Duran Ibrahim, Zimmermann Maja, Buggisch Jonathan, Hoyer-Kuhn Heike, Alexy Ute, Schoenau Eckhard
14309 Center of Prevention and Rehabilitation, University of Cologne, Medical Faculty and University Hospital, UniReha , Cologne, Germany.
Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany.
J Pediatr Endocrinol Metab. 2025 Jun 20;38(9):887-897. doi: 10.1515/jpem-2025-0225. Print 2025 Sep 25.
To generate current reference values for height velocity (HV, cm/year) in German children and adolescents and to evaluate the sensitivity of auxological parameters in the evaluation of short stature (referral criteria).
The study population consisted of healthy German participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study (1985-2022). In total, data was available from n=453 girls (mean age 9.1 ± 2.4 years) and n=473 boys (mean age of 9.6 ± 2.5 years). As the participants were measured repeatedly, 4,557 HV assessments for girls and 5,224 HV assessments for boys were analyzed (median number of observations in female was nine and in male 11). The reference percentiles were created using the LMS method. The referral criteria of the German Society for Pediatric and Adolescent Endocrinology and Diabetology (DGPAED) and of the Growth Hormone Research Society (GHRS) for further endocrinological evaluation were evaluated in a subsample.
The specificity of the referral criteria "HV<25th centile for 1 year" (DGPAED) was 10.4 % in girls and 4.3 % in boys. When this criterion was changed to "HV<3rd centile for 1 year" the specificity increased to 75.5 % in girls and 76.1 % in boys. With omission of the 5th criterion ("height> -2.0 SD AND HV< -2.0 over 1 year") of the six referral criteria of the GHRS, the specificity of the remaining five referral criteria was 91.4 % in girls and 90.5 % in boys.
New reference centiles for HV are presented. With modification of the already proposed GHRS criteria, the specificity of the assessment of HV in the evaluation of short stature could be increased significantly.
生成德国儿童和青少年身高速度(HV,厘米/年)的当前参考值,并评估体格测量参数在评估身材矮小(转诊标准)中的敏感性。
研究人群包括多特蒙德营养与人体测量纵向设计(DONALD)研究(1985 - 2022年)中的健康德国参与者。总共获得了n = 453名女孩(平均年龄9.1±2.4岁)和n = 473名男孩(平均年龄9.6±2.5岁)的数据。由于参与者接受了多次测量,因此分析了女孩的4557次HV评估和男孩的5224次HV评估(女性的观察次数中位数为9次,男性为11次)。使用LMS方法创建参考百分位数。在一个子样本中评估了德国儿科和青少年内分泌学与糖尿病学会(DGPAED)以及生长激素研究学会(GHRS)用于进一步内分泌评估的转诊标准。
“HV < 第25百分位数持续1年”(DGPAED)这一转诊标准在女孩中的特异性为10.4%,在男孩中为4.3%。当该标准改为“HV < 第3百分位数持续1年”时,女孩的特异性增加到75.5%,男孩增加到76.1%。在GHRS的六项转诊标准中省略第五项标准(“身高 > -2.0标准差且HV < -2.0持续1年”)后,其余五项转诊标准在女孩中的特异性为91.4%,在男孩中为90.5%。
给出了HV的新参考百分位数。通过修改已提出的GHRS标准,在评估身材矮小中HV评估的特异性可显著提高。