Andrzej Furman

Body mass index references for Turkish children

AIM To construct the body mass index reference curves for Turkish children aged 6 to 18 y, and to determine the prevalence of overweight and obesity. SUBJECTS AND METHODS Height and weight measurements of healthy schoolchildren (1,100 boys, 1,019 girls) were obtained biannually. Body mass index was calculated from 11,648 height and weight measurements. Centile curves were constructed using the LMS method. RESULTS The smoothed percentile values and curves for body mass index in Turkish children show that there is a constant increase in body mass index values towards adulthood, especially during the pubertal years, in both sexes. The prevalence of overweight is 25% and obesity 4% in boys at age 18 y. The percentage of overweight and obesity in girls at age 14 was 15% and 1%, respectively. The sample size was too small to come to any conclusion regarding these rates at 18 y of age. CONCLUSION This study presents data and curves for body mass index values in healthy Turkish children aged 6 to 18 y. The values are in compliance with those of Western countries.

Growth references for Turkish children aged 6 to 18 years

Aim: To create up‐to‐date reference standards for Turkish children, and to compare these with growth standards for US children (CDC 2000 Growth Charts) and with previous local data. Subjects and Methods: Height and weight measurements of 1100 boys and 1020 girls were obtained by biannual visits to six schools located in relatively well‐off districts of Istanbul city. All children came from well‐to‐do families and all were healthy. All measurements were made by two trained technicians. The LMS method was used in the analyses. Results: Heights of the boys and girls in all age groups were close to the updated 2000 USA growth references and showed an increase from data on Turkish children born 30 y earlier. Weight values were high compared to reference data on US children and to the older data on Turkish children.

Updated growth curves for Turkish children aged 15 days to 60 months

BACKGROUND Growth reference values are useful in paediatric health care as a health indicator. Secular changes in height for age values are also known to affect the timing of puberty and brain weight. Different populations may be at different stages of this secular trend. It is, therefore, necessary to periodically update the growth reference values for each population to identify these changes. The aim of this study was to update the growth reference values for Turkish infants and young children. METHODS Background information and height/length, weight and head circumference measurements on a sample of 2391 boys and 2102 girls were obtained from Well Child Clinic Records. The LMS method was used for the analyses. The percentage of exclusive breastfeeding was 62% at 4 months and 26.6% at 6 months. The continuation rate of breastfeeding at 12 months was 62.5%. RESULTS Comparison with previous Turkish data showed an increase in height of 0.9 cm for boys and 1.1 cm for girls at age 5 years. The increase in weight was 0.220 kg in girls, while a decrease of 0.160 kg was noted in boys. Comparison with the 2000 US and Swedish values indicated that population differences may exist in pre-pubertal years. CONCLUSION This study provides an enhanced instrument to evaluate the growth of Turkish infants and young children.

Puberty and Influencing Factors in Schoolgirls Living in Istanbul: End of the Secular Trend?

OBJECTIVE: To (1) establish the median ages at menarche and pubertal stages and investigate influential factors and (2) assess the secular trend in reaching puberty in a transitional society. MATERIALS AND METHODS: A probit method was used to calculate the median age at menarche and pubertal stages from a cross-sectional study of 4868 healthy schoolgirls (aged 6–18 years) in Istanbul, Turkey. The findings were compared with those from a similar study performed 4 decades earlier. Logistic regression was used to analyze the associations between the odds of attaining puberty stages and putatively influential factors. Simple statistical models were used to test the effects of BMI and consumption of certain foods on the onset of menarche. RESULTS: The median age at menarche is 12.74 years. The median ages at breast stages 2 through 5 are 9.65, 10.10, 11.75, and 14.17 years, respectively, and at pubic-hair stages 2 through 5 are 10.09, 11.19, 12.33, and 14.68 years, respectively. Girls from upper socioeconomic classes are more likely to reach menarche and B4 and B5 stages. Higher BMI seems to be a promoting factor for attaining menarche. Intrauterine growth and gestational age had no effect. The average age at menarche was not associated with the consumption of milk, eggs, chicken, or fish. CONCLUSIONS: The secular trend in puberty is probably about to end in Turkey. Although the median ages at the breast stages show a decreasing trend, the median age at menarche is approximately the same as it was 4 decades ago. Socioeconomic status and BMI are important, and related, factors that affect the age at menarche and pubertal stages.

Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children.

