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An. pediatr. (2003. Ed. impr.) ; 96(3): 221-229, mar 2022. graf, tab
Artigo em Inglês, Espanhol | IBECS | ID: ibc-202957


Introducción: La talla baja es motivo de consulta frecuente en Endocrinología Pediátrica, precisando en ocasiones tratamiento con hormona del crecimiento (GH). El objetivo del estudio fue analizar la respuesta al tratamiento en función de su inicio en la etapa puberal o prepuberal y analizar el posible beneficio de un comienzo precoz. Pacientes y métodos: Estudio longitudinal, retrospectivo y observacional en 139 pacientes tratados por déficit de GH idiopático (grave o parcial) hasta talla adulta. Principales variables estudiadas: a) antecedentes familiares: talla materna, paterna y genética; b) antecedentes perinatales; c) antropometría durante el seguimiento y al inicio puberal: peso, talla, índice de masa corporal, y d) variables durante el seguimiento y al inicio puberal: velocidad de crecimiento, edad ósea y pronóstico de crecimiento. Variables de respuesta final: talla adulta, talla adulta respecto a talla genética, talla adulta respecto al pronóstico de crecimiento inicial, talla adulta respecto a talla al inicio del tratamiento y talla adulta respecto a talla al inicio puberal. Resultados: La ganancia puberal total fue de 0,84±0,6 DE. Un 61,9% de los pacientes iniciaron tratamiento con GH en prepubertad. El inicio del tratamiento en la etapa prepuberal y una mayor ganancia puberal total se relacionaron con una mejor talla final (p=0,001, y r=0,507, p=0,00 respectivamente). Además, una mayor duración del tratamiento en la prepubertad se correlacionó con una mejor respuesta final (r=0,328, p=0,00). Conclusiones: El inicio del tratamiento en la prepubertad y una mayor duración durante este periodo son factores determinantes para alcanzar una mejor respuesta a largo plazo. La ganancia puberal total fue mayor en los pacientes que iniciaron el tratamiento en etapa puberal. (AU)

Introduction: Short stature is the most frequent reason for consultation in Pediatric Endocrinology consultations and sometimes requires treatment with growth hormone. The aim of the study was to analyze the response to treatment based on its onset in pubertal or prepubertal stages and to analyze the possible benefit of an early onset. Patients and methods: Longitudinal, retrospective and observational study in 139 patients treated for idiopathic growth hormone deficiency up to adult height. Main variables studied: (a) genetic background: maternal, paternal and genetic height; (b) perinatal history; (c) anthropometry during follow-up and at pubertal onset: weight, height, body mass index; (d) variables during follow-up and at pubertal onset: growth rate, bone age and growth prognosis. Final response variables: adult height, adult height with respect to target height, adult height with respect to initial growth prediction, adult height with respect to initial height at the start of treatment and adult height with respect to height at pubertal onset. Results: Total pubertal gain was 0.84±0.6 SD. 61.9% of the patients started treatment with rhGH in prepuberty. The initiation of treatment in the prepubertal stage and a higher total pubertal gain are correlated with a better final height (P=.001 and r=0.507, P=.00, respectively). Furthermore, a longer duration of treatment in pre-puberty is correlated with a better final response (r=0.328, P=.00). Conclusions: The start of treatment in the prepubertal stage and its longer duration during this period are determining factors to achieve a good long-term response. Total pubertal gain was greater in patients who started treatment in the pubertal stage. (AU)

Humanos , Pré-Escolar , Criança , Adolescente , Ciências da Saúde , Crescimento , Puberdade , Endocrinologia , Pediatria
Pediatr Res ; 91(1): 107-115, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33654281


BACKGROUND: Accelerated catch-up growth following intrauterine restriction increases the risk of developing visceral adiposity and metabolic abnormalities. However, the underlying molecular mechanisms of such metabolic programming are still poorly understood. METHODS: A Wistar rat model of catch-up growth following intrauterine restriction was used. A gene expression array was performed in the retroperitoneal adipose tissue sampled at postnatal day (PD) 42. RESULTS: Five hundred and forty-six differentially expressed genes (DEGs) were identified (adjusted p value < 0.05). Gene ontology enrichment analysis identified pathways related to immune and lipid metabolic processes, brown fat cell differentiation, and regulation of PI3K. Ccl21, Npr3, Serpina3n, Pnpla3, Slc2a4, and Serpina12 were validated to be upregulated in catch-up pups (all p < 0.01) and related to several fat expansion and metabolic parameters, including body weight at PD42, postnatal body weight gain, white and brown adipose tissue mass, plasma triglycerides, and insulin resistance index (all p < 0.05). CONCLUSIONS: Genes related to immune and metabolic processes were upregulated in retroperitoneal adipose tissue following catch-up growth in juvenile rats and were found to be associated with fat expansion and metabolic parameters. Our results provide evidence for several dysregulated genes in white adipose tissue that could help develop novel strategies to prevent the metabolic abnormalities associated with catch-up growth. IMPACT: Catch-up growth presents several dysregulated genes in white adipose tissue related to metabolic abnormalities. Ccl21, Npr3, Serpina3n, Pnpla3, Slc2a4, and Serpina12 were validated to be upregulated in catch-up pups and related to visceral fat expansion and metabolic parameters. Profiling and validation of these dysregulated genes in visceral adipose tissue could help develop novel strategies to prevent the metabolic abnormalities associated with catch-up growth.

