Biomedical subjects

T Gasser

Publications and source records attributed to T Gasser.

At least 235 records · Page 13Linked to original sources

PubMedDate not supplied

Short-term and long-term variability of standard deviation scores for size in children.

PRIMARY OBJECTIVE: To quantify long-term and short-term variability in the standard deviation scores (SDS's) for six skeletal size variables and body mass index (BMI) in children and to compare average values of these quantities for boys with those of girls and to make comparisons across variables. METHODS AND PROCEDURES: The analysis is based on measurements made regularly for 120 boys and 112 girls from 1 month until 20 years for seven variables (standing height, sitting height, leg height, arm length, biiliac width, bihumeral width and BMI) as part of the first Zurich longitudinal growth study. Variation in these scores due to variablity in the timing of the pubertal spurt (PS) is separated out by rescaling the age axis on an individual basis and comparing children with the same developmental age rather than the same chronological age. For a given child, the relationship between the value of its SDS and age is modelled as the sum of an arbitrary (child dependent) smooth function plus an error term. The long-term variability for that child is defined to be the mean square of the departures of this smooth function from its mean level while the short-term variability is defined to be the variance of the error term. MAIN OUTCOMES AND RESULTS: Girls' SDS scores have significantly more long-term variability than those of boys, while there is no significant difference between the sexes for short-term variability. Bihumeral width, BMI and sitting height have significantly more long-term variation than the other variables. Bihumeral width and BMI have the largest short-term variability and standing height has the smallest. Correlations between long-term variability and adult size and timing and intensity of the PS were small. CONCLUSIONS: A useful way of assessing long-term and short-term variability of SDS's, which is widely applicable has been described and applied to data relating to the growth of children. The results of this analysis are intriguing. Why is the underlying growth process of girls more variable than that of boys? Differences across skeletal parameters are also interesting and deserve further consideration.

Body Height↗

PubMedDate not supplied

Growth processes leading to a large or small adult size.

BACKGROUND: The way in which a large size in anthropometric variables is achieved is a longstanding problem, since the pubertal spurt shows statistically and clinically little association with adult size (mostly studied for height). By analysing longitudinal growth of groups of subjects with a large or a small adult size separately for height, leg and sitting height, and bihumeral and biiliac width, we studied this problem in some detail. Of interest are growth patterns specific for these variables and for boys or girls. METHODS: The data consist of 120 boys and 112 girls followed longitudinally from 4 weeks until adulthood. Statistically, structural average velocity curves were computed for each variable and each subgroup separately for comparison. This velocity curve represents the average intensity and the average tempo of growth. Since the area under the velocity curve is adult size, differences in the growth process can be visualized. RESULTS: Both sexes show similar patterns in reaching a small or large adult size. The different variables, however, show marked differences. Only for legs is the pubertal spurt delayed for the large groups (with additional gains in prepubertal years). For sitting height and biiliac width, a slightly elevated velocity all along development (after 2 years) leads to a larger size and for bihumeral width the size of the pubertal peak is decisive. CONCLUSIONS: The steering of growth to a certain target size is qualitatively similar for boys and girls, but quite different for different anthropometric variables. This leads to questions about endocrinological control for various parts of the body and differential bone growth in development.

Adolescent↗

PubMedDate not supplied

Growth of early and late maturers.

BACKGROUND: This is a study on the growth of subgroups of normal children, maturing early or late, in the variables height, leg and sitting height, arm length, biiliac and bihumeral width. While a longer growth period affects adult height only marginally, less is known about the other variables. It is also of interest to see in what way a shorter growth period is compensated by a higher velocity. METHODS: Out of 120 boys and 112 girls followed from 4 weeks until adulthood, subgroups of 40 boys and 37 girls were formed with respect to the average timing (across variables) of the pubertal spurt as an indicator of maturity. RESULTS: Only leg height shows a smaller adult size for early maturers. The shorter growth period is compensated by a higher prepubertal velocity and a higher level in pubertal years. The pubertal peak is a little larger for early maturing boys but not for girls. CONCLUSIONS: There is an inherent pacemaker for growth that leads to the same adult size for a shorter growth period via a higher basic intensity. Legs are an exception since late maturers have, on average, longer legs as adults.

