Growth and health. 1951

Why were Sardinians the shortest Europeans? A journey through genes, infections, nutrition, and sex

Since ancient times the Mediterranean island of Sardinia has been known for harboring a population with an average body height shorter than almost every other ethnic group in Europe. After over a century of investigations, the cause(s) at the origin of this uniqueness are not yet clear. The shorter stature of Sardinians appears to have been documented since prehistoric times, as revealed by the analysis of skeletal remains discovered in archaeological sites on the island. Recently, a number of genetic, hormonal, environmental, infective and nutritional factors have been put forward to explain this unique anthropometric feature, which persisted for a long time, even when environmental and living conditions improved around 1960. Although some of the putative factors are supported by sound empirical evidence, weaker support is available for others. The recent advent of whole genome analysis techniques shed new light on specific variants at the origin of this short stature. However, the marked geographical variability of stature across time and space within the island, and the well-known presence of pockets of short height in the population of the southern districts, are still puzzling findings that have attracted the interest of anthropologists and geneticists. The purpose of this review is to focus on the state-of-the-art research on stature, as well as the factors that made Sardinians the shortest among Europeans.

Patterns of growth after kidney transplantation among children with ESRD

BACKGROUND AND OBJECTIVES

Poor linear growth is a frequent complication of CKD. This study evaluated the effect of kidney transplantation on age-related growth of linear body segments in pediatric renal transplant recipients who were enrolled from May 1998 until August 2013 in the CKD Growth and Development observational cohort study.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

Linear growth (height, sitting height, arm and leg lengths) was prospectively investigated during 1639 annual visits in a cohort of 389 pediatric renal transplant recipients ages 2-18 years with a median follow-up of 3.4 years (interquartile range, 1.9-5.9 years). Linear mixed-effects models were used to assess age-related changes and predictors of linear body segments.

RESULTS

During early childhood, patients showed lower mean SD scores (SDS) for height (-1.7) and a markedly elevated sitting height index (ratio of sitting height to total body height) compared with healthy children (1.6 SDS), indicating disproportionate stunting (each P<0.001). After early childhood a sustained increase in standardized leg length and a constant decrease in standardized sitting height were noted (each P<0.001), resulting in significant catch-up growth and almost complete normalization of sitting height index by adult age (0.4 SDS; P<0.01 versus age 2-4 years). Time after transplantation, congenital renal disease, bone maturation, steroid exposure, degree of metabolic acidosis and anemia, intrauterine growth restriction, and parental height were significant predictors of linear body dimensions and body proportions (each P<0.05).

CONCLUSIONS

Children with ESRD present with disproportionate stunting. In pediatric renal transplant recipients, a sustained increase in standardized leg length and total body height is observed from preschool until adult age, resulting in restoration of body proportions in most patients. Reduction of steroid exposure and optimal metabolic control before and after transplantation are promising measures to further improve growth outcome.

Bases biológicas e evidências epidemiológicas da contribuição do crescimento fetal e pós-natal na composição corporal: uma revisão

OBJETIVOS: apresentar as bases biológicas e evidências epidemiológicas do crescimento fetal e pós-natal relacionadas ao tamanho e composição corporal. MÉTODOS: a busca de artigos publicados nos últimos 15 anos foi realizada nas bases de dados Lilacs, SciELO, Medline através dos descritores: crescimento, restrição do crescimento fetal, baixo peso ao nascer, aceleração compensatória do crescimento, composição corporal, índice de massa corporal e hormônios. Os estudos foram selecionados de acordo com a pertinência às evidências a serem analisadas. RESULTADOS: os artigos apontam para a influência da restrição do crescimento intraútero na supressão da termogênese e regulação hormonal, que por sua vez interferem no ganho de peso após o nascimento, e explicam como ambos os processos, restrição do crescimento fetal e rápido ganho de peso pós-natal, influenciam as medidas corporais em fases posteriores da vida, com consequências que poderão afetar gerações. CONCLUSÕES: o crescimento fetal influencia o padrão de crescimento pós-natal devido a diversos fatores relacionados à regulação hormonal, porém existe ainda uma lacuna sobre a contribuição da somação entre crescimento fetal e pós-natal no tamanho e composição corporal em fases posteriores da vida.

Change in mean height of Thai military recruits from 1972 through 2006

Background

Records in Western countries reveal that adult height has been increasing over the last 250 years. These height gains have been biologically associated with healthier childhoods, less illness, and longer life spans—a health-risk transition. To measure such progress in Thailand we studied height change over the last 3 decades.

