic Medical Records databases aged 3 to 15 years, with ≥1 GHD diagnosis code claim and newly initiated on somatropin between January 1, 2007 and November 30, 2019. Adherence was measured over the follow-up using the medication possession ratio (MPR); patients were classified as adherent (MPR ≥ 0.8) or nonadherent (MPR < 0.8).ResultsAmong 201 patients initiated on somatropin, 74.6% were male, mean age was 11.4 years, and the mean follow-up was 343.3 days. Approximately 76.6% of patients were adherent to somatropin over the follow-up period. Adjusted growth trajectories were similar between adherent and nonadherent patients pre-treatment initiation (P = .15). Growth trajectories post-initiation were significantly different (P = .001). On average, adherent patients gained an additional 1.8 cm over 1 year compared with nonadherent patients, adjusted for covariates.ConclusionGreater adherence to somatropin therapy is associated with improved height velocity. As suboptimal adherence to daily somatropin therapy is an issue for children with GHD, novel strategies to improve adherence may improve growth outcomes.     

Longitudinal Lung Function Growth of Mexican Children Compared with International Studies

Introduction

Our aim was to compare the longitudinal lung function growth of Mexican children and adolescents with the collated spirometric reference proposed for international use and with that of Mexican-Americans from the National Health State Examination Survey III (NHANES) III study.

Materials and Methods

A cohort of Mexican children in third year of primary school was followed with spirometry twice a year through secondary school. Multilevel mixed-effects lineal models separated by gender were fit for the spirometric variables of 2,641 respiratory-healthy Mexican children expressed as Z-scores of tested reference equations. Impact of adjustment by sitting height on differences with Mexican-American children was observed in a subsample of 1,987 children.

Results

At same gender, age, and height, Mexican children had increasingly higher forced expiratory volume in 1 s (FEV₁) and Forced vital capacity (FVC) than the children from the collated reference study (mean Z-score, 0.68 for FEV₁ and 0.51 for FVC) and than Mexican-American children (Z-score, 0.23 for FEV₁ and 0.21 for FVC) respectively. Differences with Mexican-Americans were not reduced by adjusting by sitting height.

Conclusions

For reasons that remain unclear, the gender-, age-, and height-adjusted lung function of children from Mexico City is higher than that reported by several international studies.     

Growth Pattern and Dietary Intake of Children with Chronic Renal Insufficiency

The growth pattern and dietary intake of 33 children with varying degrees of renal insufficiency has been investigated. The development of impaired renal function in infancy has a more deleterious effect on linear growth than has its onset in later years. A reduction in growth velocity may occur once the glomerular filtration rate falls below 25 ml/min/1·73m². There was a significant reduction of the energy, protein, and vitamin D intakes of children with renal insufficiency compared with those recommended for their age, and of energy intake compared with that of normal children of their own height. Reduced growth velocity occurred when energy intake fell below 80% of that recommended. The reduction in the intake of energy and nutrients in these children may in part be responsible for their growth retardation.     

Secular Change in the Growth and Sexual Maturation of Hungarian Children

The purpose of this paper is to provide a summary of contributions on secular change in the growth pattern of Hungarian children and youth over the past 100 years. We note how some absolute body dimensions have changed and what modifications are discernible in the rate of growth and comment on the effects these had on body shape. We also touch upon the inferences about the timing of the secondary sex characteristics and the age at menarche and oigarche. Under the assumption that growth and maturation patterns depend on the environment, we analyse and compare the growth data of subpopulations living under diverse socio-economic conditions. We also attempt to outline divergent trends in their physical development.     

Association between Decreased Klotho Blood Levels and Organic Growth Hormone Deficiency in Children with Growth Impairment

Objective

Klotho is an aging-modulating protein expressed mainly in the kidneys and choroid plexus, which can also be shed, released into the circulation and act as a hormone. Klotho deficient mice are smaller compared to their wild-type counterparts and their somatotropes show marked atrophy and reduced number of secretory granules. Recent data also indicated an association between klotho levels and growth hormone (GH) levels in acromegaly. We aimed to study the association between klotho levels and GH deficiency (GHD) in children with growth impairment.

