RESUMO
AIM: To analyze the secular changes in body size and composition of two cohorts of children from La Plata City, Argentina, with a 35-year follow-up. subjects and methods: Cohort 1 (C1) was measured in 1969-1970 and included 1772 children (889 boys, 883 girls), and Cohort 2 (C2), measured in 2004-2005, included 1059 children (542 boys, 517 girls). Both cohorts were obtained from matching geographical areas and comprised children from 4 to 12 years. Body weight (W); Height (H); Upper arm circumference (UAC); Tricipital (TS) and Subscapular skinfolds (SS) were measured, and Body Mass Index (BMI) and muscle (UMA) and fat (AFA) brachial areas were calculated. Prevalence of overweight and obesity was estimated by IOTF. To compare C1-C2 we used a generalized linear model with log-transformed variables, and chi square test. RESULTS: There were significant and positive differences between C2-C1 in W, UAC, SS, TS, and AFA. In contrast, H was not significantly different and UMA was significantly different but with negative values. The prevalence of overweight and obesity was 14.5% and 3.8% in C1, and 17.0% and 6.8% in C2. Differences between cohorts were significant for obesity. CONCLUSION: The shifts observed for soft tissues--positive trend for fat and negative for muscle area--occurring without changes in height lead us to suppose that in these three decades, La Plata's population has experienced deterioration in living conditions and important changes in their lifestyle, such as an increased consumption of energy-dense foods and sedentary habits.
Assuntos
Composição Corporal/fisiologia , Tamanho Corporal/fisiologia , Antropologia Física , Argentina , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , História do Século XX , História do Século XXI , Humanos , MasculinoRESUMO
This paper addresses the effect of a reduction of uterine blood flow (RUB) on postcranial bone growth in rats. The objectives were: (1) to discover and characterize the changes evoked by growth retardation through a reduction in placental blood flow, (2) to see if the resulting growth retardation is different in each bone, and (3) to analyze any sex-specific features. RUB was induced by the partial bending of uterine vessels at day 1 of pregnancy. Control and sham-operated animals were also included. The animals were X-rayed at birth. The lengths and widths of the humerus, radius, and femur and pelvic length, interischial, interpubic, and pubic widths were measured. Data were analyzed by ANOVA and LSD post hoc tests. The intersubject analysis showed significant differences between groups and non-significant differences between sexes. In males, sham-operated and RUB showed significant differences in pelvic lengths and widths, and humeral, radial, femoral, and tibial widths. In females, there were significant differences only for humeral widths, radial lengths and widths, and femoral and tibial widths. We conclude that reduced blood flow delays appendicular bone growth as observed at birth. Pelvic length was more affected than that of the limbs. The widths of the pelvic and limbs bones, in turn, were more altered than the lengths, and the growth of the males more than that of the females. Partial bending of uterine vessels compromised postcranial growth, though under such disadvantageous circumstances the females proved to be more capable of growing and thus more resilient than the males.
Assuntos
Desenvolvimento Ósseo , Retardo do Crescimento Fetal/fisiopatologia , Animais , Animais Recém-Nascidos , Feminino , Masculino , Circulação Placentária , Gravidez , Ratos , Ratos Wistar , Caracteres SexuaisRESUMO
We studied the adult height (AH) outcome, and factors likely to influence it, in Turner Syndrome (TS) girls treated with growth hormone (GH). A total of 25 TS girls treated with GH were compared with 10 TS girls not treated with GH. The percentage of girls who achieved normal third percentile was determined. Projected AH (PAH) was calculated according to height standard deviation score (HSDS) at the beginning of the treatment. Gain in height was determined as: AH - pretreatment PAH. The percentage of girls who achieved target range (midparental height±2 SD) was determined. Multiple linear regression models were fitted on baseline variables- chronological age (CA), midparental height (MPH) and HSDS; and treatment variablesduration of oestrogen-free GH therapy and duration of GH therapy+oestrogens. As for baseline data: median CA was 13.0 years (5.6-15.8). Mean HSDS was 0.25±1.1 SDS. PAH was 139.2±5.6 cm. MPH was 160.0±5.0 cm. As for follow up data: Median CA at onset oestrogens was 15.1 years (13.2-16.6). Median duration of GH therapy was 3.8 years (2.1-10.3). Median oestrogen-free GH period was 2.0 years (0.7-7.8), and median GH+oestrogens period, 1.8 years (1.0-3.2). Adult height: Mean AH was 150.4±7.0 cm in treated patients and 140.8±7.2 cm in the group not treated with GH (p=0.001). Fourteen (56%) girls achieved normal third percentile compared with an initially predicted 1 (4%). Gain in height was 11.2±3.7 cm. Thirteen (59%) girls reached an AH within target range. HSDS at the beginning of the treatment was the variable most strongly related to AH and duration of oestrogen-free GH period was the variable most strongly related to gain in height.
