Isojima Tsuyoshi, Yokoya Susumu, Ito Junko, Naiki Yasuhiro, Horikawa Reiko, Tanaka Toshiaki
Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan ; Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan.
Clin Pediatr Endocrinol. 2010 Jul;19(3):69-82. doi: 10.1297/cpe.19.69. Epub 2010 Aug 31.
We recently published new reference growth charts for Japanese girls with Turner syndrome (TS) based on the cross-sectional data of 1,447 subjects beyond the secular trend of growth in Japan. This study was undertaken for their validation and, if necessary, modification before general application. For validation, 24 subjects who had data both at younger (≤5 yr) and older ages (≥13 yr) were used. We analyzed the concordance/discordance of their height standard deviation score (SDS) defined by the charts between the two age periods. For modification, the LMS method was used with 5,772 longitudinal measurements obtained both from the previously analyzed subjects and 118 newly recruited subjects who had been followed up at the National Center for Child Health and Development or Toranomon Hospital. Significant and critical discordance (mean difference, 1.95 SDS; 95% confidence interval (CI), 1.53-2.36; p<0.0001) was detected in height SDS. This prompted us to perform the modifications. A similar analysis using the modified charts revealed no significant discordance (mean difference, 0.27 SDS; 95%CI: -0.17 - 0.71; p=0.22). They seem more adequate for clinical applications for girls with TS born after 1970. New auxological standards for Japanese girls with TS were proposed.
我们最近基于1447名受试者的横断面数据，发布了日本特纳综合征（TS）女孩的新参考生长图表，这些数据超出了日本的长期生长趋势。本研究旨在对其进行验证，并在必要时进行修改，然后再普遍应用。为了进行验证，我们使用了24名在较年轻（≤5岁）和较年长（≥13岁）时均有数据的受试者。我们分析了两个年龄阶段之间，根据图表定义的身高标准差评分（SDS）的一致性/不一致性。为了进行修改，我们使用了LMS方法，该方法基于5772次纵向测量数据，这些数据来自之前分析过的受试者以及118名新招募的受试者，这些新受试者在国立儿童健康与发展中心或虎之门医院接受了随访。在身高SDS方面检测到了显著且关键的不一致性（平均差异为1.95 SDS；95%置信区间（CI）为1.53 - 2.36；p<0.0001）。这促使我们进行修改。使用修改后的图表进行的类似分析显示没有显著的不一致性（平均差异为0.27 SDS；95%CI：-0.17 - 0.71；p = 0.22）。对于1970年以后出生的TS女孩，这些图表似乎更适合临床应用。我们提出了日本TS女孩的新体格学标准。