Crescimento , Gordura Intra-Abdominal/crescimento & desenvolvimento , Animais , Composição Corporal , Modelos Animais de Doenças , Feminino , Retardo do Crescimento Fetal , Regulação da Expressão Gênica , Gordura Intra-Abdominal/metabolismo , Masculino , Ratos , Ratos Wistar , Reação em Cadeia da Polimerase em Tempo Real , Reprodutibilidade dos Testes
Am J Epidemiol ; 191(2): 320-330, 2022 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-34643238


Growth rate is regulated by hormonal pathways that might affect early cancer development. We explored the association between rate of growth in height from ages 8 to 13 years (childhood) and from age 13 to attainment of adult height (adolescence), as measured at study entry, and the risk of breast or prostate cancer. Participants were 2,037 Icelanders born during 1915-1935, who took part in the Reykjavik Study, established in 1967. Height measurements were obtained from school records and at study entry. We used multivariable Cox regression models to calculate hazard ratios with 95% confidence intervals of breast and prostate cancer by rates of growth in tertiles. During a mean follow-up of 66 years (women) and 64 years (men), 117 women were diagnosed with breast cancer and 118 men with prostate cancer (45 with advanced disease). Women in the highest growth-rate tertile in adolescence had a higher risk of breast cancer (hazard ratio = 2.4, 95% confidence interval: 1.3, 4.3) compared with women in the lowest tertile. A suggestive inverse association was observed for highest adolescent growth rate in men and advanced prostate cancer: hazard ratio = 0.4, 95% confidence interval: 0.2, 1.0. Rapid growth, particularly in adolescence may affect cancer risk later in life.

Estatura , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/etiologia , Adolescente , Idoso , Criança , Feminino , Seguimentos , Crescimento , Humanos , Islândia/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco
Acta Paediatr ; 111(2): 225-235, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34687241


AIM: Human growth patterns are important, especially in paediatrics and public health, and the aim of this review was to provide an overview of human growth, especially secular changes of growth and pubertal growth. METHODS: This review of human growth was mainly based on studies published during the 20th and early 21st centuries. Special attention was paid to secular changes, pubertal growth, Nordic growth studies and the contribution of the Quadratic-Exponential-Pubertal-Stop (QEPS) growth model for analysing growth patterns. RESULTS: Human growth patterns showed wide variations between different individuals, sexes and populations and over time. There were ongoing positive secular change in height in four of the Nordic countries, Denmark, Finland, Norway and Sweden, over four decades. Childhood weight status had linear correlations with specific pubertal growth, in both healthy children and those with severe obesity. The QEPS model provided novel estimates of pubertal growth that made it possible to conduct more detailed analyses of pubertal growth than before. Growth references, adjusted for puberty, have been developed, and future opportunities for using the QEPS model for growth studies are highlighted. CONCLUSION: The QEPS was a valid growth model for analysing human growth patterns and developing novel types of growth references.

Estatura , Puberdade , Criança , Crescimento , Humanos , Estudos Longitudinais , Países Escandinavos e Nórdicos , Suécia
Arch Pediatr ; 29(2): 133-139, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34955308


BACKGROUND: Nutritional status among children and adolescents is assessed using growth rates. The aim of this study was to assess age- and gender-specific height, weight, and body mass index (BMI) centiles among children and adolescents relative to World Health Organization (WHO) references. METHODS: A sample of 1040 school-aged children and adolescents aged 3-18 years from Multan District in Pakistan were selected for the study between January and March 2020. Multistage stratified random sampling was used for sample selection. Centile curves of height, weight, and BMI for age and gender were obtained using the lambda-mu-sigma (LMS) method, and results were compared with WHO 2007 references. RESULTS: For boys and girls, the average height was 137.37 ± 8.24 and 135.62 ± 9.64 cm, average weight was 36.32 ± 6.84 and 35.21 ± 7.27 kg, and average BMI was 18.44 ± 2.67 and 18.36 ± 2.91, respectively. The height centiles of boys were higher than the WHO reference, and during the prepubertal period (age 8 years or older) the centiles were lower than the WHO reference. The height centiles of girls were higher than the WHO reference, and during the pubertal period (age 10 years or older) the centiles were lower than the WHO reference. The gender-wise BMI centiles were higher compared to the WHO reference. CONCLUSION: The prevalence of thinness, overweight, and obesity in boys and girls was significantly higher than the WHO reference. The results of this study on centiles are up-to-date and will be used as a standard for comparison.

