RESUMEN
BACKGROUND: We evaluated adverse short-term outcomes after open lower-extremity bypass surgery in patients with diabetes mellitus with a comparison performed based on patient height. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select patients with Current Procedural Terminology codes 35533, 35540, 35556, 35558, 35565, 35566, 35570, and 35571 and with the diagnosis of diabetes mellitus. This resulted in 83 patients 60 inches or less in height, 1,084 between 60 and 72 inches, and 211 patients 72 inches and taller. RESULTS: No differences were observed among groups with respect to the development of a superficial surgical site infection (9.6% versus 6.4% versus 5.7%; P = .458), deep incisional infection (1.2% versus 1.4% versus 2.8%; P = .289), sepsis (2.4% versus 2.0% versus 2.8%; P = .751), unplanned reoperation (19.3% versus 15.6% versus 21.8%; P = .071), or unplanned hospital readmission (19.3% versus 14.8% versus 17.1%; P = .573). A significant difference was observed among groups in the development of a wound disruption (4.8% versus 1.3% versus 4.7%; P = .001). A multivariate regression analysis was performed of the wound disruption outcome with the variables of age, sex, race, ethnicity, height, weight, current smoker, and open wound/wound infection. Race (P = .025) and weight (P = .003) were found to be independently associated with wound disruption, but height was not (P = .701). CONCLUSIONS: The results of this investigation demonstrate no significant differences in short-term adverse outcomes after lower-extremity bypass surgery based on patient height.
Asunto(s)
Estatura , Extremidad Inferior , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Extremidad Inferior/cirugía , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/etiología , Reoperación , Diabetes Mellitus/epidemiología , Resultado del Tratamiento , Factores de TiempoRESUMEN
OBJECTIVES: The aim of this study was to evaluate body composition variability assessed by bioimpedance in relation to nutritional status assessed by anthropometry in children and adolescents living in countries characterized by contrasting nutritional conditions. METHODS: The sample was comprised of 8614 children (4245 males; 4369 females), aged 3 to 19 years, from Nepal (477 children), Uganda (488 children and adolescents), UK (297 children and adolescents) and US (7352 children and adolescents). Height-for-age (HAZ) and body mass index-for-age (BAZ) z-scores were calculated according to WHO growth references. Specific bioelectrical impedance vector analysis (BIVA) was used to evaluate body composition variability. In each population sample, the relationship of HAZ and BAZ with bioelectrical outcomes was analysed by confidence ellipses and cubic spline regression, controlling for sex and age. RESULTS: The participants from Uganda and Nepal were more affected by undernutrition, and those from the US and UK by obesity. In all groups, phase angle and specific vector length were weakly associated with HAZ, with null or opposite relationships in the different samples, whereas they were positively associated with BAZ. The stronger association was between vector length, indicative of the relative content of fat mass, and BAZ in the UK and US samples. Confidence ellipses showed that the relationships are more strongly related to phase angle in Nepalese and Ugandan samples. CONCLUSIONS: Bioelectrical values were more strongly associated with BAZ than HAZ values in all population samples. Variability was more related to markers of muscle mass in Ugandan and Nepalese samples and to indicators of fat mass in UK and US samples. Specific BIVA can give information on the variability of body composition in malnourished individuals.