Adolescent↗

PubMedDate not supplied

TW3 bone age: RUS/CB and gender differences of percentiles for score and score increments.

BACKGROUND: Longitudinal data on bone age progression is scarce. AIM: The study aimed to present reference values for Tanner-Whitehouse 3 (TW3) bone age score and score increments, and to provide means and standard deviations of appearance time for all TW3 stages. Gender differences and differences between radio ulna and short bones (RUS) and carpal bone (CB) scores were studied. SUBJECTS AND METHODS: Bone age data collected for ages 3 months to 20 years in 232 subjects during the First Zurich Longitudinal Study (1954-1976) were used. Smoothed empirical percentiles of TW3 RUS and CB scores for age, of score increments for age and of score increments for attained score are presented. Means and standard deviations of the appearance times are calculated by parametric censored regression. RESULTS: There are clear differences between the RUS and CB scores and between the genders. Boys are delayed with respect to girls, with different delays for RUS and CB. For RUS, differences in maturation reflect the known differences of physical growth, with a later and more intense peak in boys. For CB, there is little difference in timing and intensity. However, girls reach the final score about 2 years earlier than boys. The consistently earlier mean appearance times in girls indicate that skeletal maturation is, already in childhood, more rapid in girls than in boys. There are significant gender differences in the sequence of appearance. CONCLUSION: Reference values for TW3 score and score increments and mean appearance times for stages add to existing knowledge and indicate important RUS/CB and gender differences, whose sources are largely unknown.

Adolescent↗

PubMedDate not supplied

Shape-invariant modelling of human growth.

A new approach to modelling human height growth is presented which is also suitable for other variables. In a mathematical algorithm, some guess about the functional form of this growth process is improved consistently using the data; the resulting shape-invariant model (SIM) allows an approximately bias-free fitting for longitudinal data from 1 to 20 years with six parameters assigned to each individual. The SIM approach and the use of velocities rather than distances proved to be suitable for biomathematical modelling in order to answer questions qualitative in nature. In comparison of an additive two-component SIM and one where the appearance of puberty inhibits further growth of the non-pubertal component ('switch-off model'), the latter proved to be superior in various aspects. Among the qualitative features found are notable: a pronounced midspurt, and a dip before the onset of puberty, as well as the asymmetry of the pubertal peak. A preliminary analysis of individual parameters confirmed some results found previously by other methods regarding sex differences and relations between parameters and with adult height.

Adolescent↗

PubMedDate not supplied

Velocity and acceleration of height growth using kernel estimation.

A method is introduced for estimating acceleration, velocity and distance of longitudinal growth curves and it is illustrated by analysing human height growth. This approach, called kernel estimation, belongs to the class of smoothing methods and does not assume an a priori fixed functional model, and not even that one and the same model is applicable for all children. The examples presented show that acceleration curves might allow a better quantification of the mid-growth spurt (MS) and a more differentiated analysis of the pubertal spurt (PS). Accelerations are prone to follow random variations present in the data, and parameters defined in terms of acceleration are, therefore, validated by a comparison with parameters defined in terms of velocity. Our non-parametric-curve-fitting approach is also compared with parametric fitting via a model suggested by Preece and Baines (1978).

Body Height↗

PubMedDate not supplied

An analysis of the mid-growth and adolescent spurts of height based on acceleration.

Height growth between four weeks and 20 years of 45 boys and 45 girls from the Zürich Longitudinal Growth Study (1955-1976) was analysed using kernel estimates. Timings of the mid-growth spurt (MS) and of the pubertal spurt (PS) were determined in an automatic way from the individual acceleration curves, together with height, percentage of height, velocity and acceleration at these ages. The small mid-growth spurt is a consistent phenomenon, peaking at 6.4 years (M,F) in acceleration and at 7.7 years (M) and 7.5 years (F) in velocity. There are no significant sex differences in its intensity. In girls, the PS follows in close succession to the MS; in boys there is a substantial period in between. In addition to the age of peak height velocity, ages of onset, maximal acceleration and end of the PS are defined. Sex differences in timing and size of the pubertal peak previously established were again verified. New results relate to the asymmetry of the PS, which is more pronounced in girls, and to sex differences in intensity and duration of the first rising phase of the PS. After this phase, boys and girls do not differ in timing but only in the intensity of deceleration.

