1
|
Chávez-Vázquez AG, Klünder-Klünder M, Lopez-Gonzalez D, Vilchis-Gil J, Miranda-Lora AL. Association between bone age maturity and childhood adiposity. Pediatr Obes 2024:e13166. [PMID: 39187394 DOI: 10.1111/ijpo.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/26/2024] [Accepted: 08/05/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Evidence shows that overweight and obesity are associated with advanced bone age (BA). OBJECTIVE To analyse the effect of adiposity on BA among Mexican children. METHODS This cross-sectional study included 902 children (5-18 years old). Anthropometric measurements, dual-energy X-ray absorptiometry (DXA) and automated hand X-ray-based BA measurements were obtained. BA curves of children stratified by sex and age were created based on nutritional status. We also calculated odds ratios for advanced BA associated with the body mass index (BMI), waist/height ratio and adiposity estimated using DXA (total and truncal fat mass). RESULTS Participants with overweight/obesity by BMI (SDS ≥1) advanced earlier in BA than did normal weight participants (6.0 vs. 12.0 years in boys and 6.0 vs. 10.3 in girls, p < 0.01); similarly, participants with a greater body fat percentage (SDS ≥1) exhibited earlier advanced BA (7.5 vs. 10.0 years in boys and 6.0 vs. 9.6 in girls, p < 0.01). Differences were also observed according to the waist/height ratio and truncal fat. Children with a BMI or DXA SDS ≥1 had greater odds of presenting an advanced BA of more than 1 year (OR 1.79-3.55, p < 0.05). CONCLUSIONS Increased adiposity in children, mainly in boys, is associated with advanced BA at earlier ages.
Collapse
Affiliation(s)
- Ana Gabriela Chávez-Vázquez
- Unit of Epidemiological Research in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Unit of Epidemiological Research in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Desiree Lopez-Gonzalez
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jenny Vilchis-Gil
- Unit of Epidemiological Research in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - América Liliana Miranda-Lora
- Unit of Epidemiological Research in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| |
Collapse
|
2
|
Gårdstedt-Berghog J, Niklasson A, Sjöberg A, Aronson AS, Pivodic A, Nierop AFM, Albertsson-Wikland K, Holmgren A. Timing of menarche and pubertal growth patterns using the QEPS growth model. Front Pediatr 2024; 12:1438042. [PMID: 39210984 PMCID: PMC11357948 DOI: 10.3389/fped.2024.1438042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/11/2024] [Indexed: 09/04/2024] Open
Abstract
Objectives To explore the timing of menarche, postmenarcheal growth, and to investigate the impact of various variables on menarcheal age and postmenarcheal and pubertal growth. Study Design This longitudinal community population-based study analyzed pubertal growth and menarcheal age in 793 healthy term-born Swedish girls, a subset of the GrowUp1990Gothenburg cohort. The timing of menarche and postmenarcheal growth was related to variables from the Quadratic-Exponential-Pubertal-Stop (QEPS) growth model, birth characteristics, and parental height. Multivariable models were constructed for clinical milestones; at birth, age 7 years, pubertal growth onset, and midpuberty. Results Menarche aligned with 71.6% (18.8) of the QEPS model's specific pubertal growth function, at a mean age of 13.0 (1.3) years, ranging from 8.2 to 17.2 years. Postmenarcheal growth averaged 8.0 (4.9) cm, varying widely from 0.2 to 31.1 cm, decreasing with later menarche. Significant factors associated with menarcheal age included height at 7 years, childhood body-mass index, parental height, and QEPS-derived pubertal growth variables. Multivariable models demonstrated increasing explanatory power for each milestone, explaining 1% of the variance in menarcheal age at birth, 8% at age 7 years, 44% at onset of pubertal growth, and 45% at midpuberty. Conclusions This study underscores the strong link between pubertal growth and age at menarche. Data available at start of puberty explain 44% of the variation in menarcheal age, apparent on average 3.2 years before menarche. In addition, the study shows a previously seldom noticed wide variation in postmenarcheal height gain from 0.2 to 31.1 cm.