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Antropometría , Composición Corporal , Índice de Masa Corporal , Impedancia Eléctrica , Desnutrición , Estado Nutricional , Humanos , Femenino , Masculino , Niño , Uganda , Adolescente , Desnutrición/epidemiología , Desnutrición/diagnóstico , Preescolar , Adulto Joven , Nepal , Reino Unido , Antropometría/métodos , Estados Unidos , Estatura , Obesidad/fisiopatologíaRESUMEN
OBJECTIVES: To develop an allometric body mass index (ABMI) reference that adjusts the weight in relation to height, taking into account the changes during development (MULT ABMI reference), and to compare it with international BMI references. METHODS: The MULT ABMI reference was constructed through the LMS method, calculated with 65 644 ABMI observations of 17 447 subjects aged 5-22 years, from the United Kingdom, Ethiopia, India, Peru, Vietnam, Portugal, and Brazil. The M, S, and L curves of the MULT ABMI reference were compared with the curves of the MULT, World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF), and Dutch Growth Study (DUTCH). RESULTS: The greater differences in the M curve between MULT ABMI and WHO, CDC, IOTF, DUTCH, and MULT BMI references were around puberty (138 to 150 months for boys; 114 to 132 for girls). MULT ABMI presented S values similar to IOTF and DUTCH BMI references for boys 60 to 114 months and then became higher, approaching the MULT BMI S values from 198 to 240 months. For girls the MULT ABMI S values were close to the IOTF, CDC, and DUTCH from 60 to 110 months, and then became higher, approaching the MULT BMI S values until 240 months. CONCLUSION: MULT ABMI presented an advantage in comparison to the existing BMI references because it takes into account the growth changes during puberty and is a new option to assess the nutritional status of multiethnic populations.
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Índice de Masa Corporal , Estado Nutricional , Humanos , Niño , Adolescente , Masculino , Femenino , Preescolar , Brasil , Adulto Joven , Valores de Referencia , Estatura , Vietnam , Peso Corporal , India , Perú , Etiopía , Reino Unido , Portugal , EtnicidadRESUMEN
Metabolic dysfunction associated fatty liver disease (MAFLD) is a common cause of liver disease in children and adolescents. The relationship between insulin resistance (IR) and MAFLD in children with short stature remains largely unknown. The present study was to investigate the relationship between the triglyceride-glucose (TyG) index and alanine aminotransferase (ALT) levels in children with short stature. A total of 1754 children with short stature were enrolled. Anthropometric, biochemical and hormonal indexes were collected through physical measurement examinations and laboratory tests. A nonlinear association was found between the TyG index and ALT. The inflection point of the curve was at a TyG index of 8.24. In multivariate piecewise linear regression, only when the TyG index was greater than 8.24 was there a significant positive association between the TyG index and ALT (ß 5.75, 95% CI 3.30, 8.19; P < 0.001). However, when the TyG index was less than 8.24, there was no significant association between the TyG index and ALT (ß -0.57, 95% CI -1.84, 0.71; P = 0.382). This study demonstrated a nonlinear relationship between TyG index and ALT in children with short stature. This finding suggests that a high TyG index is associated with elevated ALT in children with short stature.
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Alanina Transaminasa , Glucemia , Estatura , Triglicéridos , Humanos , Alanina Transaminasa/sangre , Niño , Femenino , Masculino , Triglicéridos/sangre , Glucemia/análisis , Glucemia/metabolismo , Adolescente , Resistencia a la InsulinaRESUMEN
OBJECTIVE: Estimating children's target height (TH) plays an important role in diagnosing, evaluating and treating many paediatric endocrinological diseases. However, in many countries, employing Tanner's formula to predict children's final adult height (FAH) is considered misleading. Therefore, this study aimed to re-evaluate the validity of Tanner's formula for predicting the TH of Korean adolescents and young adults and develop a new formula suitable for Korean children. DESIGN/SETTING: Data were derived from the Korean National Health and Nutrition Examination Survey 2010-2019. PATIENTS: A total of 2586 participants (1266 men, 1320 women) were included, excluding participants for whom Tanner's formula could not be calculated because of missing parental height data. MAIN OUTCOME MEASURES: Tanner-based TH was compared with the FAH. RESULTS: The difference between Tanner-based TH and FAH was 4.86±0.178 cm for men and 4.81±0.150 cm for women. Sex-specific univariable and multivariable analyses were conducted to determine variables influencing positive height gap (greater than estimated TH). Both men and women with higher education levels were more likely to exhibit a positive height gap. Those with a history of chronic illness were less likely to exhibit a positive height gap, particularly in women. Using a new formula derived using linear regression analysis, the sum of parental heights explained 27.6% and 30.6% of the variance in sons' and daughters' heights, respectively. CONCLUSIONS: Tanner's formula for calculating TH tended to underestimate FAH; hence, our new formula may offer a better alternative for estimating TH and evaluating growth in Korean children and adolescents.
