Objectives The purpose of this study is to find out the relationship between parents' heights and predicted height of the children who had been treated in the growth clinic of oriental medical hospital. Methods The study was conducted with 253 children who visited Oriental Medical Hospital from July 2010 to June 2012. They were analyzed by reviewing the children's chart and correlation analysis to find out the relationship between the two heights. Results In distribution of the sex and the age, sex were similar, but boys who came to the clinic were averagely younger than the girls. In predicting adult height by TW3 method and mean parent's height, correlation in the girls was higher than the boys, especially the girls after their first menstruation. Parents' heights were related to both the boys and the girls, but mother's height was more closely related. Predicted heights of the boys before secondary sex characteristics were correlated with the child's height, but rather correlated with parent's both heights after secondary sexual character and found to be more relevant to father's height. The girls' predicted heights before their menstruation were not correlated with father's height, but with mother's. Their heights after their first periods were correlated with parents' both heights, but more correlated with father's height. Conclusions This study helps set proper periods and goals of growth treatment based on the correlation between parents' height and predicted adult height according to TW3 method.
Objectives : The purpose of this study was to have better data and to make efficient clinical reviews about children's growth based on two methods; X-ray of hand, and ultrasound of calcaneus. Methods : The study was composed of 100 patients(50 of boys and 50 of girls) who visited in department of pediatrics, O O university oriental hospital considering growth and their development. Bone age was measured by the TW3 method's RUS score in simple X-ray image of hand and bone density through ultrasonic image of calcaneus. To predict children's estimated height, their parent's height, bone age, and present height's percentile was measured. Results and Conclusions : 1. The bone age results from X-ray image of hand and ultrasonic image of calcaneus were correlated. Younger children have older bone age from hand's X-ray than the one from calcaneus's ultrasound. Older children have older bone age from calcaneus's ultrasound than one from hand's X-ray. 2. Predicted adult height by bone age(BH) of hand's X-ray and BH of calcaneus's ultrasound were correlated, but predicted adult height by inheritance(IH) was not correlated with others. 3. Bone age and predicted adult height were correlated with age, height, weight, BMI, and especially with age and height. 4. Measuring bone age by X-ray image of hand and ultrasonic image of calcaneus was simple and effective way of estimating children's growth and development.
Purpose : This study compared bone ages measured by the Greulich-Pyle (GP) and Tanner-Whitehouse 3 (TW3) methods and investigated the differences in predicted adult heights measured by Bayley-Pinneau (BP) and TW3 methods. Methods : Bone ages were assessed from left-wrist radiographs by two investigators, one for each GP and TW3 methods in 85 normal children, 30 precocious puberty girls, and 30 constitutional growth delay boys. The differences between the measured predicted adult heights using the BP and TW3 methods were compared in each group. Results : The bone age measured by the TW3 method was less than that by the GP method in normal children. The predicted adult heights measured by the two methods showed no significant difference in normal boys, while the predicted adult height measured by the TW3 method was higher than that by the BP method for normal girls ($156.4{\pm}4.7$ cm vs. $158.9{\pm}3.8$ cm, P<0.01) and for precocious puberty girls ($156.3{\pm}4.0$ cm vs. $159.3{\pm}4.2$ cm, P<0.01). In contrast, the predicted adult height was higher from the BP method than from the TW3 method in constitutional growth delay boys ($173.3{\pm}4.4$ cm vs. $169.7{\pm}3.2$ cm, P<0.01). Conclusion : There were significant differences in predicted adult heights between the BP and TW3 method in normal girls, precocious puberty girls, or constitutional growth delay boys. In precocious puberty and constitutional growth delay, the BP method might be preferred to predict adult height, but further studies on final adult height are needed.
Objectives: Purpose of this study is to analyze and to estimate which and how much genetic and environmental factors have affected on growth. Also, a method of final height prediction can be developed from this study results. Methods: Correlation analysis and categorical regression analysis were conducted between genetic and environmental factors correlated with the final adult height, through survey from 171 male. Results: Mid parental height, neonatal body weight, intake frequency of beef, chicken, milk, fruits and coffee, sleep quantity and quality during the elementary school and sleep quantity during the middle school have affected on the final adult height. And a regression equation with 0.494 for coefficient of determination was obtained. Conclusions: Mid-parental-height has the most affected on the final adult height. Among environmental factors, food and sleep have significantly affected, but exercise doesn't. Among foods, meal, beef, and milk intake have remarkably affected on the final height, and chicken and fruit also have affected in some degree, but coffee has affected badly. Among sleep habits, sleep quantity during the elementary school has the most affected, sleep quality during the elementary school and sleep quantity during the middle school also have affected in some degree on final height. The younger the age is, the more sleep have affected and sleep quantity have more affected than sleep quality. Neonatal weight also has remarkably affected on the final height. Through this analysis, the final adult height can be predicted using regression equation which covers 49.4% of genetic and environmental factors.
