Borsboom G J, van Pelt W, Quanjer P H
Department of Physiology, Leiden University, the Netherlands.
Am J Respir Crit Care Med. 1996 Mar;153(3):1182-6. doi: 10.1164/ajrccm.153.3.8630565.
We studied interindividual variation in pubertal growth patterns from peak growth velocities (PGV) and peak growth ages (PGA) of ventilatory function, standing height, and weight in a selection of 144 boys from a longitudinal survey of 404 pupils in a Dutch secondary school. Measurements were made at intervals of approximately 0.5 yr between 1978 and 1985. Between 9 and 14 measurements were available for each selected individual. Average age on enrollment was 12.7 years. Ventilatory function was characterized by FVC, FEV1, peak expiratory flow (PEF), and maximal expiratory flow at 50% of the FVC (MEF50), derived from maximum expiratory flow volume (MEFV) curves. PGVs and PGAs were derived from monotonically increased regression splines, fitted to the data of each individual and each variable separately. The 90% percentile ranges of PGA were approximately 4.5 yr in all variables. In almost all boys, the PGA of height occurred earlier than that of ventilatory function, but the magnitude of the time lag varied considerably. Median PGAs agreed well with peak growth ages derived from average growth velocity curves fitted on exactly the same data. However, median PGVs were 1.25 to 1.40 times higher than the corresponding estimates from the average curves. The latter finding implies that in almost all cases, individual development deviates considerably from development suggested by average growth profiles. No differences in PGA and PGV were found between subjects with a prepubertal history of respiratory symptoms and those without. The large interindividual variations in PGA and PGV, and in the time lag between growth of height and of ventilatory function, are not accounted for in cross-sectional reference equations. These equations are therefore not suitable to predict individual development during adolescence.
我们从荷兰一所中学404名学生的纵向调查中选取了144名男孩,研究了青春期生长模式在通气功能、身高和体重的峰值生长速度(PGV)和峰值生长年龄(PGA)方面的个体间差异。测量在1978年至1985年期间每隔约0.5年进行一次。每个选定个体有9至14次测量数据。入学时的平均年龄为12.7岁。通气功能通过用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、呼气峰值流速(PEF)以及FVC的50%时的最大呼气流量(MEF50)来表征,这些数据来自最大呼气流量容积(MEFV)曲线。PGV和PGA通过单调递增的回归样条得出,分别拟合到每个个体和每个变量的数据上。所有变量中PGA的第90百分位数范围约为4.5年。几乎所有男孩的身高PGA都早于通气功能的PGA,但时间滞后的幅度差异很大。中位数PGA与根据完全相同数据拟合的平均生长速度曲线得出的峰值生长年龄非常吻合。然而,中位数PGV比平均曲线的相应估计值高1.25至1.40倍。后一发现意味着在几乎所有情况下,个体发育与平均生长曲线所表明的发育情况有很大偏差。有青春期前呼吸道症状病史的受试者与没有该病史的受试者在PGA和PGV方面没有差异。PGA和PGV以及身高生长和通气功能生长之间的时间滞后存在很大的个体间差异,横断面参考方程并未考虑这些差异。因此,这些方程不适用于预测青春期的个体发育。