Adolescent↗

PubMedDate not supplied

Human height growth: correlational and multivariate structure of velocity and acceleration.

In this paper the correlations between parameters quantifying the mid-growth spurt (MS) and the pubertal spurt (PS) of height are explored. These parameters are defined in individual acceleration, velocity, and distance curves, which are obtained via kernel estimates as previously introduced. The MS proves to be a phenomenon largely independent of the PS. Intensity, timing, and duration of the PS are also independent mechanisms of growth and neither of them influences adult height in an appreciable way. Adult height depends mostly on pre-adolescent velocity. Short-, medium- and long-term regulatory mechanisms for explaining height growth are considered. For short-term mechanisms, acceleration plays a crucial role.

Adolescent↗

PubMedDate not supplied

A method for determining the dynamics and intensity of average growth.

A new statistical method is presented for determining an average growth curve which is valid in the sense of representing both the average dynamic, or tempo, and the average intensity of the growth process studied. In this context, growth curve means either distance, velocity or acceleration curve. The principal idea is to shift individual curves continuously (and non-linearly) in age to an average developmental age scale. Since the resulting curves represent the typical shape rather than individual variations of it, they are of interest for comparisons of different variables of boys and girls and of subgroups. The method is illustrated with longitudinal growth data from the first Zurich longitudinal study.

Body Height↗

PubMedDate not supplied

The dynamics of linear growth in distance, velocity and acceleration.

Growth of body, leg, trunk and arm length from birth to adulthood is studied in the subjects of the First Zürich Longitudinal Growth Study, using a recently developed technique, the 'structural average curve'. In this way truly longitudinal average curves are obtained for velocity, acceleration and distances, and various phases of growth are analysed not only graphically, but also by descriptive parameters in terms of timing, intensity and duration. These phases consist of the pubertal spurt (PS), the mid-growth spurt (MS) and growth in infancy. The overall pattern is the same in all variables studied: velocity drops sharply after birth, followed by a kink between 7 and 12 months, and a more gradual decrease until the MS, which peaks around 7 years. In girls the PS immediately follows the MS, while in boys a 'latency period' of approximately constant growth velocity precedes the PS, which occurs almost 2 years later, and is more intense than in girls. There are no appreciable sex differences in the MS, but the PS is later and more intense for boys, even when accounting for the smaller adult size of girls. When comparing linear variables the PS turns out to be earlier for the legs than for the trunk, whereas the trunk has an earlier MS. The trunk starts high in relative distance and in velocity after birth, whereas the legs have a high velocity throughout childhood. In adolescence the trunk again shows more intense growth. Surprisingly, the growth of the arms in many ways resembles more that of the trunk and not that of the legs.

Adolescent↗

PubMedDate not supplied

The dynamics of growth of width in distance, velocity and acceleration.

In this paper the dynamics and intensity of the growth of bihumeral and biiliac width and of humerus and femur bicondylar diameter are studied and compared, and sex differences are established. The analysis is based on a newly introduced statistical tool, the structural average curve for distance, velocity and acceleration. It accounts for individual developmental tempo and allows pooling data for a sample of subjects. In all four variables studied, a sharp decline in velocity after birth is followed by a more gradual decline in infancy and childhood. A mid-growth spurt (MS) at about age 7 can be found in all variables, of about equal timing and intensity for the two sexes. The pubertal spurt (PS) is earlier for girls, and less intense except for biiliac width. The study shows a characteristic pattern across variables of width regarding the intensity of growth in different periods. The accentuated MS and PS for bihumeral width, contrasting with relatively early and small PS for the bicondylar width of femur, are remarkable.

Adolescent↗

PubMedDate not supplied

The dynamics of growth of weight, circumferences and skinfolds in distance, velocity and acceleration.

