ESPE2021 ePoster Category 1 Growth B (10 abstracts)
Evaluation of growth patterns from the Edinburgh and Gothenburg cohorts by the QEPS model
Anton Holmgren 1,2 , Aimon Niklasson 1 , Andreas F.M Nierop 3,4 , Gary Butler 5 & Kerstin Albertsson-Wikland 3
1GP-GRC, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Pediatrics, Halland Hospital, Halmstad, Sweden; 3Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 4Muvara bv, Multivariate Analysis of Research Data, Leiderdorp, Netherlands; 5UCL Great Ormond Street Institute of Child Health, and University College London Hospital, London, United Kingdom
Background: The QEPS-growth-model, developed and validated in GrowUpGothenburg cohorts, used for developing growth references and investigating healthy/pathological growth, lacks external validation from other longitudinal cohorts of healthy individuals.
Objective: To investigate if the QEPS-model fits the longitudinal Edinburgh growth study of another design than GrowUpGothenburg cohorts. To compare growth patterns in two longitudinal growth cohorts born in mid-1970s in North-Western Europe.
Methods: Longitudinal growth data was obtained from the Edinburgh and the GrowUp1974Gothenburg cohorts. The QEPS-model was used to describe length/height from birth to adult height with confidence intervals and multivariate regression was performed to estimate the contribution of different QEPS-functions to adult height.
Results: The main QEPS-height estimates (Emax/Qmax/Pmax) had confidence intervals of 1.1-2.1 cm in the Edinburgh cohort compared to 1.9-4.3cm in the Gothenburg group. Despite 2.8cm shorter stature (due to less QE-function growth) in the Scottish cohort, the growth patterns were similar. Timing of pubertal growth, showed no statistical differences between the study groups (Table 1).
A.Gothenburg cohort, girls (n1165) Edinburgh cohort, girls (n68)
| Variable | Mean Gothenburg | Mean Edinburgh | Difference | p–value |
| Emax(cm) | 62.85 | 61.40 | 1.45 | <.0001 |
| Qmax(cm) | 97.59 | 96.21 | 1.38 | 0.14 |
| AgeP5%1(years) | 9.87 | 9.97 | 0.10 | 0.49 |
| Age at PHV(years) | 11.84 | 11.92 | -0.08 | 0.61 |
| Pmax(cm) | 12.80 | 12.90 | -0.10 | 0.83 |
| Pubertal height gain(cm) | 26.37 | 25.80 | 0.57 | 0.24 |
| Tmax2(cm) | 167.26 | 164.44 | 2.82 | <.0001 |
| Variable | Mean Gothenburg | Mean Edinburgh | Difference | p–value |
| Emax(cm) | 65.07 | 63.95 | 1.12 | <.0001 |
| Qmax(cm) | 104.05 | 102.26 | 1.79 | 0.042 |
| AgeP5%1(years) | 11.82 | 11.98 | -0.16 | 0.13 |
| Age at PHV(years) | 13.69 | 13.86 | -0.17 | 0.12 |
| Pmax(cm) | 17.38 | 16.98 | 0.40 | 0.31 |
| Pubertal height gain(cm) | 28.97 | 28.09 | 0.88 | 0.026 |
| Tmax2(cm) | 180.53 | 177.66 | 2.87 | <.0001 |
1 = Age at onset of pubertal growth. 2=Calculated adult height by QEPS.
The contribution to adult height (percentage explained variance) from QEPS-functions was similar (Table 2).
| Variable | Mean Gothenburg | Mean Edinburgh | Difference | p–value |
| Emax | Emax Qmax | Emax Qmax Pmax | Emax Qmax Pmax AgeP50%1 | |
| Girls Gothenburg | 12.3 | 67.7 | 86.5 | 99.5 |
| Girls Edinburgh | 4.9 | 58.9 | 77.9 | 98.4 |
| Boys Gothenburg | 9.0 | 69.7 | 89.9 | 99.5 |
| Boys Edinburgh | 11.8 | 66.9 | 91.1 | 99.5 |
1 = Age at 50% of the pubertal growth.
Conclusion: The QEPS-model now validated for the first time in another longitudinal study of healthy individuals, fitted the Edinburgh cohort well, with high accuracy and narrow confidence intervals indicating high precision. Both cohorts born in mid-1970s showed for both sexes similar growth patterns, especially for pubertal growth.
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