Methods

We analyzed height records for 33 000 21-year-old male military recruits, sampling 1000 per year from 1972 through 2006. We compared the height trend in Thailand to those noted in Europe, and discuss the former in the context of improvements in living circumstances in Thailand.

Results

Over 35 years, mean height increased from 164.4 to 169.2 cm, an increment of nearly 5 cm. The height increase was negligible in the first decade (1972–1981), but substantially accelerated after that. In the period after 1990 the increase exceeded 3 cm. A similar overall height gain in Britain occurred over a much longer period (1750–1886).

Conclusions

The increase in height among Thai men is biological evidence that a Thai health-risk transition—defined by both changing risks and outcomes—is well underway for height. Military recruits born during the 1960s through the 1980s had progressively healthier childhoods. Over this period child nutrition improved, infection and mortality rates declined, and preventive health services expanded. The combined effect of these factors is indicated by the increased adult height of Thai military recruits.

Social class-related gradient in the association of skeletal growth with blood pressure among adolescent boys in India

Objective

In view of the fact that height differences between socio-economic groups are apparent early in childhood, it is of interest to examine whether skeletal growth is reflective of the social class gradient in CVD risk. The present study examined blood pressure levels, adiposity and growth of adolescent boys from high and low social classes.

Design

In a cross-sectional study, skeletal growth (height and sitting height), adiposity (weight, BMI and body fat) and blood pressure levels of the adolescents were measured.

Setting

Pune, India.

Subjects

Adolescent schoolboys (9–16 years) from high socio-economic (HSE; n 1146) and low socio-economic (LSE; n 932) class.

Results

LSE boys were thin, short and undernourished (mean BMI: 15·5 kg/m2v. 19·3 kg/m2 in HSE boys, P = 0·00). Social gradient was revealed in differing health risks. The prevalence of high systolic blood pressure (HSBP) was high in HSE class (10·5 % v. 2·7 % in LSE class, P = 0·00) and was associated with adiposity, while the prevalence of high diastolic blood pressure (HDBP) was high in LSE class (9·8 % v. 7·0 % in HSE class, P = 0·00) and had only a weak association with adiposity. Despite this, lower ratio of leg length to height was associated with significantly higher respective health risks, i.e. for HDBP in LSE class (OR = 1·99, 95 % CI 1·14, 3·47) and for HSBP in HSE class (OR = 1·69, 95 % CI 1·02, 2·77).

Conclusions

As stunting in childhood is a major problem in India and Asia, the leg length to height indicator needs to be validated in different populations to understand CVD risks.

Size at birth and height in early adolescence: a prospective birth cohort study

The aim of this study was to evaluate the association between size at birth (birthweight and birth length) and height in early adolescence in a prospective birth cohort study in Pelotas, Rio Grande do Sul, Brazil. Interviews were carried out in 1993, including measurements of birthweight and length, and in 2004-2005, including measurements of weight and height. This analysis includes 4,452 individuals, with a mean age of 11.3 years (standard deviation-SD=0.3), representing a follow-up rate of 87.5%. Mean height at 11 years was 145.8 cm (SD=7.9), or 144.9 cm (SD=7.7) in boys and 146.8 cm (SD=7.9) in girls. Birthweight and birth length were positively associated with height in early adolescence in the crude analysis, but after adjustment for confounding and for each other, only the effect of birth length was still significant. A one z-score increase in birth length was associated with a 1.63 cm increase in height at 11 years. The present study shows that birth length is a strong predictor of later height, while the effect of birth weight disappears after adjustment for birth length.

Somatic disproportion predicts risk of high blood pressure among adolescent girls in India

OBJECTIVES

To examine the importance of somatic disproportion rather than absolute values of leg height and trunk height for predicting risk of high blood pressure among adolescents.

METHODS

Adolescent girls (9-16 years old) from high (HSE) and low socio-economic (LSE) classes were examined (n = 1036 and n = 1040, respectively) in a cross-sectional study, for skeletal growth (height and sitting height), adiposity [weight, body mass index (BMI) and body fat] and blood pressure levels.

RESULTS

Girls from LSE class were thin, short and undernourished compared to those from HSE class (average age-adjusted BMI, 16.47 +/- 2.61 versus 19.77 +/- 3.85, P < 0.000). A high prevalence of high systolic blood pressure (HSBP) was a problem in girls of the HSE (9.7 versus 4.4%, P < 0.001) class, while a high prevalence of high diastolic blood pressure (HDBP) was seen in girls of the LSE (15.3 versus 2.7%, P < 0.001) class. Further, in the HSE class, the prevalence of HSBP was higher only among girls in the third tertile of BMI and body fat, while in the case of the LSE class the prevalence of HDBP was higher (7-11%) even in the lowest tertile of these measures. The odds ratio (OR) for HDBP (2.28) in the LSE class and that for HSBP (2.27) in the HSE class were significantly higher for girls in the lower tertile of leg height to height ratio. This was also true in the case of leg height to sitting height ratio.