Estatura , Peso Corporal , Crescimento , Estado Nutricional , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Sobrepeso/epidemiologia , Paquistão/epidemiologia , Valores de Referência , Instituições Acadêmicas
Rev. Nutr. (Online) ; 35: e210075, 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1376313


ABSTRACT Objective To assess linear growth and weight gain in infants with suspected cow's milk protein allergy with gastrointestinal manifestations, seen at a gastropediatrics clinic. Methods A retrospective cohort study conducted with demographic, clinical, anthropometric and dietary information on 84 infants first seen between 2015 and 2018 and followed-up for six months. Stature-for-age, weight-for-age, and body mass index-for-age in z-scores were evaluated according to the cut off points established by the World Health Organization in 2006. Accelerated growth or catch-up was considered a gain ?0.67 in the z-score of the referred indices, evaluated at 3 and 6 months. Results Median age at baseline was 4.0 months and 88.1% of the infants were already in diet exclusion. Regarding the anthropometric evaluation short stature frequency was 15.5% and the underweight frequency was 8.3% and 3.6% respectively based on the weight-for-age and body mass index-for-age indices. High recovery growth was observed during the follow-up period but was not considered catch up. In boys, the gains in weight-for-age and body mass index-for-age were significant (p=0.02 and p=0.01 respectively) and close to the threshold that characterizes the catch up, 0.58 and 0.59, respectively. In girls, significant gains in stature-for-age and weight-for-age (0.38 and 0.37 respectively, p=0.02 for both) were observed. Conclusion Infants with suspected cow's milk protein allergy with gastrointestinal manifestations should have early access to specialized nutritional counseling to avoid exposure to allergenic food and control allergy symptoms, thereby avoiding malnutrition and ensuring adequate nutritional recovery.

RESUMO Objetivo Avaliar o crescimento linear e o ganho de peso de lactentes com suspeita de alergia à proteína do leite de vaca, com manifestações gastrointestinais, atendidos em um ambulatório de gastropediatria. Métodos Estudo de coorte retrospectivo, com informações demográficas, clínicas, antropométricas e dietéticas de 84 lactentes que iniciaram atendimento entre 2015 e 2018 e foram acompanhados durante seis meses. Foram avaliados os índices estatura/idade, peso/idade e índice de massa corporal/idade em escore-z, segundo os pontos de corte da Organização Mundial de Saúde de 2006. Considerou-se crescimento acelerado (ou catch-up growth) um ganho ?0,67 escore-z nos referidos índices, avaliados em três e seis meses. Resultados No baseline, a mediana de idade foi 4,0 meses e 88,1% dos lactentes já estavam em dieta de exclusão. A frequência de baixa estatura foi de 15,5% e a de baixo peso foi de 8,3% e de 3,6% segundo os índices peso/idade e índice de massa corporal/idade, respectivamente. Houve elevado crescimento de recuperação durante o período de acompanhamento, mas que não configurou catch up. Nos meninos, ganhos no peso/idade e índice de massa corporal/idade foram significantes (p=0,02 e p=0,01) e próximos do limiar que caracteriza catch up: 0,58 e 0,59, respectivamente. Nas meninas, foram observados ganhos significantes na estatura/idade e peso/idade, de 0,38 e 0,37 (p=0,02 para ambos). Conclusão Demonstrou-se que lactentes com suspeita de alergia à proteína do leite de vaca, com manifestações gastrointestinais, deveriam ter acesso precoce ao aconselhamento nutricional para evitar exposição ao alimento alergênico, controlar sintomas e, assim, evitar a desnutrição ou garantir recuperação nutricional adequada.

