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Kim JH, Jung HS, Lee SE, Hou JU, Kwon YS. Improving difficult direct laryngoscopy prediction using deep learning and minimal image analysis: a single-center prospective study. Sci Rep 2024; 14:14209. [PMID: 38902319 PMCID: PMC11190276 DOI: 10.1038/s41598-024-65060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
Accurate prediction of difficult direct laryngoscopy (DDL) is essential to ensure optimal airway management and patient safety. The present study proposed an AI model that would accurately predict DDL using a small number of bedside pictures of the patient's face and neck taken simply with a smartphone. In this prospective single-center study, adult patients scheduled for endotracheal intubation under general anesthesia were included. Patient pictures were obtained in frontal, lateral, frontal-neck extension, and open mouth views. DDL prediction was performed using a deep learning model based on the EfficientNet-B5 architecture, incorporating picture view information through multitask learning. We collected 18,163 pictures from 3053 patients. After under-sampling to achieve a 1:1 image ratio of DDL to non-DDL, the model was trained and validated with a dataset of 6616 pictures from 1283 patients. The deep learning model achieved a receiver operating characteristic area under the curve of 0.81-0.88 and an F1-score of 0.72-0.81 for DDL prediction. Including picture view information improved the model's performance. Gradient-weighted class activation mapping revealed that neck and chin characteristics in frontal and lateral views are important factors in DDL prediction. The deep learning model we developed effectively predicts DDL and requires only a small set of patient pictures taken with a smartphone. The method is practical and easy to implement.
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Affiliation(s)
- Jong-Ho Kim
- Division of Big Data and Artificial Intelligence, Institute of New Frontier Research, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, 24253, Republic of Korea
| | - Hee-Sun Jung
- Division of Software, Hallym University, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do, 24252, Republic of Korea
| | - So-Eun Lee
- Department of Intelligence Computing, Hanyang University, Seoul, Republic of Korea
| | - Jong-Uk Hou
- Division of Software, Hallym University, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do, 24252, Republic of Korea.
| | - Young-Suk Kwon
- Division of Big Data and Artificial Intelligence, Institute of New Frontier Research, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, 24253, Republic of Korea.
- Department of Anesthesiology and Pain Medicine, Chuncheon, Sacred Heart Hospital, 77 Sakju-ro, Chuncheon-si, Gangwon-do, 24253, Republic of Korea.
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2
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Cao R, Ye W, Liu J, Chen L, Li Z, Ji H, Zhou N, Zhu Q, Sun W, Ni C, Shi L, Zhou Y, Wu Y, Song W, Liu P. Dynamic influence of maternal education on height among Chinese children aged 0-18 years. SSM Popul Health 2024; 26:101672. [PMID: 38708407 PMCID: PMC11066550 DOI: 10.1016/j.ssmph.2024.101672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/25/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024] Open
Abstract
Background Maternal education is one of key factors affecting nurturing environment which significantly impacts children's height levels throughout their developmental stages. However, the influence of maternal education on children's height is less studied. This study aims to investigate the dynamic influence of maternal education on children's height among Chinese children aged 0-18 years. Methods Children undergoing health examinations from January 2021 to September 2023 were included in this study. Clinical information including height, weight, maternal pregnancy history, blood specimens for bone metabolism-related indicators and maternal education level was collected. Children's height was categorized into 14 groups based on age and gender percentiles, following WHO 2006 growth standards. One-way analysis of variance (ANOVA), linear regression, chi-square test and Fisher's exact test were applied for data analysis. Results A total of 6269 samples were collected, including 3654 males and 2615 females, with an average age of 8.38 (3.97) for males and 7.89 (3.55) for females. Significant correlations between maternal education level, birth weight, birth order, weight percentile, vitamin D, serum phosphorus, alkaline phosphatase levels, and children's height were identified. Birth weight's influence on height varied across age groups. Compared with normal birth weight children, low birth weight children exhibited catch-up growth within the first 6 years and a subsequent gradual widening of the height gap from 6 to 18 years old. Remarkably, the impact of maternal education on height became more pronounced among children above 3-6 years old, which can mitigate the effect of low birth weight on height. Conclusion We found that weight percentile, birth weight, birth order, bone marker levels, and maternal education level have significant effect on height. Maternal education attenuates the impact of low birth weight on height. The findings indicated that maternal education plays a consistent and critical role in promoting robust and healthy growth.
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Affiliation(s)
- Ruixue Cao
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Wenjing Ye
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Jinrong Liu
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Lili Chen
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Zhe Li
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Hanshu Ji
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Nianjiao Zhou
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Qin Zhu
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Wenshuang Sun
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Chao Ni
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Linwei Shi
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Yonghai Zhou
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Yili Wu
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, Zhejiang Province, 325035, China
| | - Weihong Song
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, Zhejiang Province, 325035, China
| | - Peining Liu
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
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Mraz T, Asgari S, Karimi A, Breyer MK, Hartl S, Sunanta O, Ofenheimer A, Burghuber OC, Zacharasiewicz A, Lamprecht B, Schiffers C, Wouters EFM, Breyer-Kohansal R. Updated reference values for static lung volumes from a healthy population in Austria. Respir Res 2024; 25:155. [PMID: 38570835 PMCID: PMC10988832 DOI: 10.1186/s12931-024-02782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Reference values for lung volumes are necessary to identify and diagnose restrictive lung diseases and hyperinflation, but the values have to be validated in the relevant population. Our aim was to investigate the Global Lung Function Initiative (GLI) reference equations in a representative healthy Austrian population and create population-derived reference equations if poor fit was observed. METHODS We analysed spirometry and body plethysmography data from 5371 respiratory healthy subjects (6-80 years) from the Austrian LEAD Study. Fit with the GLI equations was examined using z-scores and distributions within the limits of normality. LEAD reference equations were then created using the LMS method and the generalized additive model of location shape and scale package according to GLI models. RESULTS Good fit, defined as mean z-scores between + 0.5 and -0.5,was not observed for the GLI static lung volume equations, with mean z-scores > 0.5 for residual volume (RV), RV/TLC (total lung capacity) and TLC in both sexes, and for expiratory reserve volume (ERV) and inspiratory capacity in females. Distribution within the limits of normality were shifted to the upper limit except for ERV. Population-derived reference equations from the LEAD cohort showed superior fit for lung volumes and provided reproducible results. CONCLUSION GLI lung volume reference equations demonstrated a poor fit for our cohort, especially in females. Therefore a new set of Austrian reference equations for static lung volumes was developed, that can be applied to both children and adults (6-80 years of age).