Asunto(s)
Estatura , Encuestas Nutricionales , Humanos , Masculino , Femenino , República de Corea , Adolescente , Adulto JovenRESUMEN
BACKGROUND: Although short stature is sometimes treatable in children, family members do not always realize that their children have short stature. To develop better educational materials for identifying short stature, we conducted a questionnaire survey on children with short stature. Using the results of the survey, we revised educational activities regarding short stature. METHODS: To assess the effectiveness of the revised activities, we examined changes in the numbers of consultations before and after the changes to the educational activities, the height of children examined after such changes, the test implementation rate, and the test results. RESULTS: After the start of direct promotion for school nursing staff in 2015, the number of outpatients with short stature who visited the hospital significantly increased (16.1/year before 2014 vs. 68.8/year after 2015; p = 0.02). The number of patients hospitalized for a growth hormone secretion stimulation test also significantly increased, from 9.3/year before 2014 to 47.0/year after 2015 (p = 0.02). However, 35% of families did not want to subject their child to a growth hormone stimulating test, even if their child was extremely short. CONCLUSIONS: Our revised educational activities for short stature among school nursing staff, school physicians, and nurses at health centers were more effective than conventional activities consisting of public relations magazines and lectures for the general public. It is important to provide proper explanations to enable a better understanding of hormone therapy.
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Estatura , Humanos , Niño , Encuestas y Cuestionarios , Femenino , Masculino , Concienciación , Trastornos del Crecimiento/diagnóstico , Educación en Salud/métodosRESUMEN
Various animal and plant species exhibit allometric relationships among their respective traits, wherein one trait undergoes expansion as a power-law function of another due to constraints acting on growth processes. For instance, the acknowledged consensus posits that tree height scales with the two-thirds power of stem diameter. In the context of human development, it is posited that body weight scales with the second power of height. This prevalent allometric relationship derives its nomenclature from fitting two variables linearly within a logarithmic framework, thus giving rise to the term "power-law relationship." Here, we challenge the conventional assumption that a singular power-law equation adequately encapsulates the allometric relationship between any two traits. We strategically leverage quantile regression analysis to demonstrate that the scaling exponent characterizing this power-law relationship is contingent upon the centile within these traits' distributions. This observation fundamentally underscores the proposition that individuals occupying disparate segments of the distribution may employ distinct growth strategies, as indicated by distinct power-law exponents. We introduce the innovative concept of "multi-scale allometry" to encapsulate this newfound insight. Through a comprehensive reevaluation of (i) the height-weight relationship within a cohort comprising 7, 863, 520 Japanese children aged 5-17 years for which the age, sex, height, and weight were recorded as part of a national study, (ii) the stem-diameter-height and crown-radius-height relationships within an expansive sample of 498, 838 georeferenced and taxonomically standardized records of individual trees spanning diverse geographical locations, and (iii) the brain-size-body-size relationship within an extensive dataset encompassing 1, 552 mammalian species, we resolutely substantiate the viability of multi-scale allometric analysis. This empirical substantiation advocates a paradigm shift from uni-scaling to multi-scaling allometric modeling, thereby affording greater prominence to the inherent growth processes that underlie the morphological diversity evident throughout the living world.