Collapse
Affiliation(s)
- Jenni Gårdstedt-Berghog
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Gynecology and Obstetrics, Halmstad Hospital, Halmstad, Sweden
| | - Aimon Niklasson
- Gothenburg Pediatric Growth Research Center (GP-GRC), Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Agneta Sjöberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - A. Stefan Aronson
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Gothenburg Pediatric Growth Research Center (GP-GRC), Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aldina Pivodic
- APNC Sweden, Gothenburg, Sweden
- Department of Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas F. M. Nierop
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Muvara bv, Multivariate Analysis of Research Data, Leiderdorp, Netherlands
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anton Holmgren
- Gothenburg Pediatric Growth Research Center (GP-GRC), Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Halmstad Hospital, Halmstad, Sweden
- Department of Research and Development, Region Halland, Halmstad, Sweden
| |
Collapse
|
3
|
Putri RR, Danielsson P, Marcus C, Hagman E. Height and Growth Velocity in Children and Adolescents Undergoing Obesity Treatment: A Prospective Cohort Study. J Clin Endocrinol Metab 2023; 109:e314-e320. [PMID: 37453086 PMCID: PMC10735311 DOI: 10.1210/clinem/dgad419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
CONTEXT Pediatric obesity affects endocrine conditions, which may alter growth. OBJECTIVE This work aimed to investigate the effect of obesity severity and obesity treatment outcome on growth. METHODS This prospective cohort study included children (aged 3-18 years) enrolled in the Swedish Childhood Obesity Treatment Register (BORIS) (1998-2020). Obesity was categorized as class I and class II obesity. Obesity treatment outcome was measured as body mass index (BMI) z score changes and categorized into good (BMI z score reduction of ≥0.25), intermediate, and poor (increasing BMI z score). Height for age z score, final height, and growth velocity were compared between class I and class II obesity. Further, the effect of obesity treatment outcome on growth velocity during 2-year follow-up was assessed. RESULTS A total of 27 997 individuals (mean age 10.2 ± 3.6 years) were included. Individuals with class II obesity were on average taller than those with class I obesity during childhood. Among males, reduced growth spurt was observed in class I obesity, and even absent in class II obesity. Females exhibited a similar but less pronounced pattern. Good obesity treatment outcome yielded lower growth velocity at ages 3 to 9 years but higher growth velocity at ages 10 to 13 years compared to poor treatment outcome. CONCLUSION Obesity severity is positively associated with height and growth velocity in childhood. A hampered growth spurt during puberty should be anticipated, particularly in adolescents with severe obesity. Therefore no difference in final height between class I and class II obesity is expected. Successful obesity treatment does not harm, but rather normalizes, the growth velocity pattern.
Collapse
Affiliation(s)
- Resthie R Putri
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm 141 57, Sweden
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm 141 57, Sweden
| | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm 141 57, Sweden
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm 141 57, Sweden
| |
Collapse
|
4
|
Zhang Y, Yuan X, Yang X, Lin X, Cai C, Chen S, Ai Z, ShangGuan H, Wu W, Chen R. Associations of Obesity With Growth and Puberty in Children: A Cross-Sectional Study in Fuzhou, China. Int J Public Health 2023; 68:1605433. [PMID: 37255545 PMCID: PMC10225596 DOI: 10.3389/ijph.2023.1605433] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/05/2023] [Indexed: 06/01/2023] Open
Abstract
Objectives: To investigate the associations of obesity with growth and puberty in children. Methods: From November 2017 to December 2019, height, weight, and Tanner stages of 26,879 children aged 3-18 years in Fuzhou, China were assessed. Results: The obese group was significantly taller than the non-obese group after age 4 years for both genders, yet there was no significant difference in height between obese and non-obese group after 15.5 years old for boys and 12.5 years old for girls. The inflection points of significant growth deceleration in obese and non-obese groups were 14.4 and 14.6 years old for boys, and 11.8 and 12.8 years old for girls, respectively. The proportions of testicular development in boys with obesity and non-obesity were 7.96% and 5.08% at 8.5-8.9 years old, respectively, while the proportions of breast development in girls were 17.19% and 3.22% at age 7.5-7.9 years old, respectively. Conclusion: Children with obesity were taller in early childhood, earlier onset of puberty and earlier cessation of growth than children with non-obesity of the same age. However, there was sex dimorphism on the effect of obesity on the incidence of precocious puberty.
