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  • Pediatric Original Article
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Patterns of linear growth and skeletal maturation from birth to 18 years of age in overweight young adults

International Journal of Obesity volume 36, pages 535–541 (2012)Cite this article

Abstract

OBJECTIVE:

To estimate differences in skeletal maturity and stature from birth to age 18 years between individuals who are overweight vs normal weight in young adulthood.

PATIENTS AND METHODS:

Weight, length and height, and relative skeletal age (skeletal—chronological age) were assessed annually from birth to age 18 years in 521 subjects (255 women) in the Fels Longitudinal Study who were overweight or obese (body mass index (BMI) >25 kg m–2, n=131) or normal weight (n=390) in young adulthood (18–30 years). Generalized estimating equations were used to test for skeletal maturity and stature differences by young adult BMI status.

RESULTS:

Differences in height increased during puberty, being significant for girls at ages 10 to 12 years, and for boys at ages 11 to 13 years (P-values<0.001), with overweight or obese adults being ∼3 cm taller at those ages than normal weight adults. These differences then diminished so that by age 18 years, overweight or obese adults were not significantly different in stature to their normal weight peers. Differences in skeletal maturity were similar, but more pervasive; overweight or obese adults were more skeletally advanced throughout childhood. Skeletal maturity differences peaked at chronological age 12 in boys and 14 in girls (P-values<0.001), with overweight or obese adults being ∼1 year more advanced than normal weight adults.

CONCLUSIONS:

This descriptive study is the first to track advanced skeletal maturity and linear growth acceleration throughout infancy, childhood and adolescence in individuals who become overweight, showing that differences occur primarily around the time of the pubertal growth spurt. Increased BMI in children on a path to becoming overweight adults precedes an advancement in skeletal development and subsequently tall stature during puberty. Further work is required to assess the predictive value of accelerated pubertal height growth for assessing obesity risk in a variety of populations.

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References

  1. Freedman DS, Thornton JC, Mei Z, Wang J, Dietz WH, Pierson RN et al. Height and adiposity among children. Obes Res 2004; 12: 846–853.

    Article  Google Scholar 

  2. Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS . Inter-relationships among childhood BMI, childhood height, and adult obesity: the Bogalusa Heart Study. Int J Obes Relat Metab Disord 2004; 28: 10–16.

    Article  CAS  Google Scholar 

  3. He Q, Karlberg J . Bmi in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res 200; 49: 244–251.

    Article  Google Scholar 

  4. Stovitz SD, Pereira MA, Vazquez G, Lytle LA, Himes JH . The interaction of childhood height and childhood BMI in the prediction of young adult BMI. Obesity 2008; 16: 2336–2341.

    Article  Google Scholar 

  5. Stovitz SD, Hannan PJ, Lytle LA, Demerath EW, Pereira MA, Himes JH . Child height and the risk of young-adult obesity. Am J Prev Med 2010; 38: 74–77.

    Article  Google Scholar 

  6. Aksglaede L, Juul A, Olsen LW, Sorensen TI . Age at puberty and the emerging obesity epidemic. PLoS One 2009; 4: e8450.

    Article  Google Scholar 

  7. Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS et al. The relation of menarcheal age to obesity in childhood and adulthood: the Bogalusa heart study. BMC Pediatr 2003; 3: 3.

    Article  Google Scholar 

  8. Denzer C, Weibel A, Muche R, Karges B, Sorgo W, Wabitsch M . Pubertal development in obese children and adolescents. Int J Obes 2007; 31: 1509–1519.

    Article  CAS  Google Scholar 

  9. Bonat S, Pathomvanich A, Keil MF, Field AE, Yanovski JA . Self-assessment of pubertal stage in overweight children. Pediatrics 2002; 110: 743–747.

    Article  Google Scholar 

  10. Raman A, Lustig RH, Fitch M, Fleming SE . Accuracy of self-assessed Tanner staging against hormonal assessment of sexual maturation in overweight African-American children. J Pediatr Endocrinol Metab 2009; 22: 609–622.

    Article  CAS  Google Scholar 

  11. Schlossberger NM, Turner RA, Irwin CE . Validity of self-report of pubertal maturation in early adolescents. J Adolesc Health 1992; 13: 109–113.