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Affiliation(s)
- Tobias Mraz
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria.
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.
| | - Shervin Asgari
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Ahmad Karimi
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Marie-Kathrin Breyer
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Owat Sunanta
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Alina Ofenheimer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Otto C Burghuber
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | | | - Bernd Lamprecht
- Department of Pulmonology, Kepler University Hospital, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | | | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Hietzing, Vienna, Austria
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Erelund S, Karp K, Arvidsson S, Johansson B, Sundström N, Wiklund U. Pulmonary function in a cohort of heart-healthy individuals from Northern Sweden-a comparison with discordant reference values. BMC Pulm Med 2023; 23:110. [PMID: 37020237 PMCID: PMC10077603 DOI: 10.1186/s12890-023-02403-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Dynamic spirometry is an important investigation to differentiate between impaired and normal lung function. This study aimed to evaluate the results of lung function testing in a cohort of subjects from Northern Sweden without any known heart or pulmonary disease. Our focus was to compare with two reference materials that have showed differences in the age-dependency of lung function in Swedish subjects. METHODS The study population consisted of 285 healthy adults (148 males, 52%) between 20-90 years of age. The subjects had been randomly selected from the population register for inclusion in a study investigating cardiac function in heart-healthy subjects, but were also assessed with dynamic spirometry. At least seven percent reported smoking. Sixteen subjects presented with pulmonary functional impairments and were excluded from the current study. The sex-specific age-dependency in lung volumes was estimated using the LMS model, where non-linear equations were derived for the mean value (M), the location (L) or skewness, and the scatter (S) or coefficient of variation. This model of the observed lung function data was compared with reference values given by the original LMS model published by the Global Lung Initiative (GLI), and with the model from the recent Obstructive Lung Disease In Norrbotten (OLIN) study, where higher reference values were presented for Swedish subjects than those given by the GLI model. RESULTS No differences were found in the age-dependency of pulmonary function between the LMS model developed in the study and the OLIN model. Although the study group included smokers, the original GLI reference values suggested significantly lower normal values of FEV1 (forced expiratory volume) and FVC (forced vital capacity), and consequently fewer subjects below the lower limit of normality, than both the rederived LMS and OLIN models. CONCLUSIONS Our results are in line with previous reports and support that the original GLI reference values underestimate pulmonary function in the adult Swedish population. This underestimation could be reduced by updating the coefficients in the underlying LMS model based on a larger cohort of Swedish citizens than was available in this study.
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Affiliation(s)
- Sofia Erelund
- Department of Surgery and Perioperative Sciences, Clinical Physiology, Umeå University, 901 87, Umeå, Sweden.
| | - Kjell Karp
- Department of Surgery and Perioperative Sciences, Clinical Physiology, Umeå University, 901 87, Umeå, Sweden
| | - Sandra Arvidsson
- Department of Surgery and Perioperative Sciences, Clinical Physiology, Umeå University, 901 87, Umeå, Sweden
| | - Bengt Johansson
- Department of Surgery and Perioperative Sciences, Clinical Physiology, Umeå University, 901 87, Umeå, Sweden
| | - Nina Sundström
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Urban Wiklund
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
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Arntsen SH, Borch KB, Wilsgaard T, Njølstad I, Hansen AH. Time trends in body height according to educational level. A descriptive study from the Tromsø Study 1979-2016. PLoS One 2023; 18:e0279965. [PMID: 36696372 PMCID: PMC9876240 DOI: 10.1371/journal.pone.0279965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/19/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The objective of our study was to describe time trends in body height according to attained educational level in women and men in Norway. METHODS We used previously collected data from six repeated cross-sectional studies in the population based Tromsø Study 1979-2016. Measured body height in cm and self-reported educational level were the primary outcome measures. We included 31 466 women and men aged 30-49 years, born between 1930 and 1977. Participants were stratified by 10-year birth cohorts and allocated into four groups based on attained levels of education. Descriptive statistics was used to estimate mean body height and calculate height differences between groups with different educational levels. RESULTS Mean body height increased by 3.4 cm (95% confidence interval (CI) 3.0, 3.8) in women (162.5-165.9 cm) and men (175.9-179.3 cm) between 1930 and 1977. The height difference between groups with primary education compared to long tertiary education was 5.1 cm (95% CI 3.7, 6.5) in women (161.6-166.7 cm) and 4.3 cm (95% CI 3.3, 5.3) in men (175.0-179.3 cm) born in 1930-39. The height differences between these educational groups were reduced to 3.0 cm (95% CI 1.9, 4.1) in women (163.6-166.6 cm) and 2.0 cm (95% CI 0.9, 3.1) in men (178.3-180.3 cm) born in 1970-77. CONCLUSIONS Body height increased in women and men. Women and men with long tertiary education had the highest mean body height, which remained stable across all birth cohorts. Women and men in the three other groups had a gradual increase in height by birth cohort, reducing overall height differences between educational groups in our study population.
