Abstract：
Despite inter-individual variations in pubertal timing, growth references are conventionally constructed relative to chronological age (C-age). Thus, they are based on reference populations containing a mix of prepubertal and pubertal individuals, making them of limited use for detecting abnormal growth during adolescence. Recently we developed new types of height and weight references, with growth aligned to age at onset of the pubertal growth spurt (P-age). Here, we aim to develop a corresponding reference for pubertal BMI.
The QEPS-height and weight models were used to define a corresponding QEPS-BMI model. QEPS-BMI was modified by the same individual, constitutional weight-height-factor (WHF) as computed for QEPS-weight. QEPS-BMI functions were computed with QEPS weight and height functions fitted on longitudinal measurements from 1418 individuals (698 girls) from GrowUp1990Gothenburg cohort. These individual BMI functions were used to develop BMI references aligned for height at AgeP5; when 5% of specific puberty-related (P-function) height had been attained. Pubertal timing, stature at pubertal onset, and childhood BMI, were investigated in subgroups of children from the cohort GrowUp1974Gothenburg using the new references.
References (median, standard deviation score (SDS)) were generated for total BMI (QEPS-functions), for ongoing prepubertal growth (QE-function) vs C-age, and for total BMI and separated into BMI specific to puberty (P-function) and BMI gain from ongoing basic growth (QES-functions), allowing individual growth to be aligned based on P-age. Growth in basic BMI was greater than average for children categorized as tall and/or with high-BMI at puberty-start. In children categorized as short at puberty-start, P-function-related-BMI was greater than average.
Use of these new pubertal BMI references will make it possible for the first time to consider individual variations owing to pubertal timing when evaluating BMI. This will improve the detection of abnormal changes in body composition when used in combination with pubertal height and weight references also abnormal growth. Other benefits in the clinic will include improved growth monitoring during treatment for children who are overweight/obese or underweight. Furthermore, in research settings these new references represent a novel tool for exploring human growth.
The QEPS-height and weight models were used to define a corresponding QEPS-BMI model. QEPS-BMI was modified by the same individual, constitutional weight-height-factor (WHF) as computed for QEPS-weight. QEPS-BMI functions were computed with QEPS weight and height functions fitted on longitudinal measurements from 1418 individuals (698 girls) from GrowUp1990Gothenburg cohort. These individual BMI functions were used to develop BMI references aligned for height at AgeP5; when 5% of specific puberty-related (P-function) height had been attained. Pubertal timing, stature at pubertal onset, and childhood BMI, were investigated in subgroups of children from the cohort GrowUp1974Gothenburg using the new references.
References (median, standard deviation score (SDS)) were generated for total BMI (QEPS-functions), for ongoing prepubertal growth (QE-function) vs C-age, and for total BMI and separated into BMI specific to puberty (P-function) and BMI gain from ongoing basic growth (QES-functions), allowing individual growth to be aligned based on P-age. Growth in basic BMI was greater than average for children categorized as tall and/or with high-BMI at puberty-start. In children categorized as short at puberty-start, P-function-related-BMI was greater than average.
Use of these new pubertal BMI references will make it possible for the first time to consider individual variations owing to pubertal timing when evaluating BMI. This will improve the detection of abnormal changes in body composition when used in combination with pubertal height and weight references also abnormal growth. Other benefits in the clinic will include improved growth monitoring during treatment for children who are overweight/obese or underweight. Furthermore, in research settings these new references represent a novel tool for exploring human growth.
摘要：
尽管青春期时间存在个体差异，生长参考通常是相对于实际年龄(C年龄)构建的。因此，它们基于包含青春期前和青春期个体混合的参考人群，使它们在青春期检测异常生长的用途有限。最近我们开发了新类型的身高和体重参考，生长与青春期生长突增（P年龄）开始时的年龄一致。这里,我们旨在为青春期BMI制定相应的参考。
使用QEPS-身高和体重模型来定义相应的QEPS-BMI模型。QEPS-BMI由同一个人修改，根据QEPS体重计算的体质体重-身高因子(WHF)。QEPS-BMI函数是根据GrowUp1990哥德堡队列的1418名个体（698名女孩）的纵向测量值拟合的QEPS体重和身高函数计算的。这些单独的BMI函数用于开发与AgeP5身高对齐的BMI参考；当达到5％的特定青春期相关（P功能）身高时。青春期的时机，青春期开始时的身材，和童年的BMI，使用新的参考文献对来自GrowUp1974Gothenburg队列的儿童亚组进行了调查。
参考(中位数，为总BMI（QEPS功能）生成标准偏差评分（SDS），对于持续的青春期前生长（QE功能）与C年龄，对于总BMI，分为青春期特定的BMI（P功能）和持续基本增长的BMI（QES功能），允许个体生长基于P年龄。在青春期开始时，被归类为高个子和/或高BMI的儿童的基本BMI增长高于平均水平。在青春期开始时被归类为矮小的儿童中，P功能相关BMI大于平均值。
在评估BMI时，使用这些新的青春期BMI参考将首次考虑由于青春期时间而引起的个体差异。当与青春期身高和体重参考也异常增长结合使用时，这将改善对身体成分异常变化的检测。诊所的其他好处将包括在超重/肥胖或体重不足的儿童治疗期间改善生长监测。此外，在研究环境中，这些新的参考文献代表了探索人类成长的新工具。
使用QEPS-身高和体重模型来定义相应的QEPS-BMI模型。QEPS-BMI由同一个人修改，根据QEPS体重计算的体质体重-身高因子(WHF)。QEPS-BMI函数是根据GrowUp1990哥德堡队列的1418名个体（698名女孩）的纵向测量值拟合的QEPS体重和身高函数计算的。这些单独的BMI函数用于开发与AgeP5身高对齐的BMI参考；当达到5％的特定青春期相关（P功能）身高时。青春期的时机，青春期开始时的身材，和童年的BMI，使用新的参考文献对来自GrowUp1974Gothenburg队列的儿童亚组进行了调查。
参考(中位数，为总BMI（QEPS功能）生成标准偏差评分（SDS），对于持续的青春期前生长（QE功能）与C年龄，对于总BMI，分为青春期特定的BMI（P功能）和持续基本增长的BMI（QES功能），允许个体生长基于P年龄。在青春期开始时，被归类为高个子和/或高BMI的儿童的基本BMI增长高于平均水平。在青春期开始时被归类为矮小的儿童中，P功能相关BMI大于平均值。
在评估BMI时，使用这些新的青春期BMI参考将首次考虑由于青春期时间而引起的个体差异。当与青春期身高和体重参考也异常增长结合使用时，这将改善对身体成分异常变化的检测。诊所的其他好处将包括在超重/肥胖或体重不足的儿童治疗期间改善生长监测。此外，在研究环境中，这些新的参考文献代表了探索人类成长的新工具。
