Weight Disorders in Short Children.

This study aimed to determine the degree of adiposity and prevalence of weight disorders in short children and to assess relationships between selected birth parameters and actual body fat content and body mass indicators. The study encompassed 85 girls and 97 boys, aged 7-14 years, with height below the 10th centile of the age and sex standard. In addition, 609 normal-height children (height between 25th and 75th centile) served as a comparison group. The children underwent measurements of body mass and height, skinfold thickness, and waist circumference. Detailed history on pregnancy and neonatal status of short children was collected. Body mass index, waist-to-height ratio, and body fat percentage (%FAT) were assessed. We found that about 27% of short children had insufficient %FAT and about 14% of them had excessive %FAT, regardless of sex. In terms of BMI, 24% of short children were underweight and only 6% were overweight or obese, while in normal-height children these percentages were 6 and 27.5%, respectively. Abdominal obesity was observed in about 5% of short children and 18% of normal-height children (p < 0.001). There was no association between birth parameters and somatic indicators in short children. We conclude that the prevalence of overweight and obesity, including abdominal obesity, among short children is much lower than that in normal-height children. The insufficient fat tissue and body mass, observed in one out of four short children, are particularly disturbing in the context of ensuring their correct development.

Physical fitness of schoolgirls with Turner syndrome.

The aim of the study was to assess physical fitness of girls with Turner syndrome (TS) and to determine the relative contributions of age, body height, and body mass to performance in fitness tests. Girls with TS aged 10-18 years (n = 184), and age- and stature-matched healthy controls (n = 280) were studied with the use of the EUROFIT test battery. Girls with TS were significantly inferior to the control group in maintaining balance, standing broad jump, sit-ups, shuttle run, and endurance shuttle run (p < .001). No significant differences were found for plate tapping, but girls with TS were superior to their healthy mates (p < .001) in handgrip, sit-and-reach, and bent-arm hang. Unlike controls, body height in girls with TS had significant effects on handgrip strength (positive) and on plate tapping speed (negative), other contributions being relatively similar in both groups. It thus seems that the somatic specificity of girls with TS explains most differences in motor fitness. The identified motor deficiencies of girls with TS call for undertaking steps toward attracting those girls to motor activities.

Weight deficit at birth and Turner's syndrome.

Turner's syndrome (TS) is one of the most frequent diseases accompanied by growth deficiency. Though developmental disorders have been observed in the fetal period, there has been disagreement as to whether short stature is frequent in newborn girls with Turner's syndrome. Hence we attempted to determine the incidence of 'small for gestational age' in TS compared with healthy newborns girls delivered at term above -2 SD (body length and weight) for gestational age. The medical records of 548 girls with TS recruited from Polish university and district hospitals were screened, with 468 of them delivered at term (gestational age > or =38 weeks) being included in this study. Mean weight (+/- SD) at birth was 2963 +/- 444 g, which was below the normal value for gestational age in nearly 90%. The mean birth weight deficiency was 600 g, but exceeded 1000 g in over 10%. When a newborn girl delivered at term has a marked weight deficit, Turner's syndrome should be considered. This is especially so when the girl is a product of a first pregnancy, when routine karyotyping is recommended. The condition may arise from a partial dysfunction of a gene or genes on the X-chromosome involved in the control of fetal growth.

Relative fat content in young women with normal BMI but differing in the degree of physical activity.

The aim of the study was to evaluate the relationship between BMI and relative body fat content. Three groups of women, aged 20-29 years and having normal BMI values, differing in the degree of practiced physical activities were studied: low activity (n=59), medium activity (n=46) and high activity (n=56). Body fat content was determined by infrared photometry (FUTREX). The percentages of women with excessive fat content (over 25%) from those 3 groups significantly differed and amounted to 44, 32 and 23, respectively. It was concluded that with increasing level of physical activities the percentage of young women with an excessive body fat content, but with BMI within normal limits, decreases. Thus, BMI ought not to be used as an indicator of body composition as it does not reflect body fat content. Individual counselling should be based on both measures, BMI and relative body fat content, taken together.

[Spontaneous growth of girls with Turner's syndrome until 6 years of age]. / Zespól Turnera: spontaniczne wzrastanie do 6 roku zycia.

