Using obese-specific charts of height and height velocity for assessment of growth in obese children and adolescents during weight excess reduction. 1999

A Falorni, and G Galmacci, and V Bini, and F Faraoni, and D Molinari, and G Cabiati, and M Sanasi, and F Celi, and G Di Stefano, and M G Berioli, and G Contessa, and M L Bacosi
Clinica Pediatrica, Servizio Regionale di Diabetologia Pediatrica, Università di Perugia, Azienda Ospedaliera di Terni, Italy.

OBJECTIVE The influence of weight excess reduction on height and height velocity of obese subjects should be evaluated on the basis of appropriate standards, since the pattern of growth of obese subjects is different from that of normal weight subjects. METHODS Height, weight and triceps skinfold thickness were recorded from 17987 school subjects (9256 males and 8731 females), 3-18 y of age, from three provinces of central Italy, and a growth reference curve of height was constructed. Using BMI (as computed using the tables of Rolland-Cachera et al) and triceps skinfold thickness, normal-weight subjects (NWS) and obese subjects (OS) were identified and specific reference curves (mean+/-s.d. every sixth month of age) were developed for both groups. Centiles of height were also calculated for OS. Various (2-4) measurements of height in school subjects were performed and a graph of height velocity (HV) was constructed in NWS and in OS using the JPPS method. The yearly mean +/-s.d. of HV was also calculated, based on square root transformed data (in order to realise a Gaussian distribution), deriving from successive measurements in total subjects, in NWS and in OS. The z-scores of height and of the square root of HV were calculated in 217 obese subjects (125 males and 92 females) before and during a weight excess reduction programme (WERP). Obese subjects in WERP who showed a reduction of z-score of BMI were considered as 'responsive'; those who either maintained or showed an increase of z-score of BMI were considered as 'non-responsive'. Obese subjects in WERP were followed for 1-4 y, giving the following results: 0-1 y, 142 responsives and 75 non-responsives; 0-2 y, 76 responsives and 33 non-responsives; 0-3 y, 35 responsives and 30 non-responsives; 0-4 y, 24 responsives and 18 non-responsives. RESULTS Compared to NWS, OS showed a significantly greater HV in 4-9y males and in 4-8y females, but in older children the pubertal spurt was reduced and more precocious. As a result, the height of OS, which was greater in 3-13 year-old males and in 3-11.5 year-old females, subsequently showed a reduction, as compared to that of NWS, in 16-18 year-old males and in 13-18 year-old females. In both responsive and non-responsive groups of obese subjects in WERP, the z-scores of height showed a reduction during WERP when evaluated using the reference curve of the total school population. In contrast, when their growth was evaluated according to the obese-specific reference curve, no significant variation was observed comparing both z-scores before and during the WERP. CONCLUSIONS More appropriate information on the growth of obese subjects may be obtained when evaluating the height and HV according to obese-specific reference standards from the same population of origin. Adopting this modality, no significant variation of height resulted during WERP in obese children.

UI MeSH Term Description Entries
D007558 Italy A country in southern Europe, a peninsula extending into the central Mediterranean Sea, northeast of Tunisia. The capital is Rome. Sardinia
D008297 Male Males
D009765 Obesity A status with BODY WEIGHT that is grossly above the recommended standards, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D001827 Body Height The distance from the sole to the crown of the head with body standing on a flat surface and fully extended. Body Heights,Height, Body,Heights, Body
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004038 Diet, Reducing A diet designed to cause an individual to lose weight. Weight Loss Diet,Weight Reduction Diet,Diet, Weight Loss,Diet, Weight Reduction,Diets, Reducing,Diets, Weight Loss,Diets, Weight Reduction,Reducing Diet,Reducing Diets,Weight Loss Diets,Weight Reduction Diets
D005260 Female Females

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