Collapse
|
5
|
Fäldt A, Nejat S, Edvinsson Sollander S, Durbeej N, Holmgren A. Increased incidence of overweight and obesity among preschool Swedish children during the COVID-19 pandemic. Eur J Public Health 2023; 33:127-131. [PMID: 36479865 PMCID: PMC9898009 DOI: 10.1093/eurpub/ckac181] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had wide effects on child health globally. Increased prevalence of childhood obesity has been observed by a number of countries during the pandemic. The absence of a formal societal lockdown during the pandemic, made Sweden stand out compared to other countries. This study aims to examine changes in BMI among preschool children in Sweden before and during COVID-19 pandemic. METHODS Retrospective population-based cross-sectional study, with longitudinal follow-up for a portion of the children. The study included 25 049 children from three Swedish regions, with growth measures at 3- (n = 16 237), 4- (n = 14 437) and 5-years of age (n = 11 711). Care Need Index was used as a socioeconomic parameter at health centre level. RESULTS There was an increase in BMI in children aged three (P = 0.028) and four (P<0.001) during the COVID-19 pandemic. Obesity in 3-year-old girls increased from 2.8% to 3.9%. Four-year-olds increased in obesity, and overweight (girls) and the prevalence of underweight decreased in boys. No change in BMI was observed in 5-year-olds. Children in areas of low socioeconomic status had higher risk of obesity. CONCLUSIONS Overweight and obesity increased among 3- and 4-year-old children in Sweden, findings that were accentuated in children attending child health centres in areas with lower socioeconomic status. The COVID-19 pandemic is likely to have affected health behaviours negatively in Swedish preschool children. Our results expose the need for extended efforts directed to prevent childhood obesity, especially targeting lower socioeconomic areas.
Collapse
Affiliation(s)
- Anna Fäldt
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden
| | - Sahar Nejat
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden.,Paediatric Public Health Unit, Sachs Children's Hospital, Stockholm, Sweden
| | - Sofia Edvinsson Sollander
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden.,Department of Pediatrics, Östersund Hospital, Östersund, Sweden.,Public Health Unit, Östersund Hospital, Östersund, Sweden
| | - Natalie Durbeej
- Department of Public Health and Caring Sciences, Uppsala University, Child and Health Parenting (CHAP), Uppsala, Sweden
| | - Anton Holmgren
- GP-GRC, Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Halland Hospital, Halmstad, Sweden.,Department of Research and Development, Region Halland, Halmstad, Sweden
| |
Collapse
|
6
|
Analysis of the Relationship between Nutritional Status and Bone Age and Sexual Development in Children and Adolescents. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8325756. [PMID: 36062175 PMCID: PMC9436596 DOI: 10.1155/2022/8325756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022]
Abstract
Purpose To observe the correlation between nutritional status, bone age, and sexual development in children and adolescents. Methods 895 children and adolescents who underwent physical examination in the growth and development clinic and height clinic of our hospital from 2019 to 2021 were selected as the research objects. The subjects were divided into emaciation group, normal group, overweight group, and obesity group. The bone age level, bone age assessment, sexual development, and early maturity rate of each group were compared. Results The bone age difference (BAD) of the overweight and obesity groups was higher than that of the normal group, and the BAD of the obesity group was higher than that of the emaciation group (P < 0.05). Compared with the normal group, the risk of advancement of bone age in the overweight group increased by 2.674 times (male) and 1.908 times (female), the risk of advancement of bone age in the obesity group increased by 6.376 times (male) and 14.687 times (female), the risk of retardation of bone age in the emaciation group increased by 2.150 times (male) and 3.092 times (female). Whether it was male or female, the sexual development of overweight and obese was higher than that of the normal weight group in the same age group. Among female children, the sexual precocious puberty rate of the overweight + obesity group is higher. Conclusion The nutritional status of children and adolescents is closely related to their bone age and sexual development.
Collapse
|
7
|
Lopes KG, Rodrigues EL, da Silva Lopes MR, do Nascimento VA, Pott A, Guimarães RDCA, Pegolo GE, Freitas KDC. Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022; 14:3260. [PMID: 36014768 PMCID: PMC9414751 DOI: 10.3390/nu14163260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022] Open
Abstract
Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant-juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.