BACKGROUND: Turner's syndrome (TS) is one of the most common genetically conditioned diseases, its incidence amounting to one per 1900-2500 live female births. A marked short stature is a prime symptom of the disease, the average adult body height of untreated women being by 23 cm lower than that of healthy ones. According to Ranke, developmental disorders appear as early as in foetal life and are responsible for body length and mass deficits at birth in relation to gestational age. OBJECTIVES: To revise present views regarding the course of physical development of girls with TS, especially at infancy and early childhood. MATERIAL AND METHODS: A total of 474 female newborns with Turner's syndrome were studied, the pregnancies, mostly second ones, not less than 38 weeks. Turner's syndrome was confirmed by chromosome analysis. Body mass at birth (BM) was related to the norms for gestational age (GA) designed by Usher and McLean. RESULTS: Growth disorders take place in TS since infancy, the growth rates in the age period of 2-3 years being similar to those observed in healthy population. After that period, however, growth rate in Turner girls steadily decreases as shown in percentile norms for TS. At the age of 6 years, the average difference in body height between Turner and healthy girls exceeds 1/3 of the final growth deficit noted in untreated adult women with TS. CONCLUSION: We have demonstrated that body mass and length of Turner newborns were normal in relation to gestational age. Only in about 5% of newborns a simultaneous length and weight deficit exceeded -2 SD, and that deficit was attributed to intrauterine growth retardation (IUGR). In clinical practice, newborns without documented decrease in foetal growth rate, but having a pronounced body length deficit, are diagnosed as IUGR-afflicted. Since simultaneous body length and mass deficits were rare in our newborns, IUGR was regarded as unlikely in bringing about growth deficit in Turner girls. In about 1/5 of Turner newborns a weight or length deficit was found (19 and 1%, respectively). Since either of those deficits evidences intrauterine dystrophy (small for gestational age, SGA), the latter one should be considered much more frequent in TS than in the general population. Therefore, SGA appears to be one of the symptoms of TS and should thus be taken into account when explaining body mass and/or length deficit in female newborns. Growth disorders in foetuses with chromosomal aberrations typical of TS are, in all probability, as frequent as in those with normal both X-chromosomes.

[Turner's syndrome: subjects with a normal body mass at birth grow taller than born small for gestational age]. / Zespól Turnera: lepszy wzrost uzyskuja chore urodzone z prawidlowa masa ciala.

BACKGROUND: Body mass deficit at birth is one of the characteristic features observed in Turner's syndrome (TS). Body mass is lower than expected for gestational age in about 90% of TS-babies, and is below -2 SD (i.e. "small for gestational age") in about 20% of patients. OBJECTIVES: The aim of the study was to compare the growth courses of TS-girls born with normal and deficient body mass. PATIENTS: A group of 157 TS-girls, delivered at term (> or =38 weeks of gestation), were studied. Body mass of 80 girls ranged from -0.5 to +0.5 SD and body length was above -2 SD (AGA group); another 54 girls had body mass below -2 SD and body length above -2 SD (disproportional SGA group), and 23 girls had both body mass and length below -2 SD (proportional SGA group). METHODS: Turner's syndrome was confirmed by chromosome analysis. Body mass at birth (BMB) was related to the norms for gestational age (GA) designed by Usher and McLean. Newborns, whose BMB was lower than -2 SD for GA, were considered small for gestational age (SGA). Postnatal body height and mass values were related to Polish norms for females with Turner's syndrome and to the norms for healthy female population. RESULTS: In the spontaneously growing TS-girls from the AGA group, a total of 275 measurements of body mass and height were carried out, the respective numbers for DSGA and PSGA groups were 176 and 100. Mean differences between the actual and expected body height for the AGA, DSGA and PSGA groups amounted to 0.40+/- 1.02, -0.21+/-0.88 and -0.95+/-0.80 SD TS, respectively, all means differing highly significantly (p<0.001) from each other. CONCLUSION: It may be concluded that spontaneously growing girls with Turner's syndrome, who had a normal (for gestational age) body mass at birth, attain a higher stature than girls with body mass deficit.

[Physical fitness of short-statured boys as related to percentile norms for calendar or growth age]. / Odniesienie wyników prób sprawnosci fizycznej niskoroslych chlopców do siatek centylowych dla wieku kalendarzowego i wzrostowego polskiej populacji.