Based on structural average curves of distance, velocity and acceleration, an analysis of the longitudinally assessed growth of weight, arm and calf circumferences and skinfolds (biceps, triceps, suprailiac, subscapular) was undertaken. The data come from the first Zürich longitudinal growth study and represent a normal sample. In addition to a graphic analysis, timing, intensity and duration of the mid-growth spurt (MS) and of the pubertal spurt (PS) are quantified via descriptive parameters of growth. Mechanisms are different and more complex for these variables, in particular for skinfolds, compared to previously studied somatic variables, such as height. Skinfolds showed a rapid decline to a negative velocity minimum in the first year, recovering to a pre-PS fat spurt, earlier and more pronounced for central (suprailiac, subscapular) than for peripheral skinfolds (biceps, triceps). At age of peak height velocity a drop occurred, stronger for boys, followed by a post-PS spurt. A further analysis demonstrates that these ups and downs in skinfold velocity are mainly due to subjects with thick skinfolds. Weight and circumferences show a distinct MS, with sex-independent characteristics and a strong, sex-dependent PS. Weight and even more arm circumference are delayed compared to height in puberty.

Adolescent↗

PubMedDate not supplied

Measures of body mass and of obesity from infancy to adulthood and their appropriate transformation.

In this paper we investigate first the choice of an appropriate index of body mass. The traditional indices weight/height (W/H), W/H2 and W/H3 are compared, as well as an approach due to Cole (1986) making the index W/Hp age-dependent, i.e. by allowing the power p to depend on age. While there may be no perfect index reflecting over- and underweight--irrespective of height and width--the Quetelet index W/H2 turned out to be a reasonable index from childhood to adulthood. Second, we study the development of the body mass index W/H2 longitudinally from birth onwards, based on structural average distance, velocity and acceleration curves. As a third topic, transformations for obtaining an approximate normal distribution for W/H2, weight and skinfolds are compared. The usual log-transformation turned out to be unsatisfactory. While for height and arm skinfolds a transformation -1/square root of x performs rather well across age and sex, a transformation -1/x is more appropriate for trunk skinfolds and W/H2.

Age Factors↗

PubMedDate not supplied

Development and outcome of indices of obesity in normal children.

Based on the Zürich longitudinal growth study, differences are analyzed between those children who later became light adults (later light) and those who later became heavy (later heavy) adults. This is of interest to discover how and when overweight develops, and which variables are most affected (weight, body mass index, circumferences and skinfolds are studied). A further question is whether maturation proceeds differently in these children. The principal idea is to split the sample with respect to adult body mass index into three parts, and to analyse the two extreme groups. It is shown that structural average curves for these subgroups lead to a substantial insight into the processes going on in different variables. Whereas maturation is not much different, subjects later heavy gain substantially more in fat and body mass index from about 4 to 5 years onwards. The natural pattern of ups and downs becomes exaggerated in subjects who are to become heavy at adult age. In those phases where it is natural to build up body mass index there is not much of a difference. In phases where later lean subjects hardly increase their body mass index, later heavy subjects continue to build it up substantially.

Adolescent↗

PubMedDate not supplied

A longitudinal study of lean and fat areas at the arm.

Using biceps and triceps skinfolds and upper arm circumference, areas of fat and lean tissue at the arm can be approximately determined based on a cylindrical assumption. Based on the first Zürich growth study a longitudinal analysis of estimated fat and lean areas is undertaken. Area may often be a more meaningful parameter than width in development, due to the increasing width of the limbs stretching the layer of fat. When comparing these quantities with the body mass index, correlations in boys were higher for lean area than for fat area, and about equally high for both measures in girls (around 0.8 beyond age 10). The primary goal of this investigation was to quantify the development of lean and fat arm areas from birth to adulthood, and to assess sex differences in this respect. The comparison with results obtained earlier from radiographic data is of particular interest, since such data can rarely be obtained any more, and overall this comparison can be considered encouraging. Lean area develops slowly until the onset of puberty, girls showing a slightly smaller value than boys. The pubertal spurt is very impressive in boys and moderate in girls, timed to age of peak height velocity in both sexes. Fat area changes only minimally in boys older than 16 months, and increases steadily in girls until age 16. The respective velocity curve shows a systematic up and down until age 5, when a gradual increase to a prepubertal fat spurt starts. It is interrupted by a trough in velocity--much more accentuated in boys--at puberty, and followed by a postpubertal fat spurt. When studying subgroups of subjects with a relatively high or relatively low adult body mass index, the heavy group differed relatively more in terms of fat area than lean area. Girls heavy as adults increase their fat area consistently more from about 5 years onwards. Boys later heavy show a qualitatively different pattern in puberty, with accentuated pre- and postpubertal fat spurts, but also a strong trough to a negative velocity in between.