Collapse
Affiliation(s)
- Kátia Gianlupi Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Elisana Lima Rodrigues
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Mariana Rodrigues da Silva Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Valter Aragão do Nascimento
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Arnildo Pott
- Institute of Biosciences, Federal University of Mato Grosso do Sul-UFMS, Campo Grande 79079-900, Brazil
| | - Rita de Cássia Avellaneda Guimarães
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Giovana Eliza Pegolo
- Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Karine de Cássia Freitas
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| |
Collapse
|
8
|
Holmgren A, Niklasson A, Nierop AFM, Butler G, Albertsson-Wikland K. Growth pattern evaluation of the Edinburgh and Gothenburg cohorts by QEPS height model. Pediatr Res 2022; 92:592-601. [PMID: 34732814 DOI: 10.1038/s41390-021-01790-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The QEPS-growth-model, developed and validated in GrowUp-Gothenburg cohorts, used for developing growth references and investigating healthy/pathological growth, lacks external validation from other longitudinal cohorts of healthy individuals. AIM To investigate if the QEPS-model can fit the longitudinal Edinburgh growth study of another design than GrowUp-Gothenburg cohorts, and to compare growth patterns in the individuals born in mid-1970s in North-Western Europe. METHODS Longitudinal growth data were obtained from the Edinburgh and the GrowUp1974Gothenburg cohorts. The QEPS-model was used to describe length/height from birth to adult height with confidence interval, and the multivariable regression model for estimating the contribution of the different QEPS-functions to adult height. RESULTS The QEPS-model fitted the Edinburgh cohort well, with high accuracy, and low confidence intervals indicating high precision. Despite 3 cm shorter stature (less QE-function growth) in Scottish children, the growth patterns of the cohorts were similar, especially for specific pubertal growth. The contribution to adult height from different QEPS functions was similar. CONCLUSION The QEPS-model is validated for the first time in a longitudinal study of healthy individuals of another design and found to fit with high accuracy and precision. The Scottish and Western-Swedish cohorts born in mid-1970s showed similar growth patterns for both sexes, especially pubertal growth. IMPACT For the first time, the QEPS height model was used and found to fit another longitudinal cohort of healthy individuals other than the Swedish longitudinal cohorts. With large numbers of individual measurements in each growth phase, the QEPS model calculates growth estimates with narrow confidence intervals (high precision) and high accuracy. The two different cohorts born in the mid-1970s from Scotland and Western Sweden have similar growth patterns, despite a 3 cm difference in adult height.
Collapse
Affiliation(s)
- Anton Holmgren
- GP-GRC, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Pediatrics, Halland Hospital, Halmstad, Sweden.
| | - Aimon Niklasson
- GP-GRC, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas F M Nierop
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Muvara bv, Multivariate Analysis of Research Data, Leiderdorp, The Netherlands
| | - Gary Butler
- UCL Great Ormond Street Institute of Child Health, and University College London Hospital, London, UK
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
9
|
Holmgren A. The Quadratic-Exponential-Pubertal-Stop model is valid for analysing human growth patterns and developing novel growth references. Acta Paediatr 2022; 111:225-235. [PMID: 34687241 DOI: 10.1111/apa.16162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 01/13/2023]
Abstract
AIM Human growth patterns are important, especially in paediatrics and public health, and the aim of this review was to provide an overview of human growth, especially secular changes of growth and pubertal growth. METHODS This review of human growth was mainly based on studies published during the 20th and early 21st centuries. Special attention was paid to secular changes, pubertal growth, Nordic growth studies and the contribution of the Quadratic-Exponential-Pubertal-Stop (QEPS) growth model for analysing growth patterns. RESULTS Human growth patterns showed wide variations between different individuals, sexes and populations and over time. There were ongoing positive secular change in height in four of the Nordic countries, Denmark, Finland, Norway and Sweden, over four decades. Childhood weight status had linear correlations with specific pubertal growth, in both healthy children and those with severe obesity. The QEPS model provided novel estimates of pubertal growth that made it possible to conduct more detailed analyses of pubertal growth than before. Growth references, adjusted for puberty, have been developed, and future opportunities for using the QEPS model for growth studies are highlighted. CONCLUSION The QEPS was a valid growth model for analysing human growth patterns and developing novel types of growth references.