CONCLUSIONS

Our findings showed that rather than absolute leg or trunk length, somatic disproportion may be a relevant biomarker associated with cardiovascular disease (CVD) risk, especially in an adolescent population.

Growth pattern and risk of schizophrenia

BACKGROUND

Foetal nutrition and growth seem to affect the risk of developing schizophrenia. Exposure to famine during foetal development and low birthweight increase the risk. However, few studies have investigated the association between schizophrenia and adult height and weight or patterns of growth.

METHOD

The study population consisted of two subpopulations: families with at least one member with schizophrenia, and families of offspring of mothers with psychotic disorder, and controls. Using a seven-parameter model of height growth curves, we compared the parameters of persons who later developed schizophrenia and their unaffected siblings from the same families. We also studied how growth curve parameters differed in children with genetic risk for schizophrenia and controls, and whether weight, height and body mass index (BMI) at different ages predicted later development of schizophrenia.

RESULTS

The predicted growth curves based on a parametric model were nearly identical for persons with schizophrenia and their unaffected siblings. Adult height of daughters of mothers with psychoses was borderline significantly (p=0.0536) lower compared to controls, while no difference was detected among sons (p=0.3283).

CONCLUSIONS

No association between growth characteristics and schizophrenia in families with at least one member with schizophrenia was found. Family-related factors should be taken into account as possible confounders in future studies on growth and schizophrenia.

Growth impairment shows an age-dependent pattern in boys with chronic kidney disease

The impact of chronological age on longitudinal body growth from early childhood through adolescence using detailed anthropometric methods has not yet been studied in children with chronic kidney disease (CKD). We have evaluated growth failure by measuring four components of linear growth: body height (HT), sitting height (SHT), arm length (AL) and leg length (LL). Data were prospectively collected for up to 7 years on 190 boys (3-21 years old) with congenital or hereditary CKD (all had developed at least stage 2 CKD by the age of 10 years). Patients showed the most severe growth failure in early childhood, followed by an acceleration in growth in pre-puberty, a slowing-down of growth at puberty, as expected, and thereafter a late speeding-up of growth until early adulthood. This pattern was observed irrespective of the degree of CKD and different treatment modalities, such as conservative treatment, recombinant human growth hormone (rhGH) therapy or transplantation. LL showed the most dynamic growth changes of all the parameters evaluated and emerged as the best indicator of statural growth in children with CKD. A specific age-dependent pattern of physical growth was identified in pediatric male CKD patients. This growth pattern should be considered in the evaluation of individual growth and the assessment of treatment efficacy such as rhGH therapy.

Estimation of body fatness from body mass index and bioelectrical impedance: comparison of New Zealand European, Maori and Pacific Island children

OBJECTIVE

To compare percentage body fat (%BF) for a given body mass index (BMI) among New Zealand European, Maori and Pacific Island children. To develop prediction equations based on bioimpedance measurements for the estimation of fat-free mass (FFM) appropriate to children in these three ethnic groups.

DESIGN

Cross-sectional study. Purposive sampling of schoolchildren aimed at recruiting three children of each sex and ethnicity for each year of age. Double cross-validation of FFM prediction equations developed by multiple regression.

SETTING

Local schools in Auckland.

SUBJECTS

Healthy European, Maori and Pacific Island children (n=172, 83 M, 89 F, mean age 9.4+/-2.8(s.d.), range 5-14 y).

MEASUREMENTS

Height, weight, age, sex and ethnicity were recorded. FFM was derived from measurements of total body water by deuterium dilution and resistance and reactance were measured by bioimpedance analysis.

RESULTS

For fixed BMI, the Maori and Pacific Island girls averaged 3.7% lower %BF than European girls. For boys a similar relation was not found since BMI did not significantly influence %BF of European boys (P=0.18). Based on bioimpedance measurements a single prediction equation was developed for all children: FFM (kg)=0.622 height (cm)(2)/resistance+0.234 weight (kg)+1.166, R(2)=0.96, s.e.e.=2.44 kg. Ethnicity, age and sex were not significant predictors.

CONCLUSIONS

A robust equation for estimation of FFM in New Zealand European, Maori and Pacific Island children in the 5-14 y age range that is more suitable than BMI for the determination of body fatness in field studies has been developed.