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Affiliation(s)
- Sondre Haakonson Arntsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Helen Hansen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- University Hospital of North Norway, Tromsø, Norway
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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.
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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
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Zhou E, Wang L, Santiago CN, Nanavati J, Rifkin S, Spence E, Hylind LM, Gills JJ, La Luna L, Kafonek DR, Cromwell DM, Drewes JL, Sears CL, Giardiello FM, Mullin GE. Adult-Attained Height and Colorectal Cancer Risk: A Cohort Study, Systematic Review, and Meta-Analysis. Cancer Epidemiol Biomarkers Prev 2022; 31:783-792. [PMID: 35247904 PMCID: PMC8983463 DOI: 10.1158/1055-9965.epi-21-0398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 10/09/2021] [Accepted: 02/02/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The influence of anthropometric characteristics on colorectal neoplasia biology is unclear. We conducted a systematic review and meta-analysis to determine if adult-attained height is independently associated with the risk of colorectal cancer or adenoma. METHODS We searched MEDLINE, EMBASE, the Cochrane Library, and Web of Science from inception to August 2020 for studies on the association between adult-attained height and colorectal cancer or adenoma. The original data from the Johns Hopkins (Baltimore, MD) Colon Biofilm study was also included. The overall HR/OR of colorectal cancer/adenoma with increased height was estimated using random-effects meta-analysis. RESULTS We included 47 observational studies involving 280,644 colorectal cancer and 14,139 colorectal adenoma cases. Thirty-three studies reported data for colorectal cancer incidence per 10-cm increase in height; 19 yielded an HR of 1.14 [95% confidence interval (CI), 1.11-1.17; P < 0.001), and 14 engendered an OR of 1.09 (95% CI, 1.05-1.13; P < 0.001). Twenty-six studies compared colorectal cancer incidence between individuals within the highest versus the lowest height percentile; 19 indicated an HR of 1.24 (95% CI, 1.19-1.30; P < 0.001), and seven resulting in an OR of 1.07 (95% CI, 0.92-1.25; P = 0.39). Four studies reported data for assessing colorectal adenoma incidence per 10-cm increase in height, showing an overall OR of 1.06 (95% CI, 1.00-1.12; P = 0.03). CONCLUSIONS Greater adult attained height is associated with an increased risk of colorectal cancer and adenoma. IMPACT Height should be considered as a risk factor for colorectal cancer screening.
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Affiliation(s)
- Elinor Zhou
- Johns Hopkins University School of Medicine, Department of Gastroenterology and Hepatology, Baltimore, MD
- Mercy Medical Center, Institute for Digestive Health and Liver Disease, Baltimore, MD
| | - Lin Wang
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD
| | | | - Julie Nanavati
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Samara Rifkin
- University of Michigan, Department of Gastroenterology and Hepatology, Ann Arbor, MI
| | - Emma Spence
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Linda M. Hylind
- Johns Hopkins University School of Medicine, Department of Gastroenterology and Hepatology, Baltimore, MD
| | - Joell J. Gills
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - David R. Kafonek
- Johns Hopkins Health Care & Surgery Center, Department of Gastroenterology and Hepatology, Green Spring Station Endoscopy Center, Lutherville, MD
| | - David M. Cromwell
- Johns Hopkins Health Care & Surgery Center, Department of Gastroenterology and Hepatology, Green Spring Station Endoscopy Center, Lutherville, MD
| | - Julia L. Drewes
- Johns Hopkins University School of Medicine, Department of Medicine, Division of Infectious Diseases, Baltimore, MD
| | - Cynthia L. Sears
- Johns Hopkins University School of Medicine, Department of Medicine, Division of Infectious Diseases, Baltimore, MD
| | - Francis M. Giardiello
- Johns Hopkins University School of Medicine, Department of Gastroenterology and Hepatology, Baltimore, MD
| | - Gerard E. Mullin
- Johns Hopkins University School of Medicine, Department of Gastroenterology and Hepatology, Baltimore, MD
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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.
