Department of Physiology/Endocrinology, Institute of Neuroscience & Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Pediatr Endocrinol Metab. 2020 Sep 25;33(9):1173-1182. doi: 10.1515/jpem-2020-0127.
Objectives Growth references of today traditionally describe growth in relation to chronological age. Despite the broad variation in age of pubertal maturation, references related to biological age are lacking. To fill this knowledge gap, we aimed to develop a new type of pubertal height reference for improved growth evaluation during puberty, considering individual variation in pubertal timing. Methods Longitudinal length/height measures were obtained from birth to adult height in 1,572 healthy Swedish children (763 girls) born at term ∼1990 to nonsmoking mothers and Nordic parents, a subgroup of GrowUp1990Gothenburg cohort. A total height reference was constructed from Quadratic-Exponential-Puberty-Stop (QEPS)-function-estimated heights from individual height curves that had been aligned for time/age at onset of pubertal growth (5% of P-function growth). References that separated growth into specific pubertal heightSDS (P-function growth) and basic heightSDS (QES-function growth) were also generated. Results References (cm and SDS) are presented for total height, and height subdivided into that specific to puberty and to basic growth arising independently of puberty. The usefulness of the new pubertal growth reference was explored by identifying differences in the underlying growth functions that translate into differences in pubertal height gain for children of varying body mass, height, and with different pubertal timings. Conclusions A new type of height reference allowing alignment of individual growth curves, based on the timing of the pubertal growth spurt was developed using QEPS-model functions. This represents a paradigm shift in pubertal growth research and growth monitoring during the adolescent period.
当今的生长参考传统上描述了与实际年龄的关系。尽管青春期成熟的年龄差异很大，但缺乏与生物年龄相关的参考值。为了填补这一知识空白，我们旨在开发一种新的青春期身高参考值，以更好地评估青春期期间的生长情况，同时考虑到青春期启动时间的个体差异。
从出生到成年高度，对 1572 名健康的瑞典儿童（763 名女孩）进行了纵向长度/身高测量，这些儿童均足月出生于 1990 年前后，母亲不吸烟，父母为北欧人，他们是来自 GrowUp1990Gothenburg 队列的一个亚组。采用二次指数青春期停止（QEPS）函数，根据个体身高曲线估算身高，将个体身高曲线进行对齐，以反映青春期生长开始时的时间/年龄（P 函数生长的 5%），从而构建了一个总身高参考值。还生成了将生长分为特定青春期身高 SDS（P 函数生长）和基本身高 SDS（QES 函数生长）的参考值。
呈现了总身高以及身高细分的参考值，包括特定于青春期的身高和独立于青春期的基本生长的身高。通过确定不同体重、身高和青春期启动时间的儿童在基础生长函数方面的差异，探讨了新的青春期生长参考值的实用性，这些差异转化为青春期身高增长的差异。
利用 QEPS 模型函数，基于青春期突增的时间，开发了一种允许个体生长曲线对齐的新型身高参考值。这代表了青春期生长研究和青少年期间生长监测的范式转变。
