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Height Gain (height + gain)
Selected AbstractsLiver transplantation for progressive familial intrahepatic cholestasis: Clinical and histopathological findings, outcome and impact on growthPEDIATRIC TRANSPLANTATION, Issue 6 2007Sema Aydogdu Abstract:, In this study, we analyze the demographic features, clinical and histopathological findings in patients who underwent liver transplantation for progressive familial intrahepatic cholestasis. We also analyze outcome and impact of liver transplantation on growth and bone mineral content. Most of the patients were presented with jaundice mainly beginning within the first six months. At the time of initial admission; eight patients had short stature (height SD score <2), and four patients had weight SD score <2. Liver transplantation were performed at the age of 43.2 ± 27 months (range 9 to 96 mfonths), 6.5 ± 3.5 months later after the first admission. Infection, surgical complications and osmotic diarrhea associated with severe metabolic acidosis were noted in 41.4%, 16.6% and 33.3%, respectively. One patient developed posttransplant lymphoproliferative disorder. Overall; 1 year graft and patient survival was 69.2% and 75%, respectively. At the end of the 1st year only 2 patients had height SD score <2. Linear regression of height gain against increase in total body BMD measured at the time of transplantation and 1 year after liver transplantation gave a coefficient r = 0.588 (p = 0.074). No correlation was found between the height gain and age and PELD score at time of transplantation, and no difference was noted between the sexes and donor type. Liver transplantation is effective treatment modality with good outcome and little morbidity, and increases the growth acceleration in patients with PFIC associated with cirrhosis. [source] Evaluation of catch-up growth after liver transplantation in children with biliary atresiaPEDIATRIC TRANSPLANTATION, Issue 3 2004G. Alonso Abstract:, Orthotopic liver transplantation (Tx) has improved survival in infants with extrahepatic biliary atresia (BA) when portoenteroanastomosis fails. Symptoms leading to Tx include liver failure, poor quality of life and growth failure. The objective of the study was to determine catch-up growth in children with BA. Medical records and growth data of 36 patients (24 girls) who received a Tx due to BA were analyzed. Thirty-two patients completed 3 yr and 15 patients 7 yr of follow-up after Tx. At Tx, the median age was 2.7 yr (range 0.7,12.6) and mean height Z score (±s.d.) was ,1.56 (±1.3). Patients were divided in two groups according to age at Tx: group I (n = 10), younger than 1.0 yr, and group II (n = 26) older than 1.0 yr. Median age (range) at Tx in group I was 0.8 yr (0.7,1.0) and in group II it was 3.35 yr (1.25,12.6). Thirteen patients (nine in group I) were receptors of living related donors. We evaluated linear growth, liver and renal function, immunosuppressive regimen and allograft rejection episodes. We did not find any significant differences in allograft or renal function, immunosuppressive therapy and number of acute rejection episodes or height Z score at Tx, second and third year post-Tx between both groups. The mean height Z score at Tx in group I was ,1.61 and in group II ,1.54; at the second year, group I ,0.66 and group II ,1.08; at the third year, group I ,0.17 and group II ,0.85; and at the seventh year (total group) ,0.3. However, the height gain at the third year was better in group I than in group II (p < 0.01, t-test). Height Z score at the third year improved more than 1 SDS in seven out of eight patients in group I and in only nine out of 24 in group II (odds ratio 11.6). We also found a correlation between height gain at the third year and age at Tx (r,0.65) and between height gain at the third year and height Z score at Tx (r,0.54) (Pearson, p < 0.05). Children with BA who are transplanted before 12 months of age presented better catch-up growth without change survival and morbidity. Orthotopic liver Tx improves survival and also enables height gain in these children. [source] Catch-up Growth or Regression to the Mean?AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2005Recovery from Stunting Revisited An important question for policy is the extent to which catch-up growth can ease the impact of early stunting. Martorell et al. (1992) showed that stunted Guatemalan infants remain stunted into adulthood, whereas Adair (1999) found appreciable catch-up growth in Filipino children from 2,12 years. Both groups defined catch-up as an inverse correlation between early height and subsequent growth, but Martorell based the correlation on height, whereas Adair used height z scores. The statistical phenomenon of regression to the mean is much like catch-up growth, an inverse correlation between initial height and later height gain. The objective of this study was to reexamine the relationship between stunting and later catch-up growth in the context of regression to the mean. The design was a theoretical analysis showing that catch-up growth is more evident based on height z scores than on height, validated using data on 495 stunted South African children seen at 2 and 5 years of age. The correlation between height at 2 and height change from 2 to 5 was small based on height (,0.11) but large and highly significant based on height z score (,0.58), providing strong evidence of catch-up growth. We argue that catch-up growth should be estimated using height z score not height and that catch-up is present only when the change in z score exceeds that predicted by regression to the mean. This leads to a compact definition of catch-up growth: if z1 and z2 are the initial and final (mean) height z scores, and r is the