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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
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Holroyd CR, Carter S, Crozier SR, D'Angelo S, Curtis EM, Moon RJ, Davies JH, Ward KA, Dennison EM, Inskip HM, Godfrey KM, Cooper C, Harvey NC. Differential relationships between parent-child DXA and pQCT bone measures: Results from the Southampton Women's Survey. Bone 2021; 153:116134. [PMID: 34332160 PMCID: PMC7611825 DOI: 10.1016/j.bone.2021.116134] [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: 05/28/2021] [Revised: 07/13/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
AIM To investigate the associations between indices of bone health in childhood and corresponding parental measures. METHODS The Southampton Women's Survey characterised 12,583 non-pregnant women aged 20-34 years; 3158 subsequently had singleton live births. In a subset, dual-energy X-ray absorptiometry (DXA) measurements of bone area (BA), bone mineral content (BMC) and areal bone mineral density (aBMD) lumbar spine and total hip were obtained in the parent/offspring (aged 8-9 years) trios. Another subset of children (aged 6-7 years), and their parents, had peripheral quantitative computed tomography (pQCT; 4% and 38% tibia) measures. Using multivariable linear regression we examined relationships between mother/father and offspring, adjusting for parental age, habitual walking speed and education; offspring age and sex; and the corresponding bone measure in the other parent (β-coefficients (95%CI) unit/unit for each bone measure). RESULTS Data were available for 260 trios with DXA and 99 with pQCT. There were positive associations for BA, BMC and aBMD between either parent and offspring. Mother-child associations were of greater magnitude than father-child; for example, mother-child aBMD (β = 0.26 g·cm-2/g·cm-2 (0.21,0.32)) and father-child aBMD (β = 0.16 g·cm-2/g·cm-2 (0.11,0.21)), P-difference in β = 0.007. In the subset with pQCT there was a positive association for mother-offspring 4% tibial total area (β = 0.33 mm2/mm2 (0.17,0.48)), but little evidence of a father-offspring association (β = -0.06 mm2/mm2 (-0.17,0.06)). In contrast offspring 38% cortical density was more strongly associated with this measure in fathers (β = 0.48 mg·cm-3/mg·cm-3 (0.15,0.82)) than mothers (β = 0.27 mg·cm-3/mg·cm-3 (-0.03,0.56)). In general mother-father differences were attenuated by adjustment for height. CONCLUSIONS Whilst offspring bone measures are independently associated with those of either parent, the magnitude of the association is often greater for maternal than paternal relationships. These findings are consistent with an in utero influence on offspring growth but might also reflect genetic and/or epigenetic parent of origin effects. SUMMARY In an established parent-offspring cohort, associations between parent and offspring bone indices were generally greater in magnitude for mother-offspring than father-offspring relationships.
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Affiliation(s)
- C R Holroyd
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S Carter
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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10
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Albertsson-Wikland K, Niklasson A, Gelander L, Holmgren A, Nierop AFM. Novel type of references for weight aligned for onset of puberty - using the QEPS growth model. BMC Pediatr 2021; 21:507. [PMID: 34774010 PMCID: PMC8590226 DOI: 10.1186/s12887-021-02954-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Growth references are traditionally constructed relative to chronological age, despite inter-individual variations in pubertal timing. A new type of height reference was recently developed allowing growth to be aligned based on onset of pubertal height growth. We here aim to develop a corresponding reference for pubertal weight. METHODS To model QEPS-weight, 3595 subjects (1779 girls) from GrowUp1974Gothenburg and GrowUp1990Gothenburg were used. The QEPS-height-model was transformed to a corresponding QEPS-weight-model; thereafter, QEPS-weight was modified by an individual, constitutional weight-height-factor. Longitudinal weight and length/height measurements from 1418 individuals (698 girls) from GrowUp1990Gothenburg were then used to create weight references aligned for height at pubertal onset (the age at 5% of P-function growth, AgeP5). GrowUp1974Gothenburg subgroups based on pubertal timing, stature at pubertal onset, and childhood body composition were assessed using the references. RESULTS References (median, SDS) for total weight (QEPS-functions), weight specific to puberty (P-function), and weight gain in the absence of specific pubertal growth (basic weight, QES-functions), allowing alignment of individual growth based on age at pubertal onset. For both sexes, basic weight was greater than average for late maturing, tall and high-BMI subgroups. The P-function-related weight was greater than average in short and lower than average in tall children, in those with high BMI, and in girls but not boys with low BMI. CONCLUSIONS New pubertal weight references allow individual variations in pubertal timing to be taken into consideration when evaluating growth. When used together with the comparable pubertal height reference, this will improve growth monitoring in clinical practice for identifying abnormal growth and serve as a valuable research tool providing insight into human growth.
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Affiliation(s)
- Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, SE Sweden
| | - Aimon Niklasson
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Gelander
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, SE Sweden
| | - Anton Holmgren
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Halmstad Hospital, Halmstad, Sweden
| | - Andreas F. M. Nierop
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, SE Sweden
- Muvara bv, Multivariate Analysis of Research Data, Leiderdorp, The Netherlands
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11
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Allinson JP, Afzal S, Çolak Y, Jarvis D, Backman H, van den Berge M, Boezen HM, Breyer MK, Breyer-Kohansal R, Brusselle G, Burghuber OC, Faner R, Hartl S, Lahousse L, Langhammer A, Lundbäck B, Nwaru BI, Rönmark E, Vikjord SAA, Vonk JM, Wijnant SRA, Lange P, Nordestgaard BG, Olvera N, Agusti A, Donaldson GC, Wedzicha JA, Vestbo J, Vanfleteren LEGW. Changes in lung function in European adults born between 1884 and 1996 and implications for the diagnosis of lung disease: a cross-sectional analysis of ten population-based studies. THE LANCET RESPIRATORY MEDICINE 2021; 10:83-94. [PMID: 34619103 DOI: 10.1016/s2213-2600(21)00313-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND During the past century, socioeconomic and scientific advances have resulted in changes in the health and physique of European populations. Accompanying improvements in lung function, if unrecognised, could result in the misclassification of lung function measurements and misdiagnosis of lung diseases. We therefore investigated changes in population lung function with birth year across the past century, accounting for increasing population height, and examined how such changes might influence the interpretation of lung function measurements. METHODS In our analyses of cross-sectional data from ten European population-based studies, we included individuals aged 20-94 years who were born between 1884 and 1996, regardless of previous respiratory diagnoses or symptoms. FEV1, forced vital capacity (FVC), height, weight, and smoking behaviour were measured between 1965 and 2016. We used meta-regression to investigate how FEV1 and FVC (adjusting for age, study, height, sex, smoking status, smoking pack-years, and weight) and the FEV1/FVC ratio (adjusting for age, study, sex, and smoking status) changed with birth year. Using estimates from these models, we graphically explored how mean lung function values would be expected to progressively deviate from predicted values. To substantiate our findings, we used linear regression to investigate how the FEV1 and FVC values predicted by 32 reference equations published between 1961 and 2015 changed with estimated birth year. FINDINGS Across the ten included studies, we included 243 465 European participants (mean age 51·4 years, 95% CI 51·4-51·5) in our analysis, of whom 136 275 (56·0%) were female and 107 190 (44·0%) were male. After full adjustment, FEV1 increased by 4·8 mL/birth year (95% CI 2·6-7·0; p<0·0001) and FVC increased by 8·8 mL/birth year (5·7-12·0; p<0·0001). Birth year-related increases in the FEV1 and FVC values predicted by published reference equations corroborated these findings. This height-independent increase in FEV1 and FVC across the last century will have caused mean population values to progressively exceed previously predicted values. However, the population mean adjusted FEV1/FVC ratio decreased by 0·11 per 100 birth years (95% CI 0·09-0·14; p<0·0001). INTERPRETATION If current diagnostic criteria remain unchanged, the identified shifts in European values will allow the easier fulfilment of diagnostic criteria for lung diseases such as chronic obstructive pulmonary disease, but the systematic underestimation of lung disease severity. FUNDING The European Respiratory Society, AstraZeneca, Chiesi Farmaceutici, GlaxoSmithKline, Menarini, and Sanofi-Genzyme.