OBJECTIVES: To assess the physical fitness of short-statured boys aged 7 - 20 years by applying fitness norms established for the Polish population in relation to calendar or growth age. MATERIAL AND METHODS: The results of EUROFIT fitness tests recorded in 3517 short-statured (below percentile 10 for body height) boys, aged 7-20 years, selected from a large (n=37 000) representative male cohort, were analysed. RESULTS: Individual results were confronted with the respective percentile norms related to calendar age (CA) or growth age (GA), since body height deficiency at given CA could have affected the results of fitness tests expected for that CA. The percentages of subjects below, the percentile 3 or above percentile 97 for given fitness test and CA or GA for the Polish population, were determined. No differences between the percentages computed for CA and GA were noted in case of the following tests: sit-and-reach (SAR) and bent-arm hang (BAH). Significant differences in percentages for both percentiles were found for the following tests: standing broad jump (SBJ), endurance shuttle run (ESR), handgrip (HGR) and plate tapping (PLT). In case of sit-ups (SUP) significant differences in percentages between CA and GA norms were found below the percentile 3, and in case of shuttle run (SHR) and flamingo balance (FLB) -- above percentile 97. SUMMARY AND CONCLUSIONS: Fitness tests were classified into two categories according to the differences between the results related to norms for calendar or growth age: those independent of whether CA or GA norms were applied (SAR and BAH), and those susceptible to the kind of norm (SBJ, HGR, PLT, SHR, FLB and SUP). The results of tests from the latter category should thus be evaluated by confronting them with the norms established for the growth age, and not calendar age.

[Fetal dystrophy--one of the feature of Turner syndrome]. / Dystrofia wewnatrzmaciczna -- jeden z objawów zespolu Turnera.

BACKGROUND: Turner's syndrome is one of the most frequent diseases with accompanying growth deficiency, the developmental disorders being observed as early as in the fetal period. OBJECTIVES: To determine the body mass of Turner's syndrome newborns delivered at term. MATERIAL AND METHODS: A total of 474 female newborns with Turner's syndrome were studied, the pregnancies, mostly second ones, lasting 40 weeks on average but not less than 38 weeks. Turner's syndrome was confirmed by chromosome analysis. Body mass at birth (BM) was related to the norms for gestational age (GA) designed by Usher and McLean. Newborns, whose BM was lower than -2 SD for GA, were considered as small for gestational age (SGA). RESULTS: Mean body mass (+/-SD) at birth was 2963 +/- g and in 87% of newborns was below the normal value for gestational age. Mean body mass deficiency amounted to 611 g, but in 20% of newborns exceeded 1000 g. CONCLUSION: In 19% of newborns body mass was below -2 SD for gestational age which classified intrauterine dystrophy as one of the most frequent features of the Turner's syndrome. It might, furthermore, imply that intrauterine dystrophy could be associated with impaired gene expression, presumably on the X-chromosome.

Allometric assessment of somatic specificities.

The clinical assessment of body build and proportions is usually based on relating anthropometric measurements to the respective mean values found for population of a given age. The other common method is relating the measurements of body parts directly to body height or body mass, i.e. as simple ratios. The first approach is inaccurate because it implies that various body parts develop independently from each other while the second one may be erroneous when the respective relationship is non-linear. The paper presents an alternative, allometric approach to anthropometric measurements and highlights the principal questions associated with points of reference used in an anthropometric assessment of body proportions. As indicated, allometry enables an accurate assessment of body proportions and is practically free from false positive or false negative results, which is of great importance in various areas, e.g. in clinical practice.

Body image of tall and medium girls aged 13-17 years.

