Carrascosa Antonio, Yeste Diego, Moreno-Galdó Antonio, Gussinyé Miquel, Ferrández Ángel, Clemente María, Fernández-Cancio Mónica
Servicio de Endocrinología Pediátrica, Hospital Universitario Materno-Infantil Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España; CIBER de Enfermedades Raras (CIBERER) ISCIII, España.
Servicio de Endocrinología Pediátrica, Hospital Universitario Materno-Infantil Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España; CIBER de Enfermedades Raras (CIBERER) ISCIII, España.
An Pediatr (Engl Ed). 2018 Sep;89(3):144-152. doi: 10.1016/j.anpedi.2017.11.018. Epub 2018 Feb 21.
Pubertal growth pattern differs according to age at pubertal growth spurt onset which occurs over a five years period (girls: 8-13 years, boys: 10-15 years). The need for more than one pubertal reference pattern has been proposed. We aimed to obtain five 1-year-age-interval pubertal patterns.
Longitudinal (6 years of age-adult height) growth study of 1,453 healthy children to evaluate height-for-age, growth velocity-for-age and weight-for-age values. According to age at pubertal growth spurt onset girls were considered: very-early matures (8-9 years, n=119), early matures (9-10 years, n=157), intermediate matures (10-11 years, n=238), late matures (11-12 years, n=127) and very-late matures (12-13 years, n=102), and boys: very-early matures (10-11 years, n=110), early matures (11-12 years, n=139), intermediate matures (12-13 years, n=225), late matures (13-14 years, n=133) and very-late matures (14-15 years, n=103). Age at menarche and growth up to adult height were recorded.
In both sexes, statistically-significant (P<.0001) and clinically-pertinent differences in pubertal growth pattern (mean height-for-age, mean growth velocity-for-age and mean pubertal height gain, values) were found among the five pubertal maturity groups and between each group and the whole population, despite similar adult height values. The same occurred for age at menarche and growth from menarche to adult height (P<.05).
In both sexes, pubertal growth spurt onset is a critical milestone determining pubertal growth and sexual development. The contribution of our data to better clinical evaluation of growth according to the pubertal maturity tempo of each child will obviate the mistakes made when only one pubertal growth reference is used.
青春期生长模式因青春期生长突增开始的年龄而异,青春期生长突增在五年期间出现(女孩:8 - 13岁,男孩:10 - 15岁)。有人提出需要不止一种青春期参考模式。我们旨在获得五种间隔为1岁的青春期模式。
对1453名健康儿童进行纵向(6岁至成人身高)生长研究,以评估年龄别身高、年龄别生长速度和年龄别体重值。根据青春期生长突增开始的年龄,女孩被分为:极早熟(8 - 9岁,n = 119)、早熟(9 - 10岁,n = 157)、中等成熟(10 - 11岁,n = 238)、晚熟(11 - 12岁,n = 127)和极晚熟(12 - 13岁,n = 102);男孩被分为:极早熟(10 - 11岁,n = 110)、早熟(11 - 12岁,n = 139)、中等成熟(12 - 13岁,n = 225)、晚熟(13 - 14岁,n = 133)和极晚熟(14 - 15岁,n = 103)。记录月经初潮年龄和直至成人身高的生长情况。
在男女两性中,尽管成人身高值相似,但在五个青春期成熟组之间以及每组与总体人群之间,青春期生长模式(平均年龄别身高、平均年龄别生长速度和平均青春期身高增加值)存在统计学显著差异(P <.0001)和临床相关差异。月经初潮年龄以及从月经初潮到成人身高的生长情况也出现了同样的情况(P <.05)。
在男女两性中,青春期生长突增的开始是决定青春期生长和性发育的关键里程碑。我们的数据有助于根据每个孩子的青春期成熟节奏更好地进行生长的临床评估,将避免仅使用一种青春期生长参考时所犯的错误。