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Árboles , Humanos , Animales , Árboles/crecimiento & desarrollo , Árboles/anatomía & histología , Femenino , Masculino , Niño , Estatura , Peso Corporal , Adolescente , Desarrollo Humano/fisiología , Mamíferos/anatomía & histología , Mamíferos/crecimiento & desarrollo , PreescolarRESUMEN
Age-stratified path analyses modeled associations between enteric pathogen reservoirs, transmission pathways and height-for-age z-scores (HAZ) to identify determinants of childhood growth in the Kolkata, India site of the Global Enteric Multicenter Study (GEMS). Models tested direct associations of potential pathogen reservoirs with HAZ at 60-day follow-up in separate moderate and severe diarrhea (MSD) case and control cohorts or indirectly when mediated by enteric infections. In the MSD cohort, rotavirus and typical EPEC (tEPEC) infections among children 0-11 months of age and ST-ETEC infections among children 12-23 months of age were associated with lower HAZ. Handwashing after defecating and before cooking reduced impaired growth through reductions in rotavirus and tEPEC infections. Water storage increased rotavirus and ST-ETEC infection risks, resulting in increased impaired growth, but was reduced with reported child feces disposal. The GII norovirus variant was inversely associated with HAZ among children 12-59 months of age in the control cohort. Reported handwashing before the handling of children reduced GII infections and impaired growth. Boiling water and the disposal of children's feces mediated by stored water were positively associated with HAZ. The targeting of pathogen-specific reservoirs and transmission pathways may more effectively improve childhood linear growth in South Asian urban communities.
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Diarrea , Humanos , India/epidemiología , Lactante , Masculino , Preescolar , Femenino , Diarrea/virología , Diarrea/epidemiología , Recién Nacido , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/virología , Estatura , Estudios de Casos y Controles , Infecciones por Rotavirus/transmisión , Infecciones por Rotavirus/prevención & control , Infecciones por Rotavirus/epidemiología , Heces/virología , Heces/microbiología , Desinfección de las Manos , Rotavirus/aislamiento & purificación , Reservorios de Enfermedades/virologíaRESUMEN
BACKGROUND: The positive changes in hygienic living conditions are commonly believed to explain secular changes in body height and the age of maturity. However, it is difficult to estimate the separate impacts of these factors due to the lack of social and economic data and variations in the sources of information. We hypothesized that final male body height could be associated with various socioeconomic indicators, such as the development of the medical care system, the quality of nutrition, and the level of sanitary and hygienic conditions. Moreover, we hypothesized that male body height could be associated with the level of morbidity in the region during the time of conscript childhood (from 1 to 7 years old). MATERIALS AND METHODS: We used two main sources of information in the analyses. The first is the data from the Statistical Reference Book published by the Central Statistical Committee in 1929. The second is the annual data from the Statistical Reference Book published in the Russian Empire. Since the conscripts were born between 1906 and 1909, we used datasets from 1910 to 1913. To analyze the data, we used a method of analyzing interacting variables called St. Nicolas House Analysis (SNHA). RESULTS: Our analyses revealed direct associations between the morbidity of some diseases and male body height and other anthropometric parameters. CONCLUSIONS: There are associations between conscript final body height and the morbidity of influenza, dysentery and some venereal diseases, such as chancroid and syphilis. There were no associations between conscript final body height and the level of morbidity during childhood. However, other final parameters, such as BMI, weight, and chest circumference, could be associated with the morbidity of malaria, scabies, scurvy, and scarlet fever during childhood. The prevalence of these diseases could be strongly connected with unfavorable living conditions. The results are similar for both urban and rural areas.