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Affiliation(s)
- James P Allinson
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK.
| | - Shoaib Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yunus Çolak
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Helena Backman
- Department of Public Health and Clinical Medicine, The OLIN Unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Maarten van den Berge
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - H Marike Boezen
- Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Respiratory Medicine, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Rosa Faner
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Lies Lahousse
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, The OLIN Unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Sigrid A Aalberg Vikjord
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway; Department of Medicine and Rehabilitation, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Sara R A Wijnant
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Peter Lange
- Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nuria Olvera
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Alvar Agusti
- Càtedra Salut Respiratòria, Universitat Barcelona, Spain; Respiratory Institute, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Gavin C Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK; North West Lung Centre, Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Lowie E G W Vanfleteren
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; COPD Centre, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
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12
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Svanes C, Bertelsen RJ, Accordini S, Holloway JW, Júlíusson P, Boateng E, Krauss-Etchmann S, Schlünssen V, Gómez-Real F, Skulstad SM. Exposures during the prepuberty period and future offspring's health: evidence from human cohort studies†. Biol Reprod 2021; 105:667-680. [PMID: 34416759 PMCID: PMC8444705 DOI: 10.1093/biolre/ioab158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/02/2021] [Accepted: 08/17/2021] [Indexed: 11/13/2022] Open
Abstract
Emerging evidence suggests that exposures in prepuberty, particularly in fathers-to-be, may impact the phenotype of future offspring. Analyses of the RHINESSA cohort find that offspring of father’s exposed to tobacco smoking or overweight that started in prepuberty demonstrate poorer respiratory health in terms of more asthma and lower lung function. A role of prepuberty onset smoking for offspring fat mass is suggested in the RHINESSA and ALSPAC cohorts, and historic studies suggest that ancestral nutrition during prepuberty plays a role for grand-offspring’s health and morbidity. Support for causal relationships between ancestral exposures and (grand-)offspring’s health in humans has been enhanced by advancements in statistical analyses that optimize the gain while accounting for the many complexities and deficiencies in human multigeneration data. The biological mechanisms underlying such observations have been explored in experimental models. A role of sperm small RNA in the transmission of paternal exposures to offspring phenotypes has been established, and chemical exposures and overweight have been shown to influence epigenetic programming in germ cells. For example, exposure of adolescent male mice to smoking led to differences in offspring weight and alterations in small RNAs in the spermatozoa of the exposed fathers. It is plausible that male prepuberty may be a time window of particular susceptibility, given the extensive epigenetic reprogramming taking place in the spermatocyte precursors at this age. In conclusion, epidemiological studies in humans, mechanistic research, and biological plausibility, all support the notion that exposures in the prepuberty of males may influence the phenotype of future offspring.