Collapse
Affiliation(s)
- Anton Holmgren
- Göteborg Pediatric Growth Research Center GP‐GRC Department of Pediatrics Institute of Clinical SciencesSahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Department of Pediatrics Halland Hospital Halmstad Sweden
| |
Collapse
|
10
|
Martos-Moreno GÁ, Martínez-Villanueva Fernández J, Frías-Herrero A, Martín-Rivada Á, Argente J. Conservative Treatment for Childhood and Adolescent Obesity: Real World Follow-Up Profiling and Clinical Evolution in 1300 Patients. Nutrients 2021; 13:nu13113847. [PMID: 34836102 PMCID: PMC8624087 DOI: 10.3390/nu13113847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Limited therapeutic tools and an overwhelming clinical demand are the major limiting factors in pediatric obesity management. The optimal protocol, environment, body mass index (BMI) change targets and duration of obesity-oriented interventions remain to be elucidated. Aims: We aimed to characterize the singularities of follow-up, anthropometric and metabolic evolution of a large cohort of pediatric patients with obesity in a specialized university hospital outpatient obesity unit. Patients and methods: Follow-up duration (up to seven years), attrition rate and anthropometric and metabolic evolution of 1300 children and adolescents with obesity were studied. An individualized analysis was conducted in patients attaining a high level of weight loss (over 1.5 BMI-SDS (standard deviation score) and/or 10% of initial weight; n = 252; 19.4%) as well as in "metabolically healthy" patients (n = 505; 38.8%). Results: Attrition rate was high during the early stages (11.2% prior to and 32.5% right after their initial metabolic evaluation). Mean follow-up time was 1.59 ± 1.60 years (7% of patients fulfilled 7 years). The highest BMI reduction occurred in the first year (-1.11 ± 0.89 SDS, p < 0.001 in 72.5% of patients). At the end of the follow-up, improvements in glucose and lipid metabolism parameters were observed (both p < 0.05), that were highest in patients with the greatest weight reduction (all p < 0.01), independent of the time spent to achieve weight loss. The pubertal growth spurt negatively correlated with obesity severity (r = -0.38; p < 0.01) but patients attaining adult height exceeded their predicted adult height (n = 308, +1.6 ± 5.4 cm; p < 0.001). "Metabolically healthy" patients, but with insulin resistance, had higher blood pressure, glucose, uric acid and triglyceride levels than those without insulin resistance (all p < 0.05). Preservation of the "metabolically healthy" status was associated with BMI improvement. Conclusions: Behavioral management of children with obesity can be effective and does not impair growth but is highly conditioned by high attrition. The best results regarding BMI reduction and metabolic improvement are achieved in the first year of intervention and can be preserved if follow-up is retained.
Collapse
Affiliation(s)
- Gabriel Á. Martos-Moreno
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain; (G.Á.M.-M.); (J.M.-V.F.); (A.F.-H.); (Á.M.-R.)
- La Princesa Research Institute, E-28009 Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, E-28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn (CIBEROBN), Instituto de Salud Carlos III, E-28029 Madrid, Spain
| | - Julián Martínez-Villanueva Fernández
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain; (G.Á.M.-M.); (J.M.-V.F.); (A.F.-H.); (Á.M.-R.)
| | - Alicia Frías-Herrero
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain; (G.Á.M.-M.); (J.M.-V.F.); (A.F.-H.); (Á.M.-R.)
| | - Álvaro Martín-Rivada
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain; (G.Á.M.-M.); (J.M.-V.F.); (A.F.-H.); (Á.M.-R.)
| | - Jesús Argente
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain; (G.Á.M.-M.); (J.M.-V.F.); (A.F.-H.); (Á.M.-R.)
- La Princesa Research Institute, E-28009 Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, E-28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn (CIBEROBN), Instituto de Salud Carlos III, E-28029 Madrid, Spain
- IMDEA Food Institute, CEI UAM & CSIC, E-28049 Madrid, Spain
- Correspondence:
| |
Collapse
|