Objective: This study aimed to integrate the existing updated reference standards for the growth of Turkish infants and children and to compare these values with World Health Organization (WHO) reference data, data from some European countries, and also with previous local data. Weight, height, and head circumference measurements were obtained on 2,391 boys and 2,102 girls who were regular attenders of a well child clinic and on 1,100 boys and 1,020 girls attending schools in relatively well-off districts in İstanbul. Mean number of measurements per child was 8.2±3.6 in the age group 0-5 years and 5.5±3.3 in the age group 6-18 years. All children were from well-to-do families and all were healthy. All measurements with the exception of measurements at birth, which were based on reported values, were done by trained personnel. Methods: The LMS method was used in the analyses and in the construction of the percentile charts. There is an increase in weight for age and body mass index values for age starting in prepubertal ages, indicating an increasing trend for obesity. Results: Compared to WHO reference data, weight and height values in Turkish children were slightly higher in infants and in children younger than 5 years, while they showed similarity to those reported for children from Norway and Belgium. Head circumference values, which were slightly higher than the WHO references in the first 5 years, were comparable to the data on Belgian and Norwegian children in the first 9 years of life. At older ages, Turkish children showed higher values for head circumference. Conclusion: The relatively larger head circumference values were interpreted to reflect a genetic characteristic.

The prevalence and risk factors of premature thelarche and pubarche in 4- to 8-year-old girls

Aim:  To assess the prevalence of premature thelarche (PT) and pubarche in healthy 4‐ to 8‐year‐old girls and to investigate factors associated with early pubertal development.

The Effect of Helicobacter Pylori and Economic Status on Growth Parameters and Leptin, Ghrelin, and Insulin-Like Growth Factor (IGF)-I Concentrations in Children

Background:  It was suggested that gastric colonization with Helicobacter pylori (H. pylori) was associated with suboptimal nutrition and growth in childhood. Furthermore, several studies indicated a relationship between H. pylori colonization and alterations in the circulating levels of growth‐related molecules (GRM). Accordingly, in this study, we investigate the effect of H. pylori infection on GRMs and on the growth of healthy school children, taking into consideration the effect of their economic status (ES) and anthropometric indices of their parents.

Molecular ecology and phylogeography of the bent‐wing bat complex (Miniopterus schreibersii) (Chiroptera: Vespertilionidae) in Asia Minor and adjacent regions

In this study we investigate population genetic structure and phylogeography of the bent‐wing bat complex (Miniopterus schreibersii) in Asia Minor and adjacent regions. PCR amplification and sequencing of the first hypervariable domain of the mitochondrial control region were used to obtain the genetic data. Morphometric differentiation between lineages was analysed by comparing forearm lengths. We found two reciprocally monophyletic lineages within the M. schreibersii complex, identified as M. s. schreibersii and M. s. pallidus. Distributions of the lineages were allopatric with a U‐shaped suture zone passing through Central Anatolia. The suture zone separated coastal regions occupied by M. s. schreibersii from inland, higher altitude regions occupied by M. s. pallidus. The lineages showed a considerable sequence divergence of c. 9%, accompanied by a corresponding difference in forearm length. The presence of the genetically distinct lineages, with allopatric distribution and corresponding morphometric differences, probably reflects their long isolation during the ice‐age in the Balkans and the Caspian/Caucasus refugia, followed subsequently by expansion into different habitats. Based on the present data, the lineages can be recognized as evolutionary significant units.

Distribution of cave-dwelling bats and conservation status of underground habitats in the Istanbul area

Populations of cave-dwelling bat species were investigated in the transitory region between the Eastern Thrace and the Western Pontus. Data were collected during 30 surveys in 13 underground sites, 10 of which had not been surveyed previously by bat researchers, between March 1999 and March 2000. Approximately 20 000 bats representing eight species were recorded. Grouping the sites according to their ecological resemblance, by means of cluster and correspondence analyses, yielded different results for the summer and winter data. In summer, there was a partial separation of the sites by their location in biogeographic regions. In winter, no regional grouping was observed. It was concluded that in the transitory region, species distribution does not differ considerably between the Eastern Thracian and Western Pontic ecosystems. In addition, a conservation scoring system is proposed for those sites investigated, their status is evaluated, and the most important local roosts are identified.

Analysis of lead body burden in Turkey

Here we report the results of pilot screening for the environmental lead contamination in Turkey. Lead blood concentrations were determined in 342 subjects from 17 cities. The mean lead blood concentration, 3.65 +/- 1.66 micrograms/dl, is much lower than the values reported previously. People smoking tobacco and driving motor vehicles had elevated concentrations of lead in blood. There was also a moderate relationship between the urban population size and the lead in blood values, but no differences were observed, that could be related to distinct geographical locations. Motor traffic was assumed to be the main source of lead pollution in the urban environment in Turkey, and the low lead blood levels were linked to the reduction of lead additives in gasoline, in 1989. Although at present, the environmental lead contamination does not pose a considerable threat to public health, in the near future, when the motorization rate and gasoline consumption will possibly double or triple, the lead content in gasoline might need to be further reduced.