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Estatura , Masculino , Humanos , Estatura/fisiología , Higiene , Federación de Rusia/epidemiología , Niño , Personal Militar/estadística & datos numéricos , Antropología Física , Adulto , Preescolar , Adulto Joven , Factores SocioeconómicosRESUMEN
OBJECTIVE: To determine the auxological response to recombinant human growth hormone (rhGH) therapy in children with growth hormone deficiency (GHD) presenting at the National Institute of Child Health, Karachi, Pakistan. STUDY DESIGN: Observational study. Place and Duration of the Study: Department of Paediatric Endocrinology, National Institute of Child Health, Karachi, Pakistan, from January 2022 to December 2023. METHODOLOGY: All pre-pubertal children with short stature aged 3-12 years diagnosed with GHD and who were prescribed rhGH therapy were included in the study. Children with any other underlying reason for short stature or any other comorbidity were excluded. Patients' demographics and baseline growth parameters were recorded in a pre-designed proforma. Patients were then followed up every three months till one year. Response to rhGH therapy was evaluated through comparison of growth parameters before and after one year of therapy. RESULTS: A total of 90 children including 47 (52.2%) males and 43 (47.8%) females with GHD were enrolled. Mean age of these patients was 7.92 ± 2.647 years. A statistically significant change in height (SD), Weight (SD), and BMI (SD) was observed before and after one year of therapy (p <0.001). Response to therapy in terms of height did not differ significantly with respect to gender (p = 0.955) or stimulated growth hormone levels (p = 0.911). However, response to rhGH therapy was significantly better in terms of increase in height, weight, and BMI in patients presenting earlier i.e. at age ≤8 years. CONCLUSION: Recombinant human growth hormone therapy was effective in children with short stature to achieve desirable growth. Children diagnosed and treated at a younger age (≤8years) achieve better height outcomes as compared to those presenting late. KEY WORDS: Short stature, Growth hormone deficiency, Recombinant human growth hormone.
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Estatura , Trastornos del Crecimiento , Hormona de Crecimiento Humana , Proteínas Recombinantes , Humanos , Femenino , Masculino , Niño , Hormona de Crecimiento Humana/uso terapéutico , Hormona de Crecimiento Humana/deficiencia , Preescolar , Estatura/efectos de los fármacos , Proteínas Recombinantes/uso terapéutico , Trastornos del Crecimiento/tratamiento farmacológico , Pakistán , Resultado del Tratamiento , Enanismo Hipofisario/tratamiento farmacológicoRESUMEN
The objective of the current study was to investigate the impact of human's height variability to the deposition percentage, the deposited and the retained dose of particulate matter in the respiratory tract. In addition, the dose to the oesophagus, blood and lymph nodes was evaluated after particle clearance. A methodology which correlates anatomical and physiological parameters with height was adopted into an existing particle dosimetry model (Exposure Dose Model 2, ExDoM2). Model results showed that deposition of particles with aerodynamic diameter (dae) ranging from 0.001 to 10 µm depends on the competition between anatomical/physiological parameters, with the maximum effect induced from height variability to be observed for particles in the size range of 0.30 µm Asunto(s)
Tamaño de la Partícula
, Material Particulado
, Sistema Respiratorio
, Humanos
, Sistema Respiratorio/efectos de los fármacos
, Contaminantes Atmosféricos
, Estatura
RESUMEN
INTRODUCTION: Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount. OBJECTIVES: To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature. METHODS: We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3-5 CKD not on dialysis, followed for at least one year. RESULTS: We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was -1.89 ± 1.84 and -2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047). CONCLUSION: Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support.
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Trastornos del Crecimiento , Insuficiencia Renal Crónica , Humanos , Masculino , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/terapia , Femenino , Estudios Retrospectivos , Niño , Factores de Riesgo , Preescolar , Trastornos del Crecimiento/etiología , Trastornos del Crecimiento/epidemiología , Estatura , Adolescente , LactanteRESUMEN
Height is known to be a classically heritable trait controlled by complex polygenic factors. Numerous height-associated genetic variants across the genome have been identified so far. It is also a representative of externally visible characteristics (EVC) for predicting appearance in forensic science. When biological evidence at a crime scene is deficient in identifying an individual, the examination of forensic DNA phenotyping using some genetic variants could be considered. In this study, we aimed to predict 'height', a representative forensic phenotype, by using a small number of genetic variants when short tandem repeat (STR) analysis is hard with insufficient biological samples. Our results not only replicated previous genetic signals but also indicated an upward trend in polygenic score (PGS) with increasing height in the validation and replication stages for both genders. These results demonstrate that the established SNP sets in this study could be used for height estimation in the Korean population. Specifically, since the PGS model constructed in this study targets only a small number of SNPs, it contributes to enabling forensic DNA phenotyping even at crime scenes with a minimal amount of biological evidence. To the best of our knowledge, this was the first study to evaluate a PGS model for height estimation in the Korean population using GWAS signals. Our study offers insight into the polygenic effect of height in East Asians, incorporating genetic variants from non-Asian populations.
