Alex F. Roche

Estimating stature from knee height for persons 60 to 90 years of age.

Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in the nonambulatory elderly person, or its value may be spurious if measured in those elderly persons with excessive spinal curvature. Simple equations are presented for estimating the stature of elderly men from a recumbent measure of knee height and for elderly women from a recumbent measure of knee height and age. The 90 per cent error bounds for these equations for an individual are about plus or minus 6.0 cm. Knee height Is highly correlated with stature. J Am Geriatr Soc 33:116, 1985

Effect of Growth Hormone Treatment on Adult Height of Children with Idiopathic Short Stature

Background Short-term administration of growth hormone to children with idiopathic short stature results in increases in growth rate and standard-deviation scores for height. However, the effect of long-term growth hormone therapy on adult height in these children is unknown. Methods We studied 121 children with idiopathic short stature, all of whom had an initial height below the third percentile, low growth rates, and maximal stimulated serum concentrations of growth hormone of at least 10 microg per liter. The children were treated with growth hormone (0.3 mg per kilogram of body weight per week) for 2 to 10 years. Eighty of these children have reached adult height, with a bone age of at least 16 years in the boys and at least 14 years in the girls, and pubertal stage 4 or 5. The difference between the predicted adult height before treatment and achieved adult height was compared with the corresponding difference in three untreated normal or short-statured control groups. Results In the 80 children who have reached adult height, growth hormone treatment increased the mean standard-deviation score for height (number of standard deviations from the mean height for chronologic age) from -2.7 to -1.4. The mean (+/-SD) difference between predicted adult height before treatment and achieved adult height was +5.0+/-5.1 cm for boys and +5.9+/-5.2 cm for girls. The difference between predicted and achieved adult height among treated boys was 9.2 cm greater than the corresponding difference among untreated boys with initial standard-deviation scores of less than -2, and the difference among treated girls was 5.7 cm greater than the difference among untreated girls. Conclusion Long-term administration of growth hormone to children with idiopathic short stature can increase adult height to a level above the predicted adult height and above the adult height of untreated historical control children.

Age- and maturity-related changes in body composition during adolescence into adulthood: The Fels Longitudinal Study

OBJECTIVES: To examine patterns of change in total body fat (TBF), percent body fat (%BF), and fat-free mass (FFM), from 8--20 y of age and the effect of rate of skeletal maturation. To determine the degree of tracking of body composition for individuals from childhood into adulthood.RESEARCH DESIGN: Annual serial data for TBF, %BF and FFM from underwater weighing using a multicomponent body composition model were collected from 130 CAUcasian males and 114 CAUcasian females between 1976 and 1996. Rate of maturation was defined as FELS skeletal age (SA) less chronological age (CA). Random effects models were used to evaluate general patterns of change and tracking of individual serial data over the 12 y age range.RESULTS: Changes in TBF followed a quadratic model for males and for females with declining rates of change. Changes for %BF followed a cubic model for males and females. General patterns of change for FFM followed a cubic model for males and a quadratic model for females. TBF for males and females increased with age, but the rates of change declined with age. %BF for females increased from age 8–20 y. For males, %BF increased with age, but the positive rates of change declined and became a negative when aged about 13 y and reached a minimum at about the age of 15 y. The rate of change for %BF increased thereafter. FFM for males and females increased with age, but the rates of change decreased with age. The extent of tracking is inversely related to the length of the time interval. At the same age, rapidly-maturing children have significantly larger amounts of TBF, %BF and FFM than slow-maturing children. Tracking in body composition for individuals persisted from childhood to adulthood.CONCLUSIONS: (1) There are gender-associated differences in these patterns of change for %BF and FFM but not for TBF; (2) TBF, %BF and FFM increased with increased rates of maturation; (3) significant tracking in body composition for individuals persists from childhood to adulthood.

Comparison of percent body fat estimates using air displacement plethysmography and hydrodensitometry in adults and children.

PURPOSE: The purpose of the study was to compare estimates of body density and percentage body fat from air displacement plethysmography (ADP) to those from hydrodensitometry (HD) in adults and children and to provide a review of similar recent studies.METHODS: Body density and percentage body fat (% BF) were assessed by ADP and HD on the same day in 87 adults aged 18–69 y (41 males and 46 females) and 39 children aged 8–17 y (19 males and 20 females). Differences between measured and predicted thoracic gas volumes determined during the ADP procedure and the resultant effects of those differences on body composition estimates were also compared. In a subset of 50 individuals (31 adults and 19 children), reliability of ADP was measured and the relative ease or difficulty of ADP and HD were probed with a questionnaire.RESULTS: The coefficient of reliability between %BF on day 1 and day 2 was 96.4 in adults and 90.1 in children, and the technical error of measurement of 1.6% in adults and 1.8% in children. Using a predicted rather than a measured thoracic gas volume did not significantly affect percentage body fat estimates in adults, but resulted in overestimates of percentage body fat in children. Mean percentage body fat from ADP was higher than percentage body fat from HD, although this was statistically significant only in adults (29.3 vs 27.7%, P<0.05). The 95% confidence interval of the between-method differences for all subjects was −7 to +9% body fat, and the root mean square error (r.m.s.e.) was approximately 4% body fat. In the subset of individuals who were asked to compare the two methods, 46 out of 50 (92%) indicated that they preferred the ADP to HD.CONCLUSION: ADP is a reliable method of measuring body composition that subjects found preferable to underwater weighing. However, as shown here and in most other studies, there are differences in percentage body fat estimates assessed by the two methods, perhaps related to body size, age or other factors, that are sufficient to preclude ADP from being used interchangeably with underwater weighing on an individual basis.