Humanos , Masculino , Feminino , Lactente , Hipersensibilidade a Leite/complicações , Gastroenteropatias/etiologia , Avaliação Nutricional , Crescimento , Lactente
Sci Rep ; 11(1): 23609, 2021 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-34880325


There are very few nationwide studies discussing the height, weight, head circumference, and dental screening of children with cleft lip with or without palate (CL/P), with most reports on this subject based on a 1900s cohort. This study aimed to characterize CL/P children in the 2000s in terms of height, weight, head circumference, and dental screening. This nationwide population-based study evaluated the National Health Insurance Service-Infants and Children's Health Screening (NHIS-INCHS), specifically the height, weight, and head circumference of millions of children. Dental screening data, including the status of each tooth and comprehensive dental judgment, were also evaluated. Syndromic and nonsyndromic CL/P children had lower height, weight, and head circumference than no CL/P children until the age of 66-71 months. Children with cleft palate only or both cleft lip and palate showed similar results. Regarding dental screening, the primary teeth of CL/P children erupted later and fell out faster than no CL/P children. Dental caries was also more common in CL/P children. Children with CL/P had inferior general growth, regardless of palatoplasty surgery. More aggressive dental treatment was required for CL/P children due to the instability of primary teeth and tendency for caries.

Fenda Labial/patologia , Fissura Palatina/patologia , Crescimento , Antropometria , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , República da Coreia
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(3): 400-405, dez 20, 2021. fig
Artigo em Português | LILACS | ID: biblio-1354253


Introdução: alterações no padrão de crescimento de recém-nascidos prematuros podem ter implicações para sua saúde futura. A literatura dispõe de diversas ferramentas e pontos de corte para avaliação da sua adequação, logo, diferentes diagnósticos podem ser obtidos a depender do parâmetro adotado. Objetivo: determinar a diferença no diagnóstico de Retardo de Crescimento Extrauterino em prematuros, durante internamento hospitalar, conforme as curvas de Fenton e Intergrowth. Metodologia: trata-se de estudo transversal, com dados secundários, coletados durante o internamento em unidade de terapia intensiva e de cuidados intermediários convencionais neonatais de uma maternidade pública, em 2019, Coletaram-se medidas de peso e perímetro cefálico ao nascer e no momento da alta/transferência e calcularam-se seus respectivos indicadores antropométricos de acordo com as duas curvas. Utilizaramse duas classificações para o Retardo: diagnóstico de Pequeno para Idade Gestacional na alta/transferência; queda no escore Z dos indicadores maior ou igual a 1 entre o nascimento e a alta/transferência. Resultados: Não houve diferença em relação ao número de crianças classificadas como Pequeno para Idade Gestacional ao nascer, entre as curvas. Porém, no momento da alta/transferência houve maior prevalência de Pequeno para a Idade Gestacional/Retardo de Crescimento Extrauterino, de acordo com Fenton (73,6% versus 64,9%). A análise longitudinal dos indicadores de crescimento para caracterização do referido retardo por meio da curva de Fenton também detectou maior número de diagnósticos. Conclusão: conclui-se que o diagnóstico do retardo apresentou diferenças entre os referenciais. Os parâmetros de Fenton determinaram maior ocorrência dele no momento do desfecho, independente da realização da avaliação transversal ou longitudinal dos indicadores.

Introduction: changes in growth pattern of preterm infants may have implications for their future health. Literature has several tools and cutoff points to assess its adequacy, therefore, different diagnosis may be obtained depending on the adopted parameter. Objective: determine the difference in diagnosis of extrauterine growth restriction (EUGR) in preterm infants during hospitalization based on Fenton 2013) and Intergrowth-21 (2014) curves. Methods: this is a cross-sectional study with secondary data which were collected during hospitalization in an intensive care unit and neonatal conventional intermediate care in a public maternity hospital, in 2019. Results: weight and head circumference measurements were collected at birth and at discharge/transfer and their respective anthropometric indicators were calculated according to Fenton and Intergrowth-21 curves. The following EUGR criteria were used: diagnosis of small for gestational age (SGA) at discharge/transfer; decrease in Z score for indicators higher or equal to 1 between birth and discharge/transfer. There was no difference in the number of children classified as SGA at birth between the curves. However, at the time of discharge/ transfer there was a higher prevalence of SGA/EUGR according to Fenton (73.6% versus 64.9%). Longitudinal analysis of growth indicators for EUGR using Fenton curve also detected a higher number of patients with EUGR. Conclusion: the conclusion is that EUGR diagnosis showed differences between Fenton and Intergrowth methods. Fenton's parameters determined a higher occurrence of EUGR at the time of outcome, regardless of whether indicators were cross-sectionally or longitudinally evaluated.