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Pueblo Asiatico , Estatura , Herencia Multifactorial , Polimorfismo de Nucleótido Simple , Humanos , Masculino , Herencia Multifactorial/genética , Femenino , Estatura/genética , República de Corea , Pueblo Asiatico/genética , Genética Forense/métodos , Adulto , Estudio de Asociación del Genoma Completo/métodos , Fenotipo , Repeticiones de Microsatélite/genética , Persona de Mediana EdadRESUMEN
RATIONALE: Glycogen storage disease type 0a (GSD0a) is a rare autosomal recessive disorder caused by glycogen synthase deficiency. Short stature is a characteristic feature in 29% of GSD0a patients, but isolated short stature as the only presenting symptom is exceedingly rare, with only 2 cases reported worldwide. PATIENT CONCERNS: A 4-year-old girl presented with persistent growth retardation despite previous treatment for renal tubular acidosis. DIAGNOSES: Based on clinical presentation and whole exome sequencing results, the patient was diagnosed with GSD0a. INTERVENTIONS: Uncooked cornstarch therapy was initiated at 2 g/kg every 6 hours. OUTCOMES: After 3 years of treatment, the patient's height SDS improved from -2.24 to -1.06, with enhanced glycemic control and no complications. LESSONS: This case emphasizes considering GSD0a in unexplained short stature and the value of continuous glucose monitoring. Early diagnosis and treatment can optimize growth in GSD0a patients.
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Enfermedad del Almacenamiento de Glucógeno , Humanos , Femenino , Preescolar , Enfermedad del Almacenamiento de Glucógeno/diagnóstico , Estatura , Trastornos del Crecimiento/diagnóstico , Trastornos del Crecimiento/etiología , Almidón/uso terapéutico , China , Pueblos del Este de Asia , Enfermedad del Almacenamiento de Glucógeno Tipo IRESUMEN
We first established percentile reference curves for infant length and head circumference in Hainan Province based on gender and age in months and compared them with the 2022 national standards and World Health Organization (WHO) standards. This cross-sectional survey involved 2736 infants (1471 boys and 1265 girls) in 18 cities and counties in Hainan Province. Standardized instruments were used to measure head circumference and length. Reference values for Hainan infants' length and head circumference were determined using the LMS method. Curves were generated using the LMS Chart Maker software. According to the newly established reference curves, the length and head circumference of Hainan infants exhibited a consistent trend of steady growth. However, the average head circumference was below the 2022 national reference values and WHO standards. The mean length was lower than the new national reference values but roughly consistent with the WHO standards. Differences exist in infant length and head circumference in Hainan compared to national and global averages. To enhance infant length and head circumference growth, the health department should encourage exclusive breastfeeding for the first 6 months, ensure infants' sleep needs at night, and promote the regularity of vitamin D supplementation during the perinatal period.
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Estatura , Cabeza , Humanos , Lactante , Masculino , Femenino , China , Recién Nacido , Valores de Referencia , Estudios Transversales , Cabeza/anatomía & histología , Cefalometría , Gráficos de Crecimiento , Organización Mundial de la SaludRESUMEN
OBJECTIVES: Clinical benefits of growth hormone (GH) in Prader-Willi syndrome (PWS) are proven and scoliosis is a known association of both PWS and GH therapy. The aims of this study were to assess GH prescribing practices and growth outcomes over time, the prevalence and predictors of scoliosis in GH-treated PWS children, and the near-final height of GH-treated PWS patients. DESIGN AND METHODS: This is a retrospective, descriptive study evaluating data from all clinic visits of patients aged 0-18 years with PWS, seen through the Children's Hospital at Westmead between March 1992 and May 2022 (n=75). RESULTS: A total of 64 patients were treated with GH (visits = 1,414). In the recent decade, the diagnosis of PWS and GH commencement were made significantly earlier in life. The prevalence of scoliosis was 41â¯%, in which age was the only significant predictor for scoliosis (odds ratio 1.19: 95â¯% CI [1.08-1.31; p=0.001]) adjusted for other predictors. In patients with data available at the age 16 years (23/28 treated with GH), those who were GH treated had significantly higher height SDS vs. nontreated group (SDS -0.67 vs. -2.58; p=0.0001) and lower BMI SDS (1.18 vs. 2.37; p<0.001). CONCLUSIONS: Significant improvements in growth and body composition were seen in the GH-treated group vs. non-treated group of children with PWS. There were no significant modifiable clinical predictors of scoliosis in children with PWS, but our findings confirm the high prevalence of scoliosis in GH-treated children with PWS reinforcing the need for close surveillance.