INTRODUCTION: Adolescent girls often experience difficulties in a rational perception of own body and consider attaining an "appropriate shape" as a key to success and happiness. Growth disorders, like e.g. very tall stature, may bring about stigmatising which, in turn, may decrease in such girls their self-esteem, especially in adolescence. Aim of the study was to assess the perceived body image of tall and medium-statured girls and to compare their self-rating with an external one. MATERIAL AND METHODS: A group of 56 girls aged 13-17 years were classified into two categories of body height: medium stature, between Percentiles 40 and 60 (n=36) and tall, above Percentile 90 (n=20). Using a template containing 9 female body shapes, the girls indicated the shape they thought they had, the shape they wished to have, and an external rating was also made. Girls rated as shapes 1 or 2 were classified as thin, shapes 3 or 4 as medium and shape 5 or higher as robust. The data were related to the BMI values. RESULTS: Thin girls self-rated their body shapes and the desired ones significantly higher (p <0.05) compared with the external rating. In medium-shaped girls the same was true for self-rating, the desired shape being concordant with the external rating. In robust girls, the external and self-ratings were concordant, the desired shapes being significantly lower (p <0.05) but higher (p <0.05) in tall than in medium-height girls (5.0 and 3.9, respectively). Tall and medium girls did not differ significantly in BMI but a very high correlation (r=0.930; p <0.001) was found between the externally rated body shape and BMI in both groups of girls. CONCLUSION: The distorted perception of own body shape by adolescent girls may result from the specific ideals of feminine beauty and excessively slim silhouette insistently promoted by mass media and fashion designers. Popularisation of the results of this and similar studies may contribute to altering the respective attitudes of adolescent girls.

[Body proportions of healthy and short stature adolescent girls]. / Proporcje ciala dziewczat z niedoborem wzrostu i dziewczat zdrowych w okresie pokwitania.

INTRODUCTION: Regularly conducted assessment of body proportions is of importance as early detection of possible growth disorders and immediate prevention may allow gathering an optimum of child's genetically conditioned level of development. AIM OF THE STUDY: To assess body proportions of adolescent girls, healthy or with growth deficiency. MATERIAL AND METHODS: Three groups were studied: 104 healthy, short-statured girls (body height below the 10th percentile), 84 girls with Turner's syndrome (ZT) and 263 healthy girls of normal stature (between percentiles 25 and 75), all aged 11-15 years. The following measurements were conducted according to common anthropometric standards: body height, sitting body height, shoulder width, upper extremity length and lower extremity length - the last one was computed as the difference between standing and sitting body heights. All measurements were converted to logarithms and allometric linear regressions vs log body height were computed. RESULTS: The Turner girls proved to have allometrically shorter legs (p<0.001) and wider shoulders (p<0.001) compared with both groups of healthy girls, and longer upper extremities (p<0.001) compared with the girls of normal stature. Healthy, short-statured girls had longer lower extremities (p<0.001) as compared to other groups; they also had wider shoulders (p<0.001) and longer upper extremities (p<0.001) compared to healthy girls of normal height. CONCLUSIONS: Allometric relations of anthropometric measurements enable a deeper insight into the body proportions, especially in the growth period. The presented discrimination of Turner girls may serve as a screening test, and recommendation for further clinical treatment.

Body fat-based weight norms for children and youths.

INTRODUCTION: The issue of establishing reference values, especially of those pertaining to somatic features, is of importance for an assessment of normal growth. It was assumed that norms ought to reflect not the actually existing status but the recommended one. Thus, weight-height relations, including body mass index (BMI), ought to be established for that fraction of the general population, in which body fat content is within physiologically acceptable limits. THE AIM OF THE STUDY: To construct weight-to-height percentile norms for boys and girls aged 7-20 years. MATERIAL AND METHODS: A cohort of healthy boys (n=1282) and girls (n=1150) attending schools in the Eastern regions of Poland participated in the study. Their body height, body mass and body fat content were determined, the latter by skinfold (Slaughter's method) or bioimpedance measurements. The data for constructing normal values of body fat content were compiled from diverse sources so as to associate them smoothly with the normal values for adults. RESULTS: By applying the proposed lower and upper limits of body fat, 1007 boys (78.5%) and 581 girls (50.5%) with acceptable fat content were selected for constructing percentile norms of body mass expected for height, as well as for BMI. CONCLUSIONS: The existing norms for BMI of children and youths, also the Polish ones, differ from each other, as these were not based on data from subjects with acceptable body fat and assessing body fat content from BMI is known to be markedly biased. Unlike BMI, the presented percentile weight-for-height norms are age-independent in the range 7-20 years and are thus much easier to use. Those norms may be recommended as a tool in assessing the course of normal growth, as well as in developmental disorders and possible clinical intervention.