Humanos , Masculino , Feminino , Recém-Nascido , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Desenvolvimento Infantil , Crescimento , Doenças do Prematuro , Estudos Transversais , Idade Gestacional
Rev. APS ; 24(Supl 1): 236-248, 2021-12-31.
Artigo em Português | LILACS | ID: biblio-1367265


O Ministério da Saúde prevê a disponibilização da Caderneta de Saúde da Criança (CSC) desde 2005 a todas as crianças nascidas no Brasil. Trata-se de uma ferramenta centralizadora para a atenção integral da saúde na infância e, portanto, de um instrumento valioso para o acompanhamento do crescimento das crianças. O registro correto e completo das informações é requisito básico para que a CSC cumpra seu papel estratégico. Elegemos a revisão de escopo com o objetivo de discutir os estudos primários que analisaram quantitativamente o preenchimento dos dados sobre crescimento na CSC. A pesquisa foi realizada nas bases de dados MEDLINE, LILACS, SciELO e na Biblioteca Virtual em Saúde usando os descritores "Saúde da criança"e "Registros de saúde pessoal" (em inglês, "Child Health" e "Health Records, Personal"). Além disso, foi usada a palavra-chave "Caderneta de Saúde da Criança. Foram identificados 191 trabalhos, sendo 15 artigos elegíveis para esta revisão. Os estudos observaram registro insatisfatório dos dados sobre o crescimento na CSC. O preenchimento dos gráficos de peso por idade variou entre 8,9% e 96,3%, por exemplo, revelando fragilidade no uso desse instrumento e necessidade de melhora dos registros no acompanhamento do crescimento das crianças.

The Ministry of Health has made the Caderneta de Saúde da Criança (CSC), a child health booklet, available to all children born in Brazil, since 2005. It is a strategic tool for comprehensive child health care, a valuable instrument for registering and monitoring growth. The correct and complete registration of this information is a basic requirement for the CSC to fulfill itsrole. We chose the scoping review in order to discuss primary studies that quantitatively analyze the filling in of data on growth in the CSC. The research was carried out in the databases MEDLINE, LILACS, SciELO, and in the Biblioteca Virtual em Saúde, using the descriptors in Portuguese: "Saúde da Criança" and "Registros de saúde pessoal"; in English: "Child Health" and "Health Records, Personal"; and, in addition, the keyword "Caderneta de Saúde da Criança" was also used. A total of 191 papers were identified, 15 of which were eligible for this review. The studies observed an unsatisfactory filling in of data on the growth of CSC. Completion of weight-for-age charts ranged between 8.9% and 96.3%, for example, revealing weaknesses in the use of this instrument and the need to improve records in monitoring the growth of children.

Registros de Saúde Pessoal , Atenção Primária à Saúde , Peso-Idade , Saúde da Criança , Monitoramento Ambiental , Integralidade em Saúde , Crescimento
Biomed Environ Sci ; 34(11): 847-858, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34955145


OBJECTIVE: This study aimed to understand the characteristics of dietary patterns among children aged 12 to 23 months and discusses the relationship between dietary patterns and the growth of children. METHOD: Cross-sectional data were selected from the National Nutrition and Health Systematic Survey for 0 to 18 year-old children in China ( n = 2,449) to describe the patterns of complementary feeding and the growth of children. Cluster analysis was used to analyze complementary feeding patterns, and an analysis of variance and Bonferroni test were conducted to analyze the relationship between Z scores and complementary feeding patterns. RESULTS: Four dietary patterns were identified among the children via cluster analysis. In Pattern 4 ( n = 104, 4.2%), children still consumed milk as their staple food. They displayed the lowest grain, fruit, vegetable, egg, and flesh foods consumption, a medium frequency of breast milk consumption, and a high frequency of dairy product consumption. Pattern 4 had the lowest length-for-age Z scores and weight-for-age Z scores, with -0.10 ± 1.34 and 0.24 ± 1.00, respectively ( F = 7.940, P < 0.001; F = 5.317, P < 0.001). CONCLUSION: Although China is undergoing rapid urbanization and economic development, there is still a phenomenon of insufficient intake of protein-rich foods and dairy-based dietary patterns at the stage of complementary food introduced among children aged 12 to 23 months.

Crescimento , Fenômenos Fisiológicos da Nutrição do Lactente , China , Estudos Transversais , Feminino , Humanos , Lactente , Masculino
Cuad. Hosp. Clín ; 62(2): 15-25, dic. 2021. ilus.
Artigo em Espanhol | LILACS | ID: biblio-1358036