Asunto(s)
Hormona de Crecimiento Humana , Síndrome de Prader-Willi , Escoliosis , Humanos , Síndrome de Prader-Willi/tratamiento farmacológico , Niño , Masculino , Femenino , Estudios Retrospectivos , Hormona de Crecimiento Humana/uso terapéutico , Hormona de Crecimiento Humana/administración & dosificación , Adolescente , Preescolar , Lactante , Escoliosis/epidemiología , Escoliosis/tratamiento farmacológico , Escoliosis/etiología , Recién Nacido , Estudios de Seguimiento , Pronóstico , Resultado del Tratamiento , Estatura/efectos de los fármacos , Centros de Atención Terciaria , PrevalenciaRESUMEN
Tracking trajectories of body size in children provides insight into chronic disease risk. One measure of pediatric body size is body mass index (BMI), a function of height and weight. Errors in measuring height or weight may lead to incorrect assessment of BMI. Yet childhood measures of height and weight extracted from electronic medical records often include values which seem biologically implausible in the context of a growth trajectory. Removing biologically implausible values reduces noise in the data, and thus increases the ease of modeling associations between exposures and childhood BMI trajectories, or between childhood BMI trajectories and subsequent health conditions. We developed open-source algorithms (available on github) for detecting and removing biologically implausible values in pediatric trajectories of height and weight. A Monte Carlo simulation experiment compared the sensitivity, specificity and speed of our algorithms to three published algorithms. The comparator algorithms were selected because they used trajectory information, had open-source code, and had published verification studies. Simulation inputs were derived from longitudinal epidemiological cohorts. Our algorithms had higher specificity, with similar sensitivity and speed, when compared to the three published algorithms. The results suggest that our algorithms should be adopted for cleaning longitudinal pediatric growth data.
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Algoritmos , Índice de Masa Corporal , Humanos , Niño , Estudios Longitudinales , Estatura , Femenino , Registros Electrónicos de Salud , Masculino , Peso Corporal , Preescolar , Método de Montecarlo , Adolescente , LactanteRESUMEN
OBJECTIVES: This study aimed to analyze the height growth pattern and the incidence of significant growth deceleration in girls with CPP and EFP on GnRHa treatment, and thereby identify relevant predictors of growth deceleration. METHODS: The data of 99 girls diagnosed with CPP and 47 girls with EFP were included in this retrospective analysis. The incidence of growth deceleration was calculated in both the first and second years. Multivariate logistic regression analysis was used to identify predictors indicative of growth deceleration. RESULTS: Growth velocity (GV) trajectories showed gradual decreases to the nadir at 18 months of treatment, and then they recovered till the 24th month of treatment, especially in girls with CPP. Nevertheless, the recovery was significantly greater in the CPP group than EFP. In the first year, no significant difference in the incidence of growth deceleration was found between the CPP group and the EFP group [17.35 vs. 25.53â¯%, p=0.249]; in the second year, the CPP group had a lower incidence than the EFP group [42.86 vs. 76.92â¯%, p=0.027]. The multivariate logistic regression analysis suggested that bone age (BA) was an independent predictor of growth deceleration (OR=2.264, 95â¯% CI: 1.268-4.042, p=0.006). The result of ROC curves showed the cut-off value of BA was 11.05 years. CONCLUSIONS: GV varies at different periods during GnRHa treatment. GnRHa should be used with more caution for EFP treatment than for CPP. BA can be used to predict the occurrence of growth deceleration during GnRHa treatment.