Se estudió la talla adulta (TA) y los factores que pudieran influenciarla en niñas con síndrome de Turner (ST) tratadas con hormona de crecimiento (HC). Se compararon 25 pacientes con ST tratadas con HC y 10 niñas no tratadas. Se determinó: el porcentaje de niñas que alcanzó el tercer percentilo de la curva de normalidad, la talla adulta proyectada (TAP) de acuerdo al score de desvío estándar de talla (SDST) al inicio del tratamiento, la ganancia en talla (TA - TAP pretratamiento) y el porcentaje de niñas que alcanzó el rango genético (talla media parental ± 2 DS). Se ajustaron modelos de regresión múltiple sobre variables basalesedad cronológica (EC), talla media parental y SDST; y variables durante el tratamiento- duración del tratamiento con GH sin estrógenos y con GH+estrógenos. Resultados: datos basales: la EC mediana fue 13.0 años (5.6- 15.8), el SDST 0.25 ± 1.1 SDS, la TAP 139.2 ± 5.6 cm y la talla media parental 160.0 ± 5.0 cm. Datos en el seguimiento: la EC mediana al inicio del estrógeno fue 15.1 años (13.2-16.6), la duración mediana del tratamiento con GH 3.8 años (2.1-10.3), del tratamiento con GH y sin estrógenos 2.0 años (0.7-7.8), y del tratamiento con GH + estrógenos 1.8 años (1.0-3.2). Talla adulta: la TA media fue 150.4 ± 7.0 cm en pacientes tratadas y 140.8 ± 7.2 cm en el grupo no tratado (p = 0.001). 14 niñas (56%) alcanzaron el tercer percentilo comparado con la predicción inicial de una niña (4%). La ganancia en talla fue 11.2 ± 3.7 cm. 13 niñas (59%) alcanzaron una TA dentro del rango genético. La variable que más se relacionó con la TA fue el SDST al inicio del tratamiento y con la ganancia en talla, la duración del tratamiento con GH libre de estrógenos.
Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Estatura/efeitos dos fármacos , Hormônio do Crescimento Humano/administração & dosagem , Síndrome de Turner , Argentina , Assistência de Longa Duração , Estudos Longitudinais , Valores de Referência , Análise de Regressão , Resultado do TratamentoRESUMO
We studied the adult height (AH) outcome, and factors likely to influence it, in Turner Syndrome (TS) girls treated with growth hormone (GH). A total of 25 TS girls treated with GH were compared with 10 TS girls not treated with GH. The percentage of girls who achieved normal third percentile was determined. Projected AH (PAH) was calculated according to height standard deviation score (HSDS) at the beginning of the treatment. Gain in height was determined as: AH - pretreatment PAH. The percentage of girls who achieved target range (midparental height +/- 2 SD) was determined. Multiple linear regression models were fitted on baseline variables- chronological age (CA), midparental height (MPH) and HSDS; and treatment variables- duration of oestrogen-free GH therapy and duration of GH therapy+oestrogens. As for baseline data: Median CA was 13.0 years (5.6-15.8). Mean HSDS was 0.25 +/- 1.1 SDS. PAH was 139.2 +/- 5.6 cm. MPH was 160.0 +/- 5.0 cm. As for follow up data: Median CA at onset oestrogens was 15.1 years (13.2-16.6). Median duration of GH therapy was 3.8 years (2.1-10.3). Median oestrogen-free GH period was 2.0 years (0.7-7.8), and median GH+oestrogens period, 1.8 years (1.0-3.2). Adult height: Mean AH was 150.4 +/- 7.0 cm in treated patients and 140.8 +/- 7.2 cm in the group not treated with GH (p=0.001). Fourteen (56%) girls achieved normal third percentile compared with an initially predicted 1 (4%). Gain in height was 11.2 +/- 3.7 cm. Thirteen (59%) girls reached an AH within target range. HSDS at the beginning of the treatment was the variable most strongly related to AH and duration of oestrogen-free GH period was the variable most strongly related to gain in height.