INTRODUCCIÓN: la presencia simultánea del retraso del crecimiento y del exceso de peso en una persona representa una de las principales paradojas en la salud pública global y es de creciente preocupación en Bolivia, donde ambas condiciones en su conjunto no han sido abordadas y ocurren en un contexto de transición nutricional en el que se encuentra el país. OBJETIVO: describir la coexistencia de la doble carga de malnutrición a nivel individual en la población escolar (3-19 años) del municipio de La Paz. MÉTODOS: se realizó un estudio observacional de corte transversal analítico con datos antropométricos de 7.654 escolares pertenecientes al municipio de La Paz del año 2019. Se determinaron las prevalencias y los intervalos de confianza al 95% para emaciación, retraso en el crecimiento, sobrepeso, obesidad y sobrepeso + obesidad por sexo y grupo de edad. A nivel poblacional, la doble carga de malnutrición (DCM), se estimó en base a los umbrales de alta prevalencia sugeridos por organizaciones internacionales, a saber, prevalencias por encima del 20% y 10% para retraso en el crecimiento y sobrepeso, respectivamente. Para los análisis a nivel individual, la DCM se definió como la coexistencia de retraso en el crecimiento y sobrepeso + obesidad en los tres grupos de estudio y se comparó con su valor esperado, bajo el supuesto de distribuciones independientes de cada condición. RESULTADOS: a nivel poblacional, la prevalencia de emaciación para toda la muestra analizada fue de 3,7%, sin diferencias significativas por sexo. La prevalencia de retraso del crecimiento para el año 2019 no superó el 20% en todos los grupos de edad analizados. La prevalencia de sobrepeso fue mayor al 10% para el grupo de escolares y adolescentes. A nivel individual la doble carga de malnutrición se encontró en 2,8%, 1,9% y 2,9% en prescolares, escolares y adolescentes, respectivamente. Valores que se encontraron por debajo de lo esperado. CONCLUSIONES: las prevalencias de doble carga de malnutrición, retraso del crecimiento y sobrepeso + obesidad a nivel individual, fueron menores de lo esperado en los tres grupos de estudio, asumiendo distribuciones independientes de las dos condiciones. A pesar de ello, la coexistencia de la doble carga poblacional (municipio de La Paz) debe ser abordada en políticas y programas adecuados de salud pública(AU).

INTRODUCTION: the simultaneous presence of growth retardation and excess weight in a person represents one of the main paradoxes in global public health and is of growing concern in Bolivia, where both conditions as a whole have not been addressed and occur in a context of nutritional transition in which the country finds itself. OBJECTIVE: to describe the coexistence of the double burden of malnutrition at the individual level in the school population (3-19 years) of the municipality of La Paz. METHODS: an analytical cross-sectional observational study was carried out with anthropometric data from 7,654 schoolchildren belonging to the municipality of La Paz in 2019. The prevalences and 95% confidence intervals were determined for wasting, stunting, overweight, obesity and overweight+obesity, by sex and age group. At the population level, the double burden of malnutrition (DBM) was estimated based on thresholds of high prevalence suggested by international organizations, namely, prevalence above 20% and 10% for stunting and overweight, respectively. For individual level analyzes, DBm was defined as the coexistence of stunting and overweight + obesity in the three study groups and was compared with its expected value, under the assumption of independent distributions of each condition. RESULTS: at the population level, the prevalence of wasting for the entire sample analyzed was 3.7%, with no significant differences by sex. The prevalence of stunting for the year 2019 did not exceed 20% in all the age groups analyzed. The prevalence of overweight was higher than 10% for the group of schoolchildren and adolescents. At the individual level, the double burden of malnutrition was found in 2.8%, 1.9% and 2.9% in preschool, schoolchildren and adolescents, respectively. Values that turned out to be lower than expected. CONCLUSIONS: the prevalence of double burden, growth retardation and overweight and obesity at the individual level, were lower than expected in the three study groups, assuming independent distributions of the two conditions. Despite this, the coexistence of the double burden in the municipality of La Paz must be addressed in appropriate public health policies and programs(AU).

Adolescente , Saúde Pública , Crescimento , Estudos de Casos e Controles , Menores de Idade , Desnutrição
BMC Pediatr ; 21(1): 507, 2021 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-34774010


BACKGROUND: Growth references are traditionally constructed relative to chronological age, despite inter-individual variations in pubertal timing. A new type of height reference was recently developed allowing growth to be aligned based on onset of pubertal height growth. We here aim to develop a corresponding reference for pubertal weight. METHODS: To model QEPS-weight, 3595 subjects (1779 girls) from GrowUp1974Gothenburg and GrowUp1990Gothenburg were used. The QEPS-height-model was transformed to a corresponding QEPS-weight-model; thereafter, QEPS-weight was modified by an individual, constitutional weight-height-factor. Longitudinal weight and length/height measurements from 1418 individuals (698 girls) from GrowUp1990Gothenburg were then used to create weight references aligned for height at pubertal onset (the age at 5% of P-function growth, AgeP5). GrowUp1974Gothenburg subgroups based on pubertal timing, stature at pubertal onset, and childhood body composition were assessed using the references. RESULTS: References (median, SDS) for total weight (QEPS-functions), weight specific to puberty (P-function), and weight gain in the absence of specific pubertal growth (basic weight, QES-functions), allowing alignment of individual growth based on age at pubertal onset. For both sexes, basic weight was greater than average for late maturing, tall and high-BMI subgroups. The P-function-related weight was greater than average in short and lower than average in tall children, in those with high BMI, and in girls but not boys with low BMI. CONCLUSIONS: New pubertal weight references allow individual variations in pubertal timing to be taken into consideration when evaluating growth. When used together with the comparable pubertal height reference, this will improve growth monitoring in clinical practice for identifying abnormal growth and serve as a valuable research tool providing insight into human growth.