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Affiliation(s)
- Cecilie Svanes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Randi J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise Western Norway, Bergen, Norway
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - John W Holloway
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Pétur Júlíusson
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Health Register Research and Development, National Institute of Public Health, Bergen, Norway
| | - Eistine Boateng
- Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL), Borstel, Germany
| | - Susanne Krauss-Etchmann
- Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL), Borstel, Germany.,Institute of Experimental Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Vivi Schlünssen
- Department of Public Health-Work, Environment and Health, Danish Ramazzini Centre, Aarhus University, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Francisco Gómez-Real
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Gynaecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Svein Magne Skulstad
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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13
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Shmoish M, German A, Devir N, Hecht A, Butler G, Niklasson A, Albertsson-Wikland K, Hochberg Z. Prediction of Adult Height by Machine Learning Technique. J Clin Endocrinol Metab 2021; 106:e2700-e2710. [PMID: 33606028 DOI: 10.1210/clinem/dgab093] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Indexed: 01/23/2023]
Abstract
CONTEXT Prediction of AH is frequently undertaken in the clinical setting. The commonly used methods are based on the assessment of skeletal maturation. Predictive algorithms generated by machine learning, which can already automatically drive cars and recognize spoken language, are the keys to unlocking data that can precisely inform the pediatrician for real-time decision making. OBJECTIVE To use machine learning (ML) to predict adult height (AH) based on growth measurements until age 6 years. METHODS Growth data from 1596 subjects (798 boys) aged 0-20 years from the longitudinal GrowUp 1974 Gothenburg cohort were utilized to train multiple ML regressors. Of these, 100 were used for model comparison, the rest was used for 5-fold cross-validation. The winning model, random forest (RF), was first validated on 684 additional subjects from the 1974 cohort. It was additionally validated using 1890 subjects from the GrowUp 1990 Gothenburg cohort and 145 subjects from the Edinburgh Longitudinal Growth Study cohort. RESULTS RF with 51 regression trees produced the most accurate predictions. The best predicting features were sex and height at age 3.4-6.0 years. Observed and predicted AHs were 173.9 ± 8.9 cm and 173.9 ± 7.7 cm, respectively, with prediction average error of -0.4 ± 4.0 cm. Validation of prediction for 684 GrowUp 1974 children showed prediction accuracy r = 0.87 between predicted and observed AH (R2 = 0.75). When validated on the 1990 Gothenburg and Edinburgh cohorts (completely unseen by the learned RF model), the prediction accuracy was r = 0.88 in both cases (R2 = 0.77). AH in short children was overpredicted and AH in tall children was underpredicted. Prediction absolute error correlated negatively with AH (P < .0001). CONCLUSION We show successful, validated ML of AH using growth measurements before age 6 years. The most important features for prediction were sex, and height at age 3.4-6.0. Prediction errors result in over- or underestimates of AH for short and tall subjects, respectively. Prediction by ML can be generalized to other cohorts.
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Affiliation(s)
- Michael Shmoish
- Bioinformatics Knowledge Unit, The Lokey Center, Technion-Israel Institute of Technology, Haifa, Israel
| | - Alina German
- Pediatric Endocrinology, Clalit Health Service, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Nurit Devir
- Computer Science Department, Technion-Israel Institute of Technology, Haifa, Israel
| | - Anna Hecht
- Computer Science Department, Technion-Israel Institute of Technology, Haifa, Israel
| | - Gary Butler
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Aimon Niklasson
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Albertsson-Wikland
- Physiology/Endocrinology, Institute of Neuroscience & Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ze'ev Hochberg
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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14
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Associations between Prenatal Exposure to Phthalates and Timing of Menarche and Growth and Adiposity into Adulthood: A Twenty-Years Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094725. [PMID: 33946657 PMCID: PMC8125681 DOI: 10.3390/ijerph18094725] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022]
Abstract
Phthalates are ubiquitous environmental chemicals with endocrine disrupting properties and potentially obesogenic effects. We hypothesised that antenatal phthalate exposure may influence growth and adiposity patterns in girls through childhood into adolescence. Among 1342 Raine Study singleton females, 462 had maternal serum and at least one outcome available up to 20 years of age. Individuals’ maternal serum collected at 18 and 34 weeks gestation was pooled and analyzed for concentrations of 32 metabolites of 15 phthalate diesters. Cox regression and linear models were used to determine associations between maternal phthalate levels and age at menarche, change in height and weight z-scores between birth and two years, height from birth to 20 years, BMI from two to 20 years, deviation from mid-parental height at age 20 and DEXA scan measures at age 20. Weak negative associations were detected with some phthalate metabolites and change in height and weight z-score during infancy. Weak positive associations between some of the high molecular weight phthalate metabolites and height z-score were detected during childhood. While still within the normal range, age at menarche was slightly delayed in girls with higher prenatal exposure to the higher molecular weight phthalate metabolites. We derived some associations between prenatal phthalate exposure with early growth patterns and age at menarche.
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15
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Berman YE, Doherty DA, Main KM, Frederiksen H, Keelan JA, Newnham JP, Hart RJ. The influence of prenatal exposure to phthalates on subsequent male growth and body composition in adolescence. ENVIRONMENTAL RESEARCH 2021; 195:110313. [PMID: 33069699 DOI: 10.1016/j.envres.2020.110313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 05/13/2023]
Abstract
Phthalates are ubiquitous environmental chemicals with predominantly anti-androgenic, and potentially obesogenic effects. We hypothesised that antenatal phthalate exposure may influence subsequent boy's growth and body composition through childhood and adolescence. Among 1399 singleton males from the Raine Study, 410 had maternal serum and at least one height, BMI or DEXA outcome available after birth and up to 20 years of age. Maternal serum collected at 18 and 34 weeks' gestation was pooled, and analyzed for concentrations of 32 metabolites of 15 phthalate diesters. Their serum concentrations were categorized into undetectable/detectable levels or tertiles. Linear mixed models were used to determine associations between maternal serum phthalate levels and longitudinal height and body mass index (BMI) z-scores in boys from birth to 20 years of age (n = 250 and n = 295 respectively). Linear regression was used to determine associations between maternal phthalate levels and deviation from mid-parental height (n = 177) and DEXA scan outcomes (n = 191) at the 20 year follow-up. Weak positive associations of participants height z-score increase were detected with exposure to some phthalate metabolites in particular to the lower molecular weight phthalate metabolites. Less consistent findings, by mixed model analyses, were detected for BMI and body composition, by dual energy X-ray absorptiometry (DEXA), with some positive associations of phthalate metabolites with BMI and some negative associations with DEXA fat tissue measures, although no consistent findings were evident. In conclusion, we derived some associations of childhood growth with prenatal phthalate exposure, particularly with respect to the lower molecular weight phthalate metabolites.