Objectives : The purpose of this study was to examine relationships between bone age and body composition to make efficient clinical reviews on children's growth. Methods : 157 of children in age of 3 years to 16 years old were participated in this study(88 of boys and 69 of girls). They visited the department of pediatrics, OO university oriental hospital and were measured their body composition and bone age. Results : 1. An age and bone age, height, weight, and body mass index were positively correlated, and also a bone age and height, weight, and body mass index were positively correlated. 2. The level of soft lean mass, body fat mass, and MPH were increased in boys in higher height percentile. Children's predicted adult height was higher in children in higher height percentile. 3. The level of body fat mass was increased as weight percentile increased. Bone age, MPH was increased as weight percentile increased, especially in case of boys. In girl's case, the level of soft lean mass, their predicted adult height, the difference between children's bone age and their actual age was increased as weight percentile increased. Conclusions : Measuring bone age and body composition is the effective way to estimate children's growth and development in future.
Purpose : The hope that arresting pubertal developement might increase final adult height has led to an attempt to use GnRH agonist (GnRHa) in children with early puberty and poor growth prognosis. We investigated the growth-promoting effect of GnRH agonists with or without growth hormone (GH) in girls with early puberty and decreased predicted adult height (PAH). Methods : Thirty five girls with advanced bone age and early pubertal signs were randomized for treatment for about 1 year with monthly GnRHa in group 1 (n=18), or with a combination of GH and GnRHa in group 2 (n=17). The following growth parameters were compared between groups, and the difference ($\Delta$) before and after treatment : chronological age (CA), bone age (BA), $\Delta$(BA-CA), height (HT), target height (TH), predicted adult height (PAH), $\Delta$ (TH-PAH), serum insulin-like growth factor (IGF-1) and insulin-like growth factor binding protein (IGFBP-3). Results : Before treatment, BA, TH, PAH Standard deviation scores (SDS), $\Delta$(TH-PAH) were not different between the two groups, but CA was higher in group 2 and $\Delta$(BA-CA) were higher in group 1 (P<0.05). After $1.06{\pm}0.93$ year of treatment, $\Delta$ (BA-CA) decreased and there were significant changes in PAH and $\Delta$ (TH-PAH), especially in group 2 (P<0.05 in group 1, and P<0.001 in group 2). In both groups, IGF-1 and IGFBP-3 were not different before and after treatment, but after treatment, IGF-1 level in group 2 was marginally higher than IGF-1 in group 1 (P<0.1). Conclusion : Compromised predicted adult height in girls with early puberty and advanced bone age was significantly improved with GnRH with/without GH treatment in the short-term period. The addition of GH to GnRHa results in a significant increase in PAH compared to GnRHa alone because GnRHa suppressed growth hormone-IGF-1 axis. For comparison of final adult height, further longitudinal follow-up will be needed.
Seo, Ji-Young;Yoon, In-Suk;Shin, Choong-Ho;Yang, Sei-Won
Clinical and Experimental Pediatrics
/
v.49
no.3
/
pp.305-311
/
2006
Purpose : GnRH analogues(GnRHa) are used to treat central precocious puberty(CPP). However, in some patients, the GV decrease is so remarkable that it impairs predicted adult height(PAH); and there fore, the addition of growth hormone(GH) is suggested. We analysed the growth changes during two years and final adult height(FAH) in girls with idiopathic CPP treated with combined therapy, compared with those of girls treated with GnRHa alone. Methods : For the analysis, we classified the patients, who was treated for longer than two years, into three groups depending on the initial PAH and combination of GH; PAH_L, treated with GnRHa and PAH less than midparental height(MPH) - 5 cm. PAH_H, treated with GnRHa and PAH greater than MPH - 5 cm. GnRHa+GH, combined GH treatment, regardless of PAH before treatment. We analysed the GV and PAH change during the first two years and FAH. Results : In PAH_L, the PAH(SDS) at first year of therapy was significantly increased to $153.5{\pm}6.5cm(-1.4{\pm}1.3)$ from $149.7{\pm}6.4cm(-2.1{\pm}1.3)$ before treatment(P=0.004). In PAH_H, there was no significant increase in PAH during the two years of treatment. During the first year of combination of GH and GnRHa, GV and PAH increased significantly. We observed significant increases in FAH, comparing to the initial PAH in the PAH_L and GnRHa+GH groups. The height gains(FAH - initial PAH) were significantly higher in the PAH_L and GnRHa+GH groups than that in the PAH_H group. Conclusion : This study suggests the FAH and height gains are improved in patients, whose predicted adult height before treatment was shorter than those with higher predicted adult height, with the treatment of GnRHa alone or in combination with GH. GH could not improve the final adult height, but compensated the growth in patients whose growth velocity was decelerated by GnRHa alone.