correlation between them, then catch-up growth for groups or individuals is given by (z2 , rz1). Am. J. Hum. Biol. 17:412,417, 2005. © 2005 Wiley-Liss, Inc. [source] ORIGINAL ARTICLE: Should short children born small for gestational age with a distance to target height <1 standard deviation score be excluded from growth hormone treatment?CLINICAL ENDOCRINOLOGY, Issue 3 2010Annemieke J. Lem Summary Context, The criteria for starting growth hormone (GH), an approved treatment for short children born small for gestational age (SGA), differ between Europe and the USA. One European requirement for starting GH, a distance to target height (DTH) of ,1 standard deviation score (SDS), is controversial. Objective, To investigate the influence of DTH on growth during GH treatment in short SGA children and to ascertain whether it is correct to exclude children with a DTH <1 SDS from GH. Patients, A large group of short prepubertal SGA children (baseline n = 446; 4 years GH n = 215). Measurements, We analysed the prepubertal growth response during 4 years of GH. We investigated the influence of the continuous variable DTH SDS on growth response and a possible DTH SDS cut-off level below which point the growth response is insufficient. Results, Height gain SDS during 4 years of GH showed a wide variation at every DTH SDS level. Multiple regression analyses demonstrated that, after correction for other significant variables, an additional DTH of 1 SDS resulted in 0·13 SDS more height gain during 4 years of GH. We found no significant differences in height gain below and above certain DTH SDS cut-off levels. Conclusions, DTH SDS had a weak positive effect on height gain during 4 years of GH, while several other determinants had much larger effects. We found no support for using any DTH cut-off level. Based on our data, excluding children with a DTH <1 SDS from GH treatment is not justified. [source] Influence of parental origin of the X chromosome on physical phenotypes and GH responsiveness of patients with Turner syndromeCLINICAL ENDOCRINOLOGY, Issue 1 2010Jung Min Ko Summary Objective, Previous studies have reported the effects of parental origin of the X chromosome on specific phenotypic and cognitive profiles in Turner syndrome (TS). Here, we investigate the possible parent-of-origin effects on physical phenotypes and responsiveness to GH in Korean patients with TS. Design and patients, Thirty-three patients with TS with nonmosaic karyotype and their parents participated in this study. The parental origin of the normal X chromosome was determined by comparing parental DNA polymorphisms using nine highly polymorphic microsatellite markers on the X chromosome. For the evaluation of parent-of-origin effects, typical phenotypic traits, including congenital malformations, auxological and endocrinological profiles, were compared. Results, The retained X chromosome was of maternal (Xm) origin in 60·6% patients and paternal (Xp) origin in 39·4% patients. No significant parent-of-origin effects on stature, body mass index, cardiac, renal, skeletal, lymphatic, hearing or ocular systems were evident. We observed no differences in height gain after GH treatment. In patients with the 45,X karyotype, patient height was positively correlated with maternal height in the Xm group (r = 0·60, P = 0·04). Moreover, patient height was more significantly correlated with maternal than paternal height, irrespective of the parental origin of the retained X chromosome. Conclusion, While we observed no significant impact of parental origin of the X chromosome on several phenotypic traits in patients with TS, a maternal imprinting effect on stature was suggested at least in patients with 45,X. Further studies on a larger number of patients with TS are essential to define the potential imprinting effects of undetermined genes on the X chromosome. [source] Long-term effects of growth hormone (GH) treatment on body composition and bone mineral density in short children born small-for-gestational-age: six-year follow-up of a randomized controlled GH trialCLINICAL ENDOCRINOLOGY, Issue 4 2007Ruben H. Willemsen Summary Context, Alterations in the GH-IGF-I axis in short small-for-gestational-age (SGA) children might be associated with abnormalities in bone mineral density (BMD) and body composition. In addition, birth weight has been inversely associated with diabetes and cardiovascular disease in adult life. Data on detailed body composition in short SGA children and long-term effects of GH treatment are very scarce. Objective, To investigate effects of long-term GH treatment on body composition and BMD by dual energy X-ray absorptiometry (DXA) in short SGA children. Design, Longitudinal 6-year GH study with a randomized controlled part for 3 years. Results, At baseline, fat percentage standard deviation score (SDS) and lumbar spine BMD SDS corrected for height (BMADLS SDS) were significantly lower than zero. Lean body mass (LBM) SDS adjusted for age was also reduced, but LBM adjusted for height (LBM SDSheight) was not decreased. GH treatment induced a decrease in fat percentage SDS and an increase in BMADLS SDS. LBM SDSheight remained similar in GH-treated children, but deteriorated in untreated controls. When these untreated controls subsequently started GH treatment, their LBM SDSheight rapidly normalized to values comparable with zero. Conclusion, During long-term GH treatment in short SGA children, fat percentage SDS decreased and BMADLS SDS increased. These effects of GH treatment were most prominent in children who started treatment at a younger age and in those with greater height gain during GH treatment. LBM SDSheight remained around 0 SDS in GH-treated children, but declined to low normal values in untreated controls. [source] | ||||||||||