ESPE2024 Poster Category 2 Growth and Syndromes (39 abstracts)
Students in Turkey show a continuing positive secular change of height but a worrying increase of overweight in males
Ozge Bayrak Demirel 1 , Cansu Koc 1 , Nur Mine Sukur 2 , Asli Derya Kardelen Al 1 , Melek Yildiz 1 , Sukran Poyrazoglu 1 , Firdevs Bas 1 , Jan Maarten Wit 3 & Feyza Darendeliler 1
1Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey. 2Istanbul University, Child Health Institute, Istanbul, Turkey. 3Division of Pediatric Endocrinology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
Background: Current Turkish growth reference charts based on anthropometric measurements of individuals with high socioeconomic status in Istanbul in 1989-2002 (TK2002) had shown an increase of mean adult height (1.4 and 2.7 cm in males and females) compared with 1978. Given recent improvements in nutrition, hygiene and access to preventive health services, we hypothesized that this positive secular trend may continue.
Methods: A prior power analysis (95% power) showed that at least 122 subjects of each sex were needed to detect a 1.8 cm height increase (P = 0.05) vs TK2002. In 2023-2024 a sample of 217 female and 248 male students (18-26 years) was randomly selected from 65,000 students at Istanbul University, originating from every region of Turkey (TK2024). Height, weight, and socioeconomic status (SES, categorized into four groups) were recorded and body mass index (BMI) was calculated. Anthropometric measurements of the top two SES groups were not significantly different, so these were combined for analyses (151 females, 157 males). Adult height and BMI were compared with TK2002 and with young adults of Turkish origin living in the Netherlands measured in 2009 (NL2009).
Results: Sample distribution aligned with Turkey's regional population distribution. Results are shown in the Table. Mean height was 1.8 cm taller in females (P = 0.003) and males (P <0.001) compared to TK2002, and also taller (2.3 and 1.2 cm, respectively, (P <0.001) than in NL2009. In females, BMI was similar to TK2002 and significantly lower than NL2009 (P <0.001). In males, BMI was significantly higher than TK2002 and NL2009 (P <0.001).
| FEMALES | MALES | |||||||
| Height (cm) | Percentiles | 3 | 50 | 97 | 3 | 50 | 97 | |
| TK2024 | 152.6 | 164.9 | 174.2 | 166.7 | 178.0 | 192.7 | ||
| TK2002 | 152.0 | 163.1 | 174.2 | 164.5 | 176.2 | 187.9 | ||
| NL2009 | 151.3 | 162.6 | 173.9 | 164.0 | 176.8 | 189.6 | ||
| BMI (kg/m2 | Percentiles | 5 | 50 | 95 | 5 | 50 | 95 | |
| TK2024 | 18.4 | 21.6 | 27.6 | 20.3 | 25.5 | 31.4 | ||
| TK2002 | 19.0 | 21.8 | 26.1 | 19.2 | 23.1 | 29.4 | ||
| NL2009 | 17.9 | 23.1 | 31.5 | 18.2 | 22.9 | 30.6 | ||
Conclusion: Adult height of Turkish students increased by 1.8 cm in both sexes over 2 decades. While BMI of females did not change, males show an alarmingly high BMI (58% overweight or obese). These results show the need of performing a population growth study to generate updated growth diagrams from birth to young adulthood, and urge to strengthen prevention programs to improve lifestyle and reduce overweight and its consequences.
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