Objectives: The purpose of this study was to compare predictions and measurements of the resting energy expenditure (REE) of overweight and obese adult women in Korea. Methods: The subjects included 65 overweight or obese adult women ranging in age from 20~60 with a recorded body mass index (BMI) of 23 or higher. Their height, weight, waist-hip ratio, and blood pressure were measured. The investigator also measured their body fat, body fat percentage, and body composition of total weight without fat using Dual energy X-ray absorptiometry (DXA) and measured resting energy expenditure by indirect calorimetry. Measured resting energy expenditures were compared with predictions from six methods: Harris-Benedict, Mifflin, Owen, WHO-WH, Henry-WH, and KDRI. Results: Harris-Benedict predictions showed the smallest differences from measured resting energy expenditure at an accurate prediction rate of 70%. The study analyzed regression between measured resting energy expenditure and body measurements including height, weight and age. The formula proposed by this research is as follows: Proposed REE equation for overweight and obese Korean women = $721-(1.5{\times}age)+(0.4{\times}height)+(9.9{\times}weight)$. Conclusions: These findings suggest that age is a significant variable when predicting resting energy expenditure in overweight and obese women. Therefore, prediction of resting energy expenditure should consider age when determining energy requirements in overweight and obese women.
Purpose : The recent results observed in precocious puberty and the hope that interrupting puberty might increase adult height have led to an attempt to use GnRH agonist(GnRHa) in children with premature puberty and a poor growth prognosis. We aimed to analyze the growth promoting effect of GnRHa in girls with early puberty and low predicted adult height(PAH). Methods : Thirty six girls were recruited. They were grouped according to the GnRHa treatment period(group 1>6 mo, n=18; group 2<6 mo, n=18). The following variables were analyzed before and after GnRHa treatment : chronological age(CA), bone age(BA), ${\Delta}age$(CA-BA), height, target height (TH), PAH, serum IGF-1, IGFBP-3. Results : Duration of the GnRHa treatment was $0.89{\pm}0.81yr$($1.37{\pm}0.92yr$ in group 1, and $0.41{\pm}0.08yr$ in group 2). Before treatment, none of the variables were different between the two groups. There were no differences in the following variables the between two groups at the end of treatment : CA, BA, ${\Delta}age$, PAH, serum IGF-1, IGFBP-3. But, growth velocity(GV) and PAH increment during treatment were significantly reduced in group 1. Compared with initial PAH, PAH at the end of treatment was significantly increased($3.7{\pm}3.2cm$). The last serum levels of IGF-1 and IGFBP-3 were lower than those before treatment. Conclusion : Even though last PAH didn't approach TH, short term GnRHa administration in early puberty with low predicted PAH was somewhat effective. But, GnRHa administration suppressed the growth hormone-IGF-1 axis. Therefore, it is recommended that growth hormone(GH) should be used in combination with GnRHa.
Objectives The purpose of this study is to evaluate the current growth via Growth indices, Obesity indices, Metabolic risk factors of Multicultural Families' Children in Dae-jeon area. Methods 5 to 12 year old children from 56 multicultural families were enrolled in this study, and were examined their bone age and body composition, and have received blood tests. Results 1. In Growth indices, average height percentile was $53.64{\pm}25.59%$. The AHP and MPH respectively, were converted into 20 years old adult height percentile, AHP of a girls was 40 percentile and MPH was 19 percentile, AHP of boys was 57 percentile and MPH was 21 percentile. 2. In Obesity indices, average of BMI pecentile was $44.16{\pm}29.52$; low-weight group (6 boys, 4 girls), normal-weight group (20 boys, 18 girls), over-weight group (8 girls). Average PWH was $100.51{\pm}15.66%$; low-weight group (9 boys, 5 girls), normal-weight group (14 boys, 15 girls), over-weight group (3 boys, 5 girls), obesity group (5 girls). 3. The results of the relationship between Growth indices and Obesity indices, 1) As RH percentile in boys was increased, skeletal maturity, AHP and AHP-MPH were also increased. Similarly, as RH percentile in girls was increased, skeletal maturity, AHP and AHP-MPH were also increased. 2) As skeletal maturity in boys was increased, BMI percentile was also increased. As skeletal maturity in girls was increased, AHP-MPH was decreased but had no significant differences. Conclusions Current growth of children in multicultural families was above the average when compared to that of average children in the same age. It was predicted that the boys' height were still above the average adult height, but the girls' height were below the average. Also this study showed that girls were more prone to be overweight than boys, thus requiring more intensive management and training in regards to eating habits and exercise.
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