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Affiliation(s)
- Ye'elah E Berman
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia
| | - Dorota A Doherty
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA, Australia, 6008
| | - Katharina M Main
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Jeffrey A Keelan
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA, Australia, 6008
| | - John P Newnham
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, WA, Australia, 6008
| | - Roger J Hart
- Women and Infants Research Foundation, Carson House, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Perth, Australia.
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Gomula A, Nowak‐Szczepanska N, Koziel S. Secular trend and social variation in height of Polish schoolchildren between 1966 and 2012. Acta Paediatr 2021; 110:1225-1230. [PMID: 32931048 DOI: 10.1111/apa.15572] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/11/2020] [Accepted: 09/08/2020] [Indexed: 01/24/2023]
Abstract
AIM To assess secular trend and changes in social inequalities of children's height across nearly 50 years, when vast socio-political changes took place in Poland. METHODS Data on schoolchildren aged 7-18 years were collected in 1966, 1978, 1988 and 2012 in Poland. Height was standardised for age using the LMS method. Socio-economic status (SES) was based on 4 factors: urbanisation level, mother's and father's education, and family size (number of children). Statistics included 2-way ANOVA with post hoc Tukey's test and effect size calculations. RESULTS Positive secular trend in height was observed across all years. All analysed SES factors had significant effect on height which differed depending on SES category and year of Survey. Differences in height between extreme categories of SES factors decreased gradually, starting from 1978. However, only general SES in girls and urbanisation level in both sexes became insignificant in 2012. CONCLUSION Improvement of living conditions across nearly 50 years was reflected in the secular trend in children's height. Despite this improvement, however, the biological effects of social inequalities, visible in differences in height, to some extent, are still present in Poland.
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Affiliation(s)
- Aleksandra Gomula
- Department of Anthropology Institute of Immunology and Experimental Therapy Polish Academy of Sciences Wroclaw Poland
| | - Natalia Nowak‐Szczepanska
- Department of Anthropology Institute of Immunology and Experimental Therapy Polish Academy of Sciences Wroclaw Poland
| | - Slawomir Koziel
- Department of Anthropology Institute of Immunology and Experimental Therapy Polish Academy of Sciences Wroclaw Poland
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Albertsson‐Wikland K, Niklasson A, Gelander L, Holmgren A, Sjöberg A, Aronson AS, Nierop AFM. Swedish references for weight, weight-for-height and body mass index: The GrowUp 1990 Gothenburg study. Acta Paediatr 2021; 110:537-548. [PMID: 32654218 DOI: 10.1111/apa.15477] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/18/2020] [Accepted: 07/08/2020] [Indexed: 01/22/2023]
Abstract
AIM To update the Swedish references for weight, weight-for-height and body mass index (BMI) considering the secular trend for height but not including that for weight. METHODS Longitudinal measures of height and weight were obtained (0-18 years) from 1418 (698 girls) healthy children from the GrowUp 1990 Gothenburg cohort born at term to non-smoking mothers and Nordic parents. A total of 145 individuals with extreme BMI value vs GrowUp 1974 BMI SDS reference were excluded (0-2 years: ±4SDS, 2 < years: -3SDS, +2.3SDS). References were constructed using the LMS method. RESULTS The updated weight reference became similar to the GrowUp 1974 Gothenburg reference: BMI increased rapidly up to lower levels in the 1990 cohort during infancy/early childhood, similar in both groups in late childhood/adolescence, despite lower values at +2SDS. Compared with the WHO weight standard, median and -2SDS weight values were higher for the 1990 cohort, whereas +2SDS values were lower, resulting in narrower normal range. Median values were greater and ±2SDS narrower for the 1990 vs the WHO weight-for-height reference. International Obesity Task force (IOTF) BMI lines for definitions for over- and underweight were added. CONCLUSION We present updated references for weight, weight-for-height and BMI, providing a healthy goal for weight development when monitoring growth within healthcare settings.
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Affiliation(s)
- Kerstin Albertsson‐Wikland
- Department of Physiology/Endocrinology Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Aimon Niklasson
- Göteborg Pediatric Growth Research Center Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Sweden
| | - Lars Gelander
- Göteborg Pediatric Growth Research Center Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Sweden
| | - Anton Holmgren
- Göteborg Pediatric Growth Research Center Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Sweden
- Department of Pediatrics Halmstad Hospital Halmstad Sweden
| | - Agneta Sjöberg
- Department of Food and Nutrition and Sport Science University of Gothenburg Gothenburg Sweden
| | | | - Andreas F. M. Nierop
- Department of Physiology/Endocrinology Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Muvara bv Multivariate Analysis of Research Data Leiderdorp The Netherlands
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18
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Albertsson-Wikland KG, Niklasson A, Holmgren A, Gelander L, Nierop AFM. A new type of pubertal height reference based on growth aligned for onset of pubertal growth. J Pediatr Endocrinol Metab 2020; 33:1173-1182. [PMID: 32809956 DOI: 10.1515/jpem-2020-0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/01/2020] [Indexed: 11/15/2022]
Abstract
Objectives Growth references of today traditionally describe growth in relation to chronological age. Despite the broad variation in age of pubertal maturation, references related to biological age are lacking. To fill this knowledge gap, we aimed to develop a new type of pubertal height reference for improved growth evaluation during puberty, considering individual variation in pubertal timing. Methods Longitudinal length/height measures were obtained from birth to adult height in 1,572 healthy Swedish children (763 girls) born at term ∼1990 to nonsmoking mothers and Nordic parents, a subgroup of GrowUp1990Gothenburg cohort. A total height reference was constructed from Quadratic-Exponential-Puberty-Stop (QEPS)-function-estimated heights from individual height curves that had been aligned for time/age at onset of pubertal growth (5% of P-function growth). References that separated growth into specific pubertal heightSDS (P-function growth) and basic heightSDS (QES-function growth) were also generated. Results References (cm and SDS) are presented for total height, and height subdivided into that specific to puberty and to basic growth arising independently of puberty. The usefulness of the new pubertal growth reference was explored by identifying differences in the underlying growth functions that translate into differences in pubertal height gain for children of varying body mass, height, and with different pubertal timings. Conclusions A new type of height reference allowing alignment of individual growth curves, based on the timing of the pubertal growth spurt was developed using QEPS-model functions. This represents a paradigm shift in pubertal growth research and growth monitoring during the adolescent period.