Adipose Tissue↗

PubMedDate not supplied

Prediction of adult skinfolds and body mass from infancy through adolescence.

In this paper age-to-age correlations for the body mass index and for skinfolds are evaluated for a sample of normal children studied from birth to adulthood. While correlations over larger age spans are modest, they become appreciable from childhood to adolescence and from adolescence to adulthood. Correlations are consistently higher for boys compared to girls, and only for the former does the body mass index correlate better than skinfolds. Significant correlations between weight increase in the first year and the adult body mass index were found, as well as between the age of 'adiposity rebound' and the adult body mass index. However, the small size of the correlations forbids any predictive applications. As it turns out, the individual prediction of the adult size of the body mass index or of skinfolds is a thorny problem, whatever variables and methods are chosen. The precision of such a prediction is very low up to late childhood and becomes somewhat better in adolescence. From a positive side, this leaves much room for overweight children to improve their state. On the other hand, the relative risk for becoming a heavy adult is much increased for those who are already heavy as children and adolescents. This underlines the dangers of early overweight from an epidemiological viewpoint.

Adolescent↗

PubMedDate not supplied

Comparison of height acceleration curves in the Fels, Zurich, and Berkeley growth data.

A new type of smoothing spline designed for nonparametric estimation of growth acceleration curves was applied to longitudinal measures of height from the Fels, Zurich, and Berkeley growth studies. Landmark features of the individual acceleration curves were located and examined for site effects and site by sex interaction. The curves in each group were structurally averaged by transforming the age scale of each child to align the landmarks with overall means. The modal shapes of the structural average curves were found to be highly similar in the three studies, although the relative number of children who conformed to the modal pattern differed among the studies. Significant site by sex interactions were found in the timing of the landmarks associated with the pubertal growth spurt and with the prepubertal 'midspurt'.

Adolescent↗

PubMedDate not supplied

An analysis of variance of the pubertal and midgrowth spurts for length and width.

Using data from the first Zurich Longitudinal Growth Study characteristics of the growth of six variables--bihumeral width, biiliac width, standing height, sitting height, leg height and arm length--are studied. The main interest is in differences between boys and girls, and across variables and in particular in whether there are sex differences that are specific for some variables. For each child and variable, individual velocity and acceleration curves are estimated using a kernal smoother. From these curves, parameters characterizing the midgrowth spurt (MS) and the pubertal spurt (PS) are estimated: timings, durations and intensities. The level of childhood velocity is used for characterizing early growth. These parameters are analysed using a repeated measures analysis of variance (ANOVA) to assess the statistical significance of differences between boys and girls and across variables. This necessitates some kind of standardization and two types of standardization are used here. The MS shows negligible or small differences between boys and girls, and the same is true for velocity in childhood. Differences across variables during the MS are much more pronounced: with respect to intensity, bihumeral width has an MS about six times more intense than height. The PS is later for boys (as is well known), and there are significant differences across variables: bihumeral width and sitting height are late while legs are early. With the exception of biiliac width, the duration of the PS (which has been subdivided into three phases-early, middle and late) is slightly longer for boys for all variables: boys have a longer starting phase, the middle phase is about equal in length for both boys and girls, and girls have a slightly longer late phase. Leg height and height experience a PS of short duration while bihumeral and biiliac width experience a long one and these differences are highly statistically significant. For all variables, with the exception of biiliac width, boys have a more intense PS (in terms of maximal acceleration), even having adjusted for their larger adult size. Differences in intensity are also marked across variables, bihumeral width and sitting height having the highest intensity and legs the lowest. Differences between sexes and across variables are much smaller for the stopping intensity, characterized by maximal deceleration.

Adolescent↗