Growth in weight, recumbent length, and head circumference for preterm low-birthweight infants during the first three years of life using gestation- adjusted ages

Data from 867 preterm low-birthweight participants in the Infant Health and Development Program (IHDP) were used to develop reference data for growth status at an age and for increments from term to 36 month gestation-adjusted age (GAA). Weight, length and head circumference were recorded at 4 month intervals in the first year and at 6 month intervals in the second and third years. Selected percentiles for values at an age (status values) and increments for age intervals are presented in graphs separately for VLBW infants (< or = 1500 g at birth) and for LBW infants (1501-2500 g at birth). Percentiles of weight increments are presented beginning shortly before term for 1 month intervals to 6 month GAA, for 2 month intervals to 12 month GAA, and for 3-month intervals to 36 month GAA. Percentiles for length and head circumference increments are presented from term to 6 months for 2-month intervals, and to 36 month GAA for 3 month intervals. Among LBW infants, boys, had larger status and increment values than girls (P < 0.05), but there were no significant sex-associated differences in VLBW infants for status or increments. The mean status values and increments in weight and head circumference of the LBW infants were larger than those of VLBW infants, but the differences in length were not significant.

Reference data on gains in weight and length during the first two years of life

Serial data from studies of infants at the University of Iowa and from the Fels Longitudinal Study were used to develop sex-specific percentiles for increments in weight and recumbent length for selected intervals during the first 24 months of life. Weight increments are presented for 1-month intervals from birth to 6 months, 2-month intervals from birth to 12 months, and 3-month intervals from birth to 24 months. Length increments are presented for 2-month intervals from birth to 6 months, and for 3-month intervals from birth to 24 months of age. Weights and lengths at the target ages were obtained for the Iowa data by simple interpolation, and for the Fels data by fitting families of three-parameter mathematical functions to the serial data from ages 1 to 24 months. The tabular presentations are based on the Iowa data from birth to 3 months of age, on the combined Iowa and Fels data from 3 to 6 months of age, and on the Fels data from 6 to 24 months of age. We believe that these reference data will be useful in screening for deviations from normal growth and may aid in early detection of failure to thrive or excessive weight gain during early life.

Body size and fatness in young adults in relation to age at menarche

The relationships among age at menarche, body size, and body composition were considered in university students surveyed in 1970 (n = 342) and 1987 (n = 109). Recalled ages at menarche, stature, weight, and the triceps skinfold thickness were measured. Subjects ranged in age from 17.5 to 22.5 years in both surveys and were divided into four categories by age at menarche: before 12 years, 12.0 through 12.99 years, 13.0 through 13.99 years, and older than 14 years. In both the 1970 and 1987 surveys, later maturers had significantly more linear physiques than those experiencing menarche earlier. Late maturers also showed a tendency to lower values for the body mass index (BMI) and triceps skinfold compared with early maturers. Comparative data for women of the same age from the Fels Longitudinal Study (n = 234) showed similar findings. Women who reached menarche at ages older than 14 years were significantly taller than women with menarcheal ages less than 13 years. Women with menarcheal ages younger than 12 years were significantly heavier and had higher BMIs than those from any older menarcheal category. They also had significantly thicker triceps skinfolds than those with menarcheal ages older than 14 years.

Tall girls: A survey of 15 years of management and treatment

In the past 15 years 450 girls have been seen because of concern about tall stature; 168 of them have been treated with stilbestrol to control the growth rate. Of the latter group 87 have been followed after treatment for a sufficiently long time to be sure growth had ceased and to provide the data for this report. At the onset of treatment the following data (mean values) were recorded: chronologic age, 13.0 years; skeletal age, 13.2 years; height, 172.9 cm; estimated mature height 180.2 cm; and growth potential, 7.3 cm. At the end of treatment data of interest (mean values) were: reduction in final height, 3.5 cm; duration of therapy, 2.1 years; amount of stilbestrol given, 2.3 gm; age of last visit, 17.6 years. Side effects were minimal, though two girls developed parovarian cysts that required surgery during treatment. Not included in the series of 87, one additional girl was seen with a serous cystadenoma of the ovary, and one girl developed superficial venous thrombosis of the lalf. Long-term follow-up has revealed no late complications. It is concluded that estrogen can reduce significantly the growth rate of almost all tall girls, but treatment must be carried out under very careful supervision, bearing in mind possible side effects.

Sex Differences in Bone Mass Acquisition During Growth: The Fels Longitudinal Study

Risk of osteoporosis in later life may be determined during adolescence and young adulthood. The present study used longitudinal data to examine the accumulation of bone mineral content (BMC) and bone mineral density (BMD) in Caucasian subjects ages 6-36 yr. Growth in BMC and BMD (measured by dual X-ray absorptiometry; Lunar, Madison, WI) of 94 males and 92 females was monitored for a mean period of 4.29 yr. The main findings were that there were no sex differences in BMC or BMD during the prepubertal stage; however, females had significantly higher BMD of the pelvis and BMC and BMD of the spine during puberty, and postpubertal males generally had significantly higher BMC and BMD than their female counterparts. In addition, the longitudinal rate of bone accumulation in both sexes increased rapidly during childhood and adolescence and was nearly complete at the end of puberty. Finally, peak BMC and BMD was achieved between the ages of 20 and 25 and occurred earlier in females than in males. The rates of growth and timing of peak bone mass as reported here define the crucial period during which intervention protocols should be developed for maximizing skeletal mass to prevent the development of osteoporosis.

Manual of physical status and performance in childhood

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