Estatura , Puberdade , Composição Corporal , Criança , Feminino , Crescimento , Humanos , Masculino
PLoS One ; 16(11): e0260137, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34793547


OBJECTIVE: Growth-based determination of pubertal onset timing would be cheap and practical. We aimed to determine this timing based on pubertal growth markers. Secondary aims were to estimate the differences in growth between cohorts and identify the role of overweight in onset timing. DESIGN: This multicohort study includes data from three Finnish cohorts-the Type 1 Diabetes Prediction and Prevention (DIPP, N = 2,825) Study, the Special Turku Coronary Risk Factor Intervention Project (STRIP, N = 711), and the Boy cohort (N = 66). Children were monitored for growth and Tanner staging (except in DIPP). METHODS: The growth data were analyzed using a Super-Imposition by Translation And Rotation growth curve model, and pubertal onset analyses were run using a time-to-pubertal onset model. RESULTS: The time-to-pubertal onset model used age at peak height velocity (aPHV), peak height velocity (PHV), and overweight status as covariates, with interaction between aPHV and overweight status for girls, and succeeded in determining the onset timing. Cross-validation showed a good agreement (71.0% for girls, 77.0% for boys) between the observed and predicted onset timings. Children in STRIP were taller overall (girls: 1.7 [95% CI: 0.9, 2.5] cm, boys: 1.0 [0.3, 2.2] cm) and had higher PHV values (girls: 0.13 [0.02, 0.25] cm/year, boys: 0.35 [0.21, 0.49] cm/year) than those in DIPP. Boys in the Boy cohort were taller (2.3 [0.3, 4.2] cm) compared with DIPP. Overweight girls showed pubertal onset at 1.0 [0.7, 1.4] year earlier compared with other girls. In boys, there was no such difference. CONCLUSIONS: The novel modeling approach provides an opportunity to evaluate the Tanner breast/genital stage-based pubertal onset timing in cohort studies including longitudinal data on growth but lacking pubertal follow-up.

Previsões/métodos , Puberdade/metabolismo , Puberdade/fisiologia , Adolescente , Idade de Início , Fenômenos Biológicos , Estatura , Mama/crescimento & desenvolvimento , Criança , Estudos de Coortes , Feminino , Finlândia , Genitália/crescimento & desenvolvimento , Crescimento/fisiologia , Humanos , Masculino , Homens , Modelos Teóricos , Sobrepeso , Fatores de Risco , Mulheres
Revista brasileira de ciência e movimento ; 29(1): [1-12], nov. 2021. tab
Artigo em Português | LILACS | ID: biblio-1344047


: O número de crianças e adolescentes com índice de sobrepeso e obesidade está aumentando. Já é consolidado que o baixo condicionamento cardiorrespiratório tem relação com riscos cardiovasculares e metabólicos. O objetivo desse trabalho é avaliar o nível de condicionamento cardiorrespiratório em adolescentes do ensino médio e relacionar com indicadores de sobrepeso e obesidade e a maturação somática. O método utilizado caracteriza-se como transversal com método associativo e abordagem quantitativa. Participaram do estudo 51 adolescentes de duas escolas (privada e pública) de uma cidade da região serrana do RS. Após medição dos índices antropométricos foi realizado um teste de campo para medição do VO2pico. As associações indicaram que a razão cintura/quadril foi o indicador antropométrico que mais se associou com o VO2pico, independente da distância para o pico de velocidade do crescimento. Todavia quando analisamos os sexos em separado, essa associação manteve o padrão apenas nas meninas, indicando que o sexo é um moderador na associação entre razão cintura/quadril, maturação somática e VO2pico em adolescentes.(AU)

The number of overweight and obese children and adolescents is increasing. It is already established that low cardiorespiratory conditioning is related to cardiovascular and metabolic risks. The aim of this study is to evaluate the level of cardiorespiratory fitness in high school adolescents and to relate with indicators of overweight and obesity and somatic maturation. This is a cross-sectional study with an associative method and quantitative approach. The study included 51 adolescents from two schools (private and public) at a countryside of Rio Grande do Sul state, Brazil. After measuring the anthropometric variables, a field test was performed to measure VO²Peak. The associations indicated that the waist/hip ratio was the anthropometric indicator that was most associated with VO2peak, regardless of the distance to the peak growth velocity. However, when we analyzed the sexes separately, this association maintained the pattern only in girls, indicating that sex is a moderator in the association between waist/hip ratio, somatic maturation and VO2peak in adolescents.(AU)

Humanos , Masculino , Feminino , Adolescente , Exercício Físico , Adolescente , Aptidão Cardiorrespiratória , Crescimento , Educação Física e Treinamento , Ensino Fundamental e Médio , Sobrepeso , Teste de Esforço , Fatores de Risco de Doenças Cardíacas , Metabolismo , Obesidade
Reprod Biomed Online ; 43(4): 719-726, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34493461


RESEARCH QUESTION: Is the growth of term singletons born after frozen embryo transfer (FET) comparable to those born after fresh embryo transfer and natural conception up to 5 years of age? DESIGN: Observational cohort study in an academic medical centre and municipal child health clinics with repeated measurements carried out by medical professionals. Term singletons born after FET (n = 110) and fresh embryo transfer (n = 181) and their matched natural conception controls (n = 543) born in Oulu, Northern Finland, were included. Mean weights, lengths, heights and head circumferences at the ages of 4, 8 and 18 months and 3 and 5 years were compared. At 3 and 5 years, body mass indices were compared. RESULTS: Childhood growth did not differ between term singletons born after FET, fresh embryo transfer and natural conception, correcting for exact age at measurement and adjusting for maternal body mass index and paternal height. CONCLUSIONS: Similar growth between children born after FET, fresh embryo transfer and natural conception offers reassurance of the safety and feasibility of the steadily increasing use of embryo cryopreservation in assisted reproduction.

Desenvolvimento Infantil , Criopreservação/estatística & dados numéricos , Transferência Embrionária/estatística & dados numéricos , Embrião de Mamíferos , Crescimento , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Estudos Retrospectivos
Commun Biol ; 4(1): 1077, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34526648


In the last decades, non-invasive and portable neuroimaging techniques, such as functional near infrared spectroscopy (fNIRS), have allowed researchers to study the mechanisms underlying the functional cognitive development of the human brain, thus furthering the potential of Developmental Cognitive Neuroscience (DCN). However, the traditional paradigms used for the analysis of infant fNIRS data are still quite limited. Here, we introduce a multivariate pattern analysis for fNIRS data, xMVPA, that is powered by eXplainable Artificial Intelligence (XAI). The proposed approach is exemplified in a study that investigates visual and auditory processing in six-month-old infants. xMVPA not only identified patterns of cortical interactions, which confirmed the existent literature; in the form of conceptual linguistic representations, it also provided evidence for brain networks engaged in the processing of visual and auditory stimuli that were previously overlooked by other methods, while demonstrating similar statistical performance.

Inteligência Artificial , Neurociência Cognitiva/métodos , Crescimento , Neuroimagem/instrumentação , Espectroscopia de Luz Próxima ao Infravermelho/estatística & dados numéricos , Neurociência Cognitiva/instrumentação , Humanos , Lactente
Proc Natl Acad Sci U S A ; 118(40)2021 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-34583988


RNA polymerase (Pol) III synthesizes abundant short noncoding RNAs that have essential functions in protein synthesis, secretion, and other processes. Despite the ubiquitous functions of these RNAs, mutations in Pol III subunits cause Pol III-related leukodystrophy, an early-onset neurodegenerative disease. The basis of this neural sensitivity and the mechanisms of disease pathogenesis are unknown. Here we show that mice expressing pathogenic mutations in the largest Pol III subunit, Polr3a, specifically in Olig2-expressing cells, have impaired growth and developmental delay, deficits in cognitive, sensory, and fine sensorimotor function, and hypomyelination in multiple regions of the cerebrum and spinal cord. These phenotypes reflect a subset of clinical features seen in patients. In contrast, the gross motor defects and cerebellar hypomyelination that are common features of severely affected patients are absent in the mice, suggesting a relatively mild form of the disease in this conditional model. Our results show that disease pathogenesis in the mice involves defects that reduce both the number of mature myelinating oligodendrocytes and the ability of these cells to produce a myelin sheath of normal thickness. The findings suggest unique sensitivities of oligodendrogenesis and myelination to perturbations of Pol III transcription.

Doenças Desmielinizantes/fisiopatologia , Mutação , RNA Polimerase III/genética , Animais , Doenças Desmielinizantes/genética , Crescimento , Humanos , Masculino , Camundongos , Camundongos Mutantes