Design

Prospective study comprising 99 children and adolescents (aged 9.0±3.7 years, 49 male) undergoing GH stimulation tests for short stature (height-SDS = −2.1±0.6). Klotho serum levels were measured using an α-klotho ELISA kit.

Results

Klotho levels were significantly lower (p<0.001) among children with organic GHD (n = 11, 727±273 pg/ml) compared to both GH sufficient participants (n = 59, 1497±754 pg/ml) and those with idiopathic GHD (n = 29, 1645±778 pg/ml). The difference between GHS children and children with idiopathic GHD was not significant. Klotho levels positively correlated with IGF-1- standard deviation scores (SDS) (R = 0.45, p<0.001), but were not associated with gender, pubertal status, age or anthropometric measurements.

Conclusions

We have shown, for the first time, an association between low serum klotho levels and organic GHD. If validated by additional studies, serum klotho may serve as novel biomarker of organic GHD.     

Reference Growth Curves for Cypriot Children 6 to 17 Years of Age

Objective: The purpose of the study was to present smoothed percentiles for body weight and height, waist circumference, and body mass index (BMI) in Cypriot children and to compare their BMI 85th and 95th percentiles with those of children in other countries. Research Methods and Procedures: The study was a cross‐sectional study, including a representative sample of 2472 healthy children (49.1% boys) in Cyprus ages 6 to 17 years, who were evaluated during the 1999–2000 school year. Body weight and height and waist circumference were measured using standard procedures. BMI was calculated as weight in kilograms per height in square meters. Smoothed, sex‐specific percentiles for these variables were calculated using polynomial regression models. Crude weight, height, waist, and BMI percentile values are presented in sex‐specific tables and smoothed percentile curves are presented in charts. The 85th and 95th percentiles for BMI were compared with measurements from other countries, because of the concern of the upper limits of BMI in respect to the evaluation of obesity. Results: The 85th and 95th BMI percentile values are higher in Cypriot boys than in Swedish and Iranian boys through all ages and in girls ages 6 to 15 years, whereas after the age of 15 years, both Swedish and Iranian girls’ percentiles are equalized with their Cypriot peers. Discussion: Weight, height, waist circumference, and BMI values and charts are presented for the first time for Cypriot children and adolescents. Much concern should be addressed to the observation that for the majority of the Cypriot sample, the upper BMI limits are higher than the peers of developing and developed countries.     

Accelerated Growth in Early Life and Obesity in Preschool Chilean Children

In Chile, childhood obesity rates are high. The purpose of this article is to compare BMI growth characteristics of normal (N), overweight (OW), and obese (OB) 5‐year olds from 0 to 5 years and explore the influence of some prenatal factors on these patterns of growth. The study was done on a retrospective cohort of 1,089 5‐year olds with birth weight >2,500 g. Weight and height were obtained from records at nine occasions (0–36 months); at 52 and 60 months, we measured them. At 60 months, children were classified as N, OW, and OB. At each age, BMI and z‐score of BMI (BMI Z) differences were compared among groups. The influence of birth weight, pre‐pregnancy BMI, and prenatal variables (weight gain, smoking, and presence of diabetes and preeclampsia) on BMI Z differences between N and OB was also explored. Adiposity rebound (AR) was not observed for the N, although for the OW, it occurred ～52 months and for the OB at ～24 months. BMI Z differences between N and OB were significant from birth, but were greatest between 6–12 and 36–52 months. Additional adjustment by birth weight, pre‐pregnancy BMI, and prenatal variables decreased the BMI Z differences for the first 24 months with virtually no effect after this age. Accelerated growth in OB children from post‐transition countries occurs immediately after birth, much earlier than the AR. The influence of prenatal factors on adiposity acquisition may extend at most until 2 years of life, although BMI gains thereafter are more related to postnatal variables.