[Body image of short- and normally statured girls in pubertal age]. / Wizerunek ciala nisko- i normoroslych dziewczat w wieku okolopokwitaniowym.

INTRODUCTION: Short stature and other growth disorders may be a subject of public stigmatising and that, especially during puberty, may lead to lowered self-esteem and increase inadequate self-perception of one's body image. THE AIM OF THE STUDY: To assess own body perception in short- and normally statured girls and to evaluate the concordance of self-image with an assessment performed by an external expert. MATERIAL AND METHODS: Two groups of girls aged 14-16 years took part in the study: 25 short-statured girls (body height below 10th percentile) and 49 girls of normal body height. The subjects were given templates with 9 body silhouettes. They were asked to point out the silhouette that best represented their body and then the desired one. The third evaluation was performed by an external expert. Basing on the expert's assessment, the subjects were divided into three groups: slim (silhouettes 1 and 2), normal (3-4) and stocky (above 4). RESULTS: Regression slopes computed for the relationship between self-image and expert's assessment differed significantly in both groups: slim, short-statured girls overestimated their body image by about 1.5 unit while the stocky, short-statured ones by about one unit. Girls with normal body height overestimated their body image by about one unit irrespectively of the group they have been classified to. Additionally, stocky girls and those with normal body image from both groups wished to be leaner. CONCLUSIONS: Incompletely developed sense of identity as well as rapid changes in body composition and body proportions can be attributed to pubescence and may be the reason of inadequate perception of own body image. Additionally, self-image may be strongly affected by the beauty standards widely promoted by mass-media.

Weight-height relationship in girls with normal body fat content--Turner's syndrome vs. healthy short-statured.

INTRODUCTION: Turner's syndrome is characterised by severely deficient body height and distorted body proportions as compared with healthy girls. It could be expected that shorter legs with respect to trunk length, together with a wider shoulder girdle, would disturb weight-height proportions. THE AIM OF THE STUDY: To compare weight-height relation in Turner girls with that in healthy, short-statured girls, provided both had body fat content within "normal" limits. MATERIAL AND METHODS: The study included 39 girls with Turner's syndrome and 63 healthy short-statured girls aged 10-20 years. Body height, body mass and body fat content were determined. Data analysis was performed for only those girls whose body fat content was within approximate normal limits for age calculated for the purpose of presented study. Body height and body mass were transformed to logarithms in order to obtain allometric relations. RESULTS: No significant differences were found between regression slopes what means that body mass was proportional to body height in both groups. On the other hand, regression constants differed significantly (p<0.001); Turner girls were, on average, by 11% heavier than their healthy mates. CONCLUSION: The selection of Turner and healthy, short-statured subjects with "normal" percentage of body fat content led to conclusion that increased relative body mass of Turner girls resulted from their specific body proportions and not from increased fat content.

[Evaluation of expected body mass in girls with Turner's Syndrome using Body Mass Index]. / Ocena prawidlowej masy ciala dziewczat z zespolem Turnera za pomoca wskaznika masy ciala.

AIM OF STUDY: To verify the usefulness of Body Mass Index (BMI) in the evaluation of expected body mass in girls with Turner's Syndrome (TS). MATERIAL AND METHODS: 36 girls with Turner's Syndrome aged 10-14 years took part in the study. Body height, body mass, sitting height and body fat content were measured, the latter by bioelectrical impedance method (Bodystat 5,000). Relative body fat content of TS girls was related to "normal" limits for healthy girls, determined for the purpose of this study. RESULTS: Compared to healthy girls, 50% of TS girls exhibited evaluated levels of body fat. Using BMI, only 14% of these girls were classified as overweight, 33% as "normal-weight" and 3% as undernourished. Similar misclassification was observed in case of TS girls with reduced body fat (8%), all of them being classified by BMI as having normal body mass. Significant correlation (r = -0,707) was found between body fat content and sitting height. SUMMARY AND CONCLUSIONS: It seems unjustified to use BMI in the evaluation of normal body mass in girls with TS as it does not reflect the relative body fat content. The observed misclassification of the BMI and bioelectrical impedance method may be also due to abnormal body proportions of TS girls.