Context: Specific references for height, weight and BMI that consider the maturation tempo for onset of puberty are lacking worldwide.
Aim: To fill the gap, by developing specific pubertal references for heightSDS, weightSDS and BMISDS, all aligned for the individual onset of puberty.
Method: Reference population: a subgroup of GrowUp1990Gothenburg cohort of 1572 (763 girls) healthy children born at term around 1990 in Sweden of non-smoking mothers, with as mean 24 measures of weight and height from birth to adult height. QEPS-model1,2: For each individual, a QEPS-function estimated height curve was obtained and onset of puberty defined as AgeP5, age of 5% of the specific P-function growth. This was used for aligning the onset of puberty of the individuals in the reference population used for the pubertal references for total height, specific-pubertal height (P-function) and non-specific-pubertal (QES-functions) height references. This alignment was also used for the LMS method developed total weight and total BMI references.
Results: For both girls and boys we present onset-of-puberty-aligned references for 1) total heightSDS, specific-pubertal heightSDS and non-specific-pubertal heightSDS; for 2) total weightSDS and for 3) BMISDS. The height reference was updated for the positive secular trend in height that is still ongoing in Sweden. In contrast, the weight and BMI references were developed to be similar to the weight status in Swedish children from before the obesity epidemic, ie as the previous references obtained from GrowUp1974Gothenburg cohort.
Conclusion: A paradigm shift for monitoring growth and weight status during puberty is now possible by using this innovative type of references for pubertal height, weight and BMI, all aligned-for-onset-of-puberty and thereby for the first time considering the individual timing of puberty. It opens up new possibilities to monitor growth and weight status during puberty: in the clinic for the individual child and in research for groups of children in order to estimate the change obtained for every time-period defined from onset until end of puberty. By using these tools, new knowledge will be obtained for both detection of diseases and for individualizing their treatment during the puberty.
References:1. Nierop et al. J Theor Biol, 2016:406:143 2. Holmgren et al. BMC Pediatr, 2017:17:107.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology