Age at hormonal onset of puberty based on luteinizing hormone, inhibin B, and body composition in preadolescent U.S. girls

Phosphate Flame Retardants and Plasticizers and Their Association with Reproductive and Steroid Hormone Levels among Peripubertal-Aged Children: The Hokkaido Birth Cohort Study

This cross-sectional study investigated associations between exposure to organophosphate flame retardants and plasticizers (PFRs) and reproductive and steroid hormones in peripubertal children from the Hokkaido Birth Cohort (429 children aged 9-12 years; between September 2017 and March 2020). Thirteen urinary PFR metabolites and 14 plasma steroid hormones were investigated using LC-MS/MS and four reproductive hormones were investigated using immunoassays. Linear regression for single PFR, quantile g-computation, and Bayesian machine kernel regression (BKMR) models for the PFR mixtures were used to examine the association between hormones and PFRs. Among boys, significant positive associations were observed between estradiol and ΣTCIPP and ΣTBOEP, and inverse associations were identified between insulin-like factor-3 (INSL3) and ΣTCIPP, and between luteinizing hormone (LH) and ΣEHDPHP. The PFR mixture was associated with the trends of increasing estradiol and androstenedione, and decreasing cortisol, cortisone, LH, inhibin B, and INSL3. Among girls, androstenedione and ΣTCIPP, testosterone and ΣEHDPHP, (androstenedione + testosterone)/DHEA-S and ΣTCIPP, and ΣEHDPHP and ΣTPHP were significantly correlated. The PFR mixture showed trends of increasing testosterone, androstenedione, and inhibin B, and decreasing cortisol, cortisone, and INSL3. Individual PFRs and PFR mixtures altered steroids and reproductive hormones in peripubertal children.

Pubertal luteinizing hormone levels in children with chronic kidney disease and association with change in glomerular filtration rate

BACKGROUND

Children with chronic kidney disease (CKD) are at risk for abnormalities in pubertal development. We aimed to describe the timing of pubertal onset by luteinizing hormone (LH) levels and the association between hormonal onset of puberty with changes in GFR.

METHODS

Data from the Chronic Kidney Disease in Children (CKiD) study were collected prospectively. GFR was estimated at annual visits and measured by iohexol clearance every other year. LH was measured from stored repository serum samples in a nested sample of 124 participants. Hormonal onset of puberty was defined as LH level greater than or equal to 0.3 IU/L. A mixed effects model with random intercepts and slopes was used to compare the slope of decline of GFR before and after hormonal onset of puberty. The model was adjusted for age, glomerular disease diagnosis, baseline proteinuria on the log scale, and BMI.

RESULTS

Median age at hormonal onset of puberty was 9.9 years (IQR 8.1, 11.9) in girls and 10.2 years (IQR 9.2, 11.0) in boys. The mixed effects model showed faster decline in both estimated GFR and measured GFR in boys after hormonal onset of puberty (p < 0.001), and a similar but attenuated accelerated estimated GFR decline was observed for girls with no difference for measured GFR.

CONCLUSIONS

LH levels in the post-pubertal range were observed prior to clinical manifestations of puberty in children with CKD. Hormonal onset of puberty was associated with faster decline in GFR, particularly among boys with CKD.

Sex and Age Characteristics in Acute or Chronic Myocarditis A Descriptive, Multicenter Cohort Study

BACKGROUND

Understanding the clinical features of myocarditis in various age groups is required to identify age-specific disease patterns.

OBJECTIVES

The objective of this study was to examine differences in sex distribution and clinical outcomes in patients with myocarditis of various ages.

METHODS

Patients with acute or chronic myocarditis in 3 centers in Berlin, Germany from 2005 to 2021 and in the United States (National Inpatient Sample) from 2010 to 2019 were included. Age groups examined included "prepubescent" (below 11 years for females and below 13 years for males), adolescents (11 [female] or 13 [male] to 18 years), young adults (18-35 years), "middle-aged adults" (35-54 years), and older adults (age >54 years). In patients admitted to the hospital, hospital mortality, length of stay, and medical complication rates were examined.

RESULTS

Overall, 6,023 cases in Berlin and 9,079 cases in the U.S. cohort were included. In both cohorts, there were differences in sex distribution among the 5 age categories, and differences in the distribution were most notable in adolescents (69.3% males vs 30.7% females) and in young adults (73.8% males vs 26.3% females). Prepubescent and older adults had the highest rates of in-hospital mortality, hospital length of stay, and medical complications. In the Berlin cohort, prepubescent patients had higher levels of leukocytes (P < 0.001), antistreptolysin antibody (P < 0.001), and NT-proBNP (P < 0.001) when compared to young adults.

CONCLUSIONS

In this study, we found that sex differences in myocarditis and clinical features of myocarditis were age-dependent.

Association Between Markers of Adiposity During Childhood and Puberty Onset in Latino Girls

CONTEXT

Prepubertal adiposity is associated with earlier puberty. It is unclear when this association starts, if all adiposity markers are similarly associated, and whether all pubertal milestones are similarly affected.

OBJECTIVE

To evaluate the association between different adiposity markers during childhood and the timing of different pubertal milestones in Latino girls.

DESIGN, SETTING, AND PARTICIPANTS

Longitudinal follow-up of 539 female participants of the Chilean Growth and Obesity Cohort recruited from childcare centers (mean age 3.5 years) from the southeast area of Santiago, Chile. Participants were singletons born between 2002 and 2003 within the normal birthweight range. Since 2006, a trained dietitian measured weight, height, waist circumference (WC) and skinfolds to estimate body mass index (BMI) Centers for Disease Control and Prevention percentiles, central obesity, percentage of fat mass (%FM), and fat mass index (FMI, fat mass/height2).

MAIN OUTCOME

Since 2009, sexual maturation was assessed every 6 months to assess age at (1) thelarche, (2) pubarche, (3) menarche, and (4) peak height velocity (PHV).

RESULTS

At thelarche, 12.5% were obese and 2% had central obesity. The median age of pubarche, menarche, and PHV were all associated with markers of adiposity at different time points during childhood whereas thelarche only with %FM and FMI. Adiposity clusters models showed that children with trajectories of high WC, %FM, and FMI during childhood were related with earlier thelarche, pubarche, menarche, and PHV but BMI trajectories only with menarche and PHV.

CONCLUSIONS

Higher WC, %FM, and FMI were associated with earlier age at thelarche, pubarche, menarche, and PHV. The effect of BMI was less consistent.

Longitudinal Investigation of Pubertal Milestones and Hormones as a Function of Body Fat in Girls

CONTEXT

Epidemiologic studies have demonstrated that overweight/obese girls (OW/OB) undergo thelarche and menarche earlier than normal weight girls (NW). There have been no longitudinal studies to specifically investigate how body weight/fat affects both clinical and biochemical pubertal markers in girls.

OBJECTIVE

To investigate the effect of total body fat on reproductive hormones and on the maturation of estrogen-sensitive tissues during puberty in girls.

METHODS

Ninety girls (36 OW/OB, 54 NW), aged 8.2 to 14.7 years, completed 2.8 ± 1.7 study visits over 4 years. Visits included dual-energy x-ray absorptiometry to calculate total body fat (TBF), Tanner staging, breast ultrasound for morphological staging (BMORPH; A-E), pelvic ultrasound, hormone tests, and assessment of menarchal status. The effect of TBF on pubertal markers was determined using a mixed, multistate, or Cox proportional hazards model, controlling for baseline BMORPH.

RESULTS

NW were older than OW/OB (11.3 vs 10.2 years, P < .01) at baseline and had more advanced BMORPH (P < .01). Luteinizing hormone, estradiol, and ovarian and uterine volumes increased with time with no effect of TBF. There was a time × TBF interaction for follicle-stimulating hormone, inhibin B, estrone, total and free testosterone, and androstenedione: Levels were initially similar, but after 1 year, levels increased in girls with higher TBF, plateaued in girls with midrange TBF, and decreased in girls with lower TBF. Girls with higher TBF progressed through BMORPH stage D more slowly but achieved menarche earlier than girls with lower TBF.

CONCLUSION

In late puberty, girls with higher TBF demonstrate differences in standard hormonal and clinical markers of puberty. Investigation of the underlying causes and clinical consequences of these differences in girls with higher TBF deserves further study.

Adjusting for Pubertal Status Reduces Overweight and Obesity Prevalence in the United States

OBJECTIVE

To compare pediatric overweight and obesity prevalence among non-Hispanic white, Mexican American, and non-Hispanic black US youths before and after adjusting body mass index (BMI) for pubertal status, as assessed by Tanner stage.

STUDY DESIGN

We analyzed cross-sectional anthropometric and pubertal data from non-Hispanic white, Mexican American, and non-Hispanic black youths in the National Health and Nutrition Examination Survey (NHANES) III. We developed specialized Tanner stage and chronological age-adjusted models to establish Tanner-stage adjusted BMI z-scores, which were then used to determine adjusted overweight/obesity prevalence. We compared pediatric overweight/obesity prevalence before and after pubertal status adjustment.

RESULTS

Among 3206 youths aged 8-18 years (50% male; 26% non-Hispanic white, 35% Mexican American, 39% non-Hispanic black), adjusting BMI for Tanner stage significantly reduced overweight (males, from 29% to 21%; females, from 29% to 17%) and obesity (males, from 14% to 7%; females, from 11% to 5%) prevalence across all races/ethnicities. The obesity prevalence reduction was more pronounced in Mexican Americans (males, 11% reduction; females, 9% reduction) and non-Hispanic blacks (males and females, 10% reduction) compared with non-Hispanic whites (males, 6% reduction; females, 5% reduction). Similar patterns were seen in overweight prevalence.

CONCLUSIONS

Adjusting for pubertal status reduced the prevalence of overweight/obesity in non-Hispanic white, Mexican American, and non-Hispanic black youth. This suggests that adjusting for puberty incorporates changes otherwise not captured when only considering the age of a child. Adjusting BMI for pubertal status may be important when interpreting a youth's weight status and consideration for obesity management, as well as when interpreting pediatric overweight/obesity prevalence data.

Unilateral section of the superior ovarian nerve induces first ovulation in the Zucker fatty (fa/fa) rat

Hyperactivity in the sympathetic nervous system has been shown to be related to the development of ovarian pathologies. In addition, obesity has been found to be associated with multiple reproductive anomalies and is considered a chronic stress condition of low intensity with changes in the peripheral sympathetic activity. Therefore, in the present study, we aimed to evaluate if the information reaching the ovaries through the superior ovarian nerve (SON) modifies the ovarian function of Zucker fatty rats. We performed a unilateral section of the SON at 32 days of age and autopsies were carried out on the day of the first vaginal estrus. The results showed that fatty animals do not ovulate on the day of the first vaginal estrus and exhibit an increase in catecholaminergic fibers and the presence of precystic structures in the ovaries, without changes in the onset of puberty or in the secretion of ovarian and hypophyseal hormones. We also found that the section of the right SON resulted in ovulation on the day of the first vaginal estrus, which was accompanied by a decrease in ovarian noradrenaline content. The section of the left SON caused a delay in puberty without changes in the rest of the parameters. These results provide functional evidence that the peripheral sympathetic innervation participates in the regulation of ovarian functions in an animal model of genetic obesity.

Desmopressin responsiveness by age in type 1 von Willebrand disease

BACKGROUND

Patients with type 1 von Willebrand disease (VWD) undergo a desmopressin (DDAVP) responsiveness challenge at diagnosis to assess whether DDAVP reverses their coagulation deficits. Current practice assumes DDAVP responsiveness remains constant over the lifetime. In patients with type 1 VWD, VWF-related parameters increase with age. This study explores whether DDAVP responsiveness also differs with age in this population.

METHODS

We conducted a retrospective chart review of 106 patients enrolled at our center since 1990. Our primary outcome was DDAVP responsiveness at 1 hour after DDAVP challenge. Locally weighted scatterplot smoothing fit and Spearman correlation coefficients were used to study the relationship between age and DDAVP responsiveness. For female participants, we used the Kruskal-Wallis test to compare absolute and relative changes in DDAVP responsiveness at various ages.

RESULTS

We had 79 patients (56 female) with type 1 VWD with at least 1 DDAVP challenge. In women with type 1 VWD, the absolute change in DDAVP responsiveness did not vary significantly with age (VWF:antigen [Ag], -0.08, P = .56; VWF:ristocetin cofactor [RCo], -0.16, P = .26; low-molecular-weight component of factor VIII [FVIII:C], -0.01, P = .93), nor did the relative change in DDAVP responsiveness (VWF:Ag, -0.03, P = .86; VWF:RCo, -0.25, P = .09; FVIII:C, -0.14, P = .34). The data plot suggested a relationship.

CONCLUSION

In women with type 1 VWD, DDAVP responsiveness may vary over the life cycle. Our exploratory findings are limited by our retrospective data, cross-sectional design, and small sample. Future studies should investigate the relationship between age and DDAVP responsiveness prospectively to evaluate whether there is clinical utility in rechallenging postpubertal female patients with type 1 VWD.

Early breast development in overweight girls: does estrogen made by adipose tissue play a role?

Background

Girls who are overweight/obese (OB) develop breast tissue but do not undergo menarche (the first menstrual period) significantly earlier than girls of normal weight (NW). It has been proposed that estrogen synthesized by adipose tissue may be contributory, yet OB do not have higher serum estrogen levels than NW matched on breast stage. We hypothesized that estrogen synthesized locally, in mammary fat, may contribute to breast development. This hypothesis would predict that breast development would be more advanced than other estrogen-sensitive tissues as a function of obesity and body fat.

Methods

80 pre-menarchal girls (26 OB, 54 NW), aged 8.2–14.7 yrs, underwent dual-energy x-ray absorptiometry to calculate percent body fat (%BF), Tanner staging of the breast, breast ultrasound for morphological staging, trans-abdominal pelvic ultrasound, hand x-ray (bone age), a blood test for reproductive hormones, and urine collection to determine the vaginal maturation index (VMI), an index of estrogen exposure in urogenital epithelial cells.

Results

When controlling for breast morphological stage determined by ultrasound, %BF was not associated with serum estrogen or gonadotropin (LH and FSH) levels or on indices of systemic estrogen action (uterine volume, endometrial thickness, bone age advancement, and VMI). Tanner breast stage did not correlate with breast morphological stage and led to misclassification of chest fatty tissue as breast tissue in some OB.

Conclusions

These studies do not support the hypothesis that estrogen derived from total body fat or local (mammary) fat contributes to breast development in overweight/obese girls.

Outcomes in different age groups with primary Ewing sarcoma of the spine: a systematic review of the literature

OBJECTIVE

Ewing sarcoma (ES) is among the most prevalent of bone sarcomas in young people. Less often, it presents as a primary lesion of the spine (5%-15% of patients with ES).

METHODS

A systematic literature search was performed, querying several scientific databases per PRISMA guidelines. Inclusion criteria specified all studies of patients with surgically treated ES located in the spine. Patient age was categorized into three groups: 0-13 years (age group 1), 14-20 years (age group 2), and > 21 (age group 3).

RESULTS

Eighteen studies were included, yielding 28 patients with ES of the spine. Sixty-seven percent of patients experienced a favorable outcome, with laminectomies representing the most common (46%) of surgical interventions. One-, 2-, and 5-year survival rates were 82% (n = 23), 75% (n = 21), and 57% (n = 16), respectively. Patients in age group 2 experienced the greatest mortality rate (75%) compared to age group 1 (9%) and age group 3 (22%). The calculated relative risk score indicated patients in age group 2 were 7.5 times more likely to die than other age groups combined (p = 0.02).

CONCLUSIONS

Primary ES of the spine is a rare, debilitating disease in which the role of surgery and its impact on one's quality of life and independence status has not been well described. This study found the majority of patients experienced a favorable outcome with respect to independence status following surgery and adjunctive treatment. An increased risk of recurrence and death was also present among the adolescent age group (14-20 years).

Prevalence of underweight and overweight among young adolescents aged 12-15 years in 58 low-income and middle-income countries

BACKGROUND

The co-existence of underweight and overweight is a great challenge for public health in low-income and middle-income countries (LMICs).

OBJECTIVES

The objective of the study is to report the prevalence of underweight, overweight and obesity among young adolescents in 58 LMICs.

METHODS

Data were from the Global School-based Student Health Survey (2007-2013) in 57 LMICs and from the Chinese National Surveys on Students' Constitution and Health (2010). A total of 177 325 young adolescents aged 12-15 years from 58 LMICs were included. Weight status was defined based on both the updated International Obesity Task Force (IOTF) and World Health Organization (WHO) criteria.

RESULTS

Based on the IOTF/WHO criteria, the overall prevalence of weight categories among young adolescents in LMICs was 13.4%/4.7% for underweight, 15.4%/17.3% for overweight and 5.6%/8.6% for obesity. However, the prevalence varied largely across countries and regions. Based on the IOTF criteria, the prevalence of underweight ranged from 0.0% in Niue to 48.8% in Sri Lanka and obesity ranged from 0.1% in Vanuatu to 35.0% in Niue; a prevalence exceeding 10.0% for both underweight and excess weight (overweight and obesity combined) was found in 29.3% of these countries. Underweight was more prevalent in Southeast Asia and Africa, while obesity was more frequent in Central and South Americas. There were no age and sex differences in the prevalence of weight categories for most countries.

CONCLUSIONS

Our data confirm the continued dual burden of underweight and overweight in young adolescents in many LMICs and the need for policy and programmes to address both conditions.

Effect of Interaction between Early Menarche and Genetic Polymorphisms on Triglyceride

Early menarche has been associated with increased risk of metabolic syndrome. Therefore, investigating the association of each component of metabolic syndrome with age at menarche, and interactions between them, might lead to a better understanding of metabolic syndrome pathogenesis. In this study, we evaluated age at menarche for risk of metabolic syndrome and associations with its components. As a result, the risk of MetS incidence was significantly increased only at ≤12 years of age at menarche (OR = 1.91, P < 0.05). Women with early menarche (≤12 years) had significantly higher levels of triglycerides (β coefficient = 37.83, P = 0.02). In addition, hypertriglyceridemia was significantly increased at early menarche with 1.99 (95% CI: 1.16–3.41, P < 0.01). With GWAS-based pathway analysis, we found the type 2 diabetes mellitus, stress-activated protein kinase signaling, and Jun amino-terminal kinase cascade pathways (all nominal P < 0.001, all FDR < 0.05) to be significantly involved with early menarche on triglyceride levels. These findings may help us understand the role of early menarche on triglyceride and interaction between gene and early menarche on triglyceride for the development of metabolic syndrome.

Association between the onset age of puberty and parental height

Background

The onset age of physiological puberty is greatly variable. This variability has been attributed to environmental factors and to genetic factors although a very little is explained by genome-wide associations studies. Previously, we reported the existence of an association between the onset age of puberty and final height. It is known that final height is associated with parental height (specifically, with the "target height"). We hypothesized that the variability of the onset age of puberty contributes to the attainment of a final height which is similar to the target height. We hypothesized that whenever a child's height-percentile differs from the target height percentile (we called this difference the "height gap"), the onset of puberty is advanced or delayed so that they are closer or even equal at the end of pubertal growth. The association between height gap and onset age of puberty was investigated in the reported study.

Methods

The study is an observational retrospective study on growth during puberty in 170 Israeli (60 girls) and 335 Polish children (162 girls). Anthropometric measurements were analyzed by multivariable linear regression with the onset age of the pubertal growth spurt (PGS) as the dependent variable, and two independent variables "height gap" and body mass index (BMI)—both standardized.

Results

The adjusted coefficient of determination (adj R²) between the onset age of the PGS and the two independent variables was 0.69 (Israeli girls), 0.50 (Israeli boys, BMI excluded), 0.25 (Polish girls) and 0.13 (Polish boys). A prediction model for the onset age of puberty is presented.

Conclusions

The association between the "height gap" and the onset age of puberty suggests that the variability of this age is part of the targeted process of statural growth. The proposed model may explain idiopathic cases of precocious and delayed puberty.

Physiology of puberty in boys and girls and pathological disorders affecting its onset

Puberty is a physiological event involving the attainment of reproductive capability and complete development of sexual and physical organs. Changing from childhood to adulthood is a complex process and is tightly controlled by interconnection pathways at the level of the hypothalamus which can be influenced by environmental, psychosocial, and endocrine factors. Although various mechanisms underlying the onset of normal puberty have been investigated in humans and animals, the exact molecular mechanisms thereof remain unclear. The aim of this review is to summarize the current state of knowledge and provide a synoptic overview about the physiology of puberty in adolescent boys and girls, and describe pathological disorders affecting its onset.

Effect of Adjusting for Tanner Stage Age on Prevalence of Short and Tall Stature of Youths in the United States

OBJECTIVE

To evaluate the extent to which pubertal timing alters the classification of extremes of attained stature across race-ethnicity groups of youths in the US.

STUDY DESIGN

We performed analyses of height and Tanner staging data of 3206 cross-sectional national sample of youths ages 8-18 years (53% male, n = 1606), 72% of whom were non-Hispanic white, 9% Mexican American, and 19% non-Hispanic black . Specialized growth models were used to derive Tanner-stage-age-adjusted z scores (TSA_HAZ). The prevalence of shortness (<-1SD) and tallness (≥+1SD) status was quantified using TSA_HAZ.

RESULTS

Highly variable patterns of prevalence of shortness and tallness via chronologic age height z score (CA_HAZ) were observed in results stratified by race-ethnicity and sex. Tallness CA_HAZ prevalence was high among non-Hispanic white and non-Hispanic black male youths relative to Mexican American (40.0%-43.3% vs 20.5%) with a similar pattern in female youths. In both sexes, this pattern was eliminated with TSA_HAZ, with Mexican American youth becoming statistically not different from their non-Hispanic white and non-Hispanic black peers.

CONCLUSIONS

Differences in timing of puberty between race-ethnicity groups affects estimated prevalence of shortness and tallness of attained height that remains uncaptured with CA_HAZ. Adjustment for pubertal development might help isolate crucial determinants of attained stature and other aspects of body composition that may be most responsive to intervention programs in populations. The curves developed by adjusting for pubertal status may help the clinician avoid misclassification of children with early and late pubertal development.

Timing of pubertal growth and menarche in indigenous Qom girls of Argentina

BACKGROUND

Pubertal timing is in part mediated by environmental factors, with greater energy availability often associated with earlier or more rapid development. Many indigenous populations are undergoing socioeconomic change that may affect pubertal development and related health risks, necessitating fundamental longitudinal research on growth and development in these populations.

AIM

Growth velocity and time to menarche among peri-urban indigenous Qom (Toba) girls in Argentina are described.

SUBJECTS AND METHODS

From 2011-2015, monthly anthropometrics and menstrual status were collected from 61 Qom girls aged 7-14. Growth velocity curves were generated using the 'Super-imposition by translation and rotation' (SITAR) method. Median time to menarche was estimated by Kaplan-Meier survival analysis.

RESULTS

Mean ages at peak height, weight and BMI velocity were estimated at 10.8, 10.5 and 10.7 years and median age at menarche at 11.6 years (95% CI = 11.4-11.9). At menarche, 45% of girls were overweight or obese and only one participant was short-statured by international standards.

CONCLUSION

Qom participants in this study exhibit relatively fast pubertal development as compared to other Latin American indigenous populations studied previously by others. Genetic and environmental factors influencing body size, diet and/or activity levels should be investigated further in this population.

Growth Patterns and Individual Variation in Mid-sagittal Facial Soft Tissue Depth from Childhood to Adulthood

Previous studies have used longitudinal samples to investigate growth of the skeletal aspects of the face, although far less has been done on facial soft tissue. This study uses a larger sample than previous studies on the same data (Denver and Fels growth series) to explore covariation of bony and soft facial dimensions comprehensively from childhood to adulthood. A total of 1036 lateral cephalometric radiographs were digitized from 60 individuals, and distances between facial landmarks were measured using ImageJ. Multivariate analysis of variance (MANOVA) showed all bony facial landmark distances were significantly different (p > 0.05) between age groups; however, only half were significantly different between sexes. Further analysis showed the effect of age (calculated as eta-squared) explained a greater percentage of total variation (20%) than sex (15%). Overall, soft tissue changes between 0 and 19 years of age were small (<3 mm) and only some were correlated to underlying facial skeleton dimensions.

Early growth faltering in post-institutionalized youth and later anthropometric and pubertal development

BackgroundEarly-life adversity that increases the risk of growth stunting is hypothesized to increase the risk of obesity and, in girls, early-onset puberty. This hypothesis was tested in children adopted from orphanages.MethodsPost-institutionalized (PI) youth were compared with youth reared in comparable families (non-adopted; NA) on height, weight, pubertal stage, and fat mass (127 PI, 80 female; 156 NA, 85 female, aged 7-14 years). Anthropometric findings at adoption were obtained from first US clinic visits.ResultsOverall, 25% of PI youth were height-stunted (<3rd percentile) at adoption. Years post adoption, PI youth had lower BMI-for-age (P=0.004), height-for-age (P<0.001), and less body fat (P<0.001) than NA youth had, but they did not differ by sex. Pubertal status did not differ by group or sex. The anthropometric findings held when the stunted-at-adoption subset was examined; they were also less likely to be in central puberty than other PI youth.ConclusionEarly deprived orphanage care increases the risk of growth stunting but not obesity in children adopted into US families, and it does not independently contribute to early-onset puberty for PI girls. The role of the environment following early adversity may modify the impact of early adverse care.

Posterior-Anterior Brain Maturation Reflected in Perceptual, Motor and Cognitive Performance

Based on several postmortem morphometric and in vivo imaging studies it has been postulated that brain maturation roughly follows a caudal to rostral direction. In this study, we linked this maturational pattern to psychological function employing a series of well-established behavioral tasks. We addressed three distinct functions and brain regions with a perceptual (contour integration, CI), motor (finger tapping, FT), and executive control (Navon global–local) task. Our purpose was to investigate basic visual integration functions relying on primary visual cortex (V1) in CI; motor coordination function related to primary motor cortex (M1) in FT, and the executive control component, switching, related to the dorsolateral prefrontal region of the brain in the Navon task. 122 volunteer subjects were recruited to participate in this study between the ages of 10 and 20 (females n = 63, males n = 59). Employing conventional statistical methods, we found that 10 and 12 year olds are performing significantly weaker than 20 year olds in all three tasks. In the CI and Navon global–local tasks, even 14 years old perform poorer than adults. We have also investigated the developmental trajectories by fitting sigmoid curves on our data streams. The analysis of the developmental trajectories of the three tasks showed a posterior to anterior pattern in the emergence of the developmental functions with the earliest development in the visual CI task (V1), followed by motor development in the FT task (M1), and cognitive development as measured in the Navon global–local task (DLPC) being the slowest. Gender difference was also present in FT task showing an earlier maturation for girls in the motor domain.

Pubertal height gain is inversely related to peak BMI in childhood

BACKGROUND

Childhood BMI may influence subsequent growth in height as well as the timing of puberty. The aim of the present study was to investigate associations between BMI in childhood and subsequent height gain/pubertal growth.

METHODS

Longitudinal growth data were used (GrowUp₁₉₉₀Gothenburg cohort, n = 1,901). The QEPS growth-model was used to characterize height gain in relation to the highest BMI_SDS value between 3.5 and 8 y of age. Children were defined as overweight/obese (OwOb) or normal weight/underweight (NwUw), using the 2012 International Obesity Task Force criteria.

RESULTS

A negative association between childhood BMI_SDS and pubertal height gain was observed. Already at birth, OwOb children were heavier than NwUw children, and had a greater height velocity during childhood. Onset of puberty was 3.5/3.0 mo earlier in OwOb girls/boys, and they had 2.3/3.1 cm less pubertal height gain from the QEPS-models specific P-function than NwUw children. Adult height was not related to childhood BMI.

CONCLUSION

We found that pubertal height gain was inversely related to peak BMI in childhood. Higher childhood BMI_SDS was associated with more growth before onset of puberty, earlier puberty, and less pubertal height gain, resulting in similar adult heights for OwOb and NwUw children.

Overweight and Underweight Prevalence Trends in Children from Romania - Pooled Analysis of Cross-Sectional Studies between 2006 and 2015

AIM

High-quality national representative data on obesity in Romanian children are needed to shape public health policies. To provide a unified data landscape on national prevalence, trends and other factors associated with underweight, overweight, and obesity in Romanian children aged 6-19 years, across the last decade (2006-2015).

METHODS

Using a common protocol, we selected published and unpublished studies that measured Romanian children in schools between 2006 and 2015. Children's BMI was classified using the current WHO, IOTF, and CDC references.

RESULTS

25,060 children from 8 Romanian counties were included in the analysis. The prevalence of underweight children was 5%/4.5%/8.5% (WHO/IOTF/CDC), while the prevalence of overweight (including obese) children was 28.3%/23%/23.2% (WHO/IOTF/CDC). The prevalence of overweight children did not change significantly over the last decade (chi-square test p = 0.6). Male gender (odds ratio (OR) 1.37; 95% CI 1.29-1.45, compared to female); prepubertal age (OR = 3.86; 95% CI 3.41-4.36,compared to postpubertal age), and urban environment (OR 1.12; 95% CI 1.01-1.26, compared to rural environment) had higher risk for overweight.

CONCLUSION

While the prevalence of underweight children was low, almost one in four children in Romania was overweight or obese (according to WHO criteria) between 2006 and 2015. This prevalence remained relatively stable over the last decade. Male gender, prepubertal age, and urban environment, were the most relevant risk factors associated with overweight status in Romanian children.

Sexualized behaviors in cohorts of children in the child welfare system

The current retrospective archival study investigated the patterns of normative sexualized behavior (NSB), problematic sexualized behavior (PSB), and sexual perpetration for three age cohorts of boys and girls in a high-risk child welfare sample. All children in the present sample had exhibited some form of PSB in the past. We hypothesized that the incidence rates (IR) of NSBs would increase linearly from the early childhood cohort (Ages 2/3-7) to the middle childhood cohort (Ages 8-11) to the preadolescence/adolescence cohort (Ages 12-17), for girls and boys. Although the base rate of sexual behaviors generally increases as children age, children tend to hide sexual behaviors starting at an early age. We therefore hypothesized that a concave quadratic trend would be evident for most PSBs. We further predicted that older children would have a greater incidence of PSB, as well as more victims, compared with younger children. We found the predicted upward linear trend for NSB for both girls and boys, with minimal IR differences between the early childhood and middle childhood cohorts. IRs were remarkably high and comparable across age groups for both boys and girls, with respect to the same three PSBs. For the two perpetration history variables, there was a concave effect, with girls and boys in the middle childhood cohort exhibiting the lowest IR. Results are explained in the context of previously established patterns of sexualized behavior, as well as the reporting of such behaviors.

Promoting healthful family meals to prevent obesity: HOME Plus, a randomized controlled trial

Background

Family meal frequency has been shown to be strongly associated with better dietary intake; however, associations with weight status have been mixed. Family meals-focused randomized controlled trials with weight outcomes have not been previously conducted. Therefore, this study purpose was to describe weight-related outcomes of the HOME Plus study, the first family meals-focused randomized controlled trial to prevent excess weight gain among youth.

Methods

Families (n = 160 8-12-year-old children and their parents/guardians) were randomized to intervention (n = 81) or control (n = 79) groups. Data were collected at baseline (2011–2012), post-intervention (12-months post-baseline) and follow-up (21-months post-baseline). The intervention included ten monthly group sessions (nutrition education; hands-on meal and snack planning, preparation, and skill development; screen time reductions) and five motivational, goal-setting phone calls. The main outcome was child body mass index (BMI) z-score.

Results

General linear models, adjusted for baseline values and demographics, showed no significant treatment group differences in BMI z-scores at post-intervention or follow-up; however, a promising reduction in excess weight gain was observed. Post-hoc stratification by pubertal onset indicated prepubescent children in the intervention group had significantly lower BMI z-scores than their control group counterparts.

Conclusions

The study used a strong theoretical framework, rigorous design, quality measurement and a program with high fidelity to test a family meals-focused obesity prevention intervention. It showed a modest decrease in excess weight gain. The significant intervention effect among prepubescent children suggests the intervention may be more efficacious among relatively young children, although more research with appropriately powered samples are needed to replicate this finding.

Trial registration

This study is registered at www.clinicaltrials.gov NCT01538615. Registered 01/17/2012.