Asunto(s)
Estatura , Humanos , Femenino , Estudios Retrospectivos , Niño , Estudios Longitudinales , Estatura/efectos de los fármacos , Trastornos del Crecimiento/tratamiento farmacológico , Pubertad Precoz/tratamiento farmacológico , Pronóstico , Estudios de Seguimiento , Adolescente , Desarrollo Infantil/efectos de los fármacosRESUMEN
BACKGROUND: Running exposes the body to physiological and mechanical stresses that generate musculoskeletal injuries, such as low back pain due to large spinal loading. Increasing running cadence may reduce impact forces and spinal shrinkage. RESEARCH QUESTION: This study aimed to determine the relationship between spinal loading and running cadence. METHODS: This cross-sectional study included 15 runners from the local community (36 ± 11 years; 23 ± 2â¯kg.m-2, and 8 ± 9 years of running experience) who ran for 30â¯min (R30) and 60â¯min (R60) at a constant speed (10â¯km.h-1). The spinal loading was assessed via fine stature variation measurements before the run (baseline) at R30 and R60. Cadence was monitored via a wristwatch. The cadence ranged from 150 to 180 steps.min-1. A t-test was used to compare stature loss between R30 and R60 (relative to baseline), and a stepwise linear regression equation was used to identify the relationship between cadence and stature variation in each instant. RESULTS: There was a stature loss throughout the race (R30 = 5.27 ± 1.92â¯mm and R60 =7.51 ± 2.51â¯mm). A linear regression analysis revealed a negative relationship between stature loss and cadence, indicating that running at a faster cadence produces smaller spinal loading than running at slower cadences after R60 (R2 = 0.38; p<0.05). SIGNIFICANCE: Increasing running cadence might cause less spinal loading than running with a slower cadence, which may reduce the risk of injury and back disorders in runners.
Asunto(s)
Carrera , Soporte de Peso , Humanos , Carrera/fisiología , Estudios Transversales , Adulto , Masculino , Fenómenos Biomecánicos , Femenino , Soporte de Peso/fisiología , Persona de Mediana Edad , Columna Vertebral/fisiología , Estatura , Dolor de la Región Lumbar/etiologíaRESUMEN
BACKGROUND: While body mass index (BMI) defines obesity as a well-established risk factor for cardiovascular disease, the paradoxical theory of BMI suggests that obesity may indeed have a favorable impact on the prognosis of cardiovascular disease. Therefore, this study aims to assess the correlation between body shape index (ABSI), which is a novel measure of obesity, and coronary heart disease (CHD) among obese individuals in the United States. METHODS: The data from the National Health and Nutrition Examination Survey (NHANES) were evaluated by us for 5046 patients. We assessed the exposure variable ABSI, which includes waist circumference (WC), height, and BMI. The outcome variable was CHD. RESULTS: The cross-sectional study included a total of 5046 obese adults aged over 20 years, with an average age (standard deviation: SD) of 49.86 (16.24) years and a male proportion of 44.57%.The odds ratio (OR) values for CHD in Model 1, Model 2, 3 were found to be 2.45 (95%CI: 2.12, 2.83), 1.53 (95%CI:1.30, 1.81) and 1.31 (95%CI:1.09, 1.56) per SD increase in ABSI, respectively. In the fully adjusted model, we designated participants in the T1 group as the reference group. Our findings indicate a significant increase in the prevalence of CHD (OR:1.82, 95%CI: 1.07-3.10) only within the T3 group. Although there is an increased prevalence of CHD (OR:1.32, 95%CI: 0.77-2.29) in the T2 group, no statistically significant difference was observed. CONCLUSIONS: The increase in ABSI is strongly associated with the rise in CHD prevalence among obese individuals in the United States.