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Affiliation(s)
- Kerstin G Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience & Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aimon Niklasson
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anton Holmgren
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Halmstad Hospital, Halmstad, Sweden
| | - Lars Gelander
- Göteborg Pediatric Growth Research Center, 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 & Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Muvara bv, Multivariate Analysis of Research Data, Leiderdorp, The Netherlands
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Miller BS, Sarafoglou K, Addo OY. Development of Tanner Stage-Age Adjusted CDC Height Curves for Research and Clinical Applications. J Endocr Soc 2020; 4:bvaa098. [PMID: 32818164 PMCID: PMC7426000 DOI: 10.1210/jendso/bvaa098] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 07/14/2020] [Indexed: 01/17/2023] Open
Abstract
Background and Objective Variations in normal pubertal development, pubertal disorders, and race/ethnicity can lead to differences in growth patterns and timing that are not captured by the Centers for Disease Control and Prevention (CDC) height-for-chronological age (CAHeight) charts. Therefore, we sought to develop new Tanner stage-adjusted height-for-age (TSAHeight) charts accounting for these differences. Study Design Population-based Tanner staging and anthropometric data for 13 358 children age 8 to 18 years from 3 large US national surveys: National Health Examination Surveys (NHES cycle III); the Hispanic Health and Nutrition Examination Surveys (HHANES) and the third National Health and Nutrition Examination Surveys (NHANES III) were analyzed. TSAHeight semi-parametric models with additive age splines were used to develop smoothed TSAHeight curves accounting for maturation stage and calendar age. Results As expected, the TSAHeight curves did not track along the respective percentile curves for the CDC 2000 CAHeight curves. We generated race/ethnicity-nonspecific and race/ethnicity-specific TSAHeight charts stratified by sex and plotted against the CDC 2000 CAHeight curves to account for the pubertal status differences between these models. An online calculator to adjust height for pubertal status was created. Conclusions TSAHeight charts provide a much-needed tool to assess and manage linear growth for US children over the course of puberty. These tools may be useful in clinical management of children with pubertal timing variations.
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Affiliation(s)
- Bradley S Miller
- Pediatric Endocrinology, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota
| | - Kyriakie Sarafoglou
- Pediatric Endocrinology, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota.,Department of Experimental & Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | - O Yaw Addo
- Rollins School of Public Health, Emory University, Atlanta, Georgia
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Albertsson‐Wikland K, Niklasson A, Holmgren A, Gelander L, Nierop AFM. A new Swedish reference for total and prepubertal height. Acta Paediatr 2020; 109:754-763. [PMID: 31811779 PMCID: PMC7154623 DOI: 10.1111/apa.15129] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 10/14/2019] [Accepted: 12/05/2019] [Indexed: 11/29/2022]
Abstract
Aim We aimed to develop up‐to‐date references with standard deviation scores (SDS) for prepubertal and total height. Methods Longitudinal length/height measures from 1572 healthy children (51.5% boys) born at term in 1989‐1991 to non‐smoking mothers and Nordic parents were obtained from the GrowUp 1990 Gothenburg cohort. A total height SDS reference from birth to adult height was constructed from Quadratic‐Exponential‐Pubertal‐Stop (QEPS) function estimated heights based on individual growth curves. A prepubertal height SDS reference, showing growth trajectory in the absence of puberty, was constructed using the QE functions. Results The total height reference showed taller prepubertal mean heights (for boys 1‐2 cm; for girls 0.5‐1.0 cm) with a narrower normal within ± 2SDS range vs the GrowUp 1974 Gothenburg reference. Adult height was increased by + 0.9 cm for women (168.6 cm) and by + 1.6 cm for men (182.0 cm). Height in children growing at −2SDS (the cut‐off used for referrals) differed up to 2 cm vs the GrowUp 1974 Gothenburg reference, 3 cm vs Swedish 1981 references and World Health Organisation (WHO) 0‐5 years standard, and 6‐8 cm vs the WHO 5‐19 years reference. Conclusion Up‐to‐date total and prepubertal height references offer promise of improved growth monitoring compared with the references used in Sweden today.
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Affiliation(s)
- Kerstin Albertsson‐Wikland
- Department of Physiology/Endocrinology Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Aimon Niklasson
- Department of Pediatrics Gothenburg Pediatric Growth Research Center Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Anton Holmgren
- Department of Pediatrics Gothenburg Pediatric Growth Research Center Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatrics Halmstad Hospital Halmstad Sweden
| | - Lars Gelander
- Department of Pediatrics Gothenburg Pediatric Growth Research Center Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Andreas F. M. Nierop
- Department of Physiology/Endocrinology Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Muvara bv Multivariate Analysis of Research Data Leiderdorp The Netherlands
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