    Article  CAS  Google Scholar 

  12. Cameron N . Assessment of maturation: bone age and pubertal assessment. In: Glorieux FH, Pettifor JH, Juppner H (eds). Pediatric Bone: Biology and Diseases. Academic Press: London, UK, 2003. pp 325–338.

    Chapter  Google Scholar 

  13. Roche AF . Growth, Maturation and Body Composition: The Fels Longitudinal Study 1929–1991. Cambridge University Press: Cambridge, 1992.

    Book  Google Scholar 

  14. Lohman T, Roche A, Martorell R . Anthropometric Standardization Reference Manual. Human Kinetics Publishers: Champaign, IL, 1998.

    Google Scholar 

  15. Roche A, Chumlea W, Thissen D . Assessing the Skeletal Maturity of the Hand-Wrist. Charles C Thomas: Springfield, IL, 1988.

    Google Scholar 

  16. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  Google Scholar 

  17. Stovitz SD, Demerath EW, Hannan PJ, Lytle LA . Growing into obesity: patterns of height growth in those who become normal weight, overweight or obese as young adults. Am J Hum Biol 2011; 23: 635–641.

    Article  Google Scholar 

  18. Perry CL, Stone EJ, Parcel GS, Ellison RC, Nader PR, Webber LS et al. School-based cardiovascular health promotion: the child and adolescent trial for cardiovascular health (CATCH). J Sch Health 1990; 60: 406–413.

    Article  CAS  Google Scholar 

  19. Leonard MB, Shults J, Wilson BA, Tershakovec AM, Zemel BS . Obesity during childhood and adolescence augments bone mass and bone dimensions. Am J Clin Nutr 2004; 80: 514–523.

    Article  CAS  Google Scholar 

  20. Minuto F, Barreca A, Del Monte P, Fortini P, Resentini M, Morabito F et al. Spontaneous growth hormone and somatomedin-C/insulin-like growth factor-I secretion in obese subjects during puberty. J Endocrinol Invest 1988; 11: 489–495.

    Article  CAS  Google Scholar 

  21. Russell DL, Keil MF, Bonat SH, Uwaifo GI, Nicholson JC, McDuffie JR et al. The relation between skeletal maturation and adiposity in African American and Caucasian children. J Pediatr 2001; 139: 844–848.

    Article  CAS  Google Scholar 

  22. Heger S, Korner A, Meigen C, Gausche R, Keller A, Keller E et al. Impact of weight status on the onset and parameters of puberty: analysis of three representative cohorts from central Europe. J Pediatr Endocrinol Metab 2008; 21: 865–877.

    Article  Google Scholar 

  23. Neville KA, Walker JL . Precocious pubarche is associated with SGA, prematurity, weight gain, and obesity. Arch Dis Child 2005; 90: 258–261.

    Article  CAS  Google Scholar 

  24. Remer T . Adrenarche and nutritional status. J Pediatr Endocrinol Metab 2000; 13 (Suppl 5): 1253–1255.

    PubMed  Google Scholar 

  25. Prentice AM, Jebb SA . Beyond body mass index. Obes Rev 2001; 2: 141–147.

    Article  CAS  Google Scholar 

  26. Wells JC, Chomtho S, Fewtrell MS . Programming of body composition by early growth and nutrition. Proc Nutr Soc 2007; 66: 423–434.

    Article  Google Scholar 

  27. Maynard LM, Wisemandle W, Roche AF, Chumlea WC, Guo SS, Siervogel RM . Childhood body composition in relation to body mass index. Pediatrics 2001; 107: 344–350.

    Article  CAS  Google Scholar 

  28. Cameron N, Pettifor J, De Wet T, Norris S . The relationship of rapid weight gain in infancy to obesity and skeletal maturity in childhood. Obes Res 2003; 11: 457–460.

    Article  Google Scholar 

  29. Dennison BA, Edmunds LS, Stratton HH, Pruzek RM . Rapid infant weight gain predicts childhood overweight. Obesity 2006; 14: 491–499.

    Article  Google Scholar 

  30. Ong KK, Ahmed ML, Emmett PM, Preece MA, Dunger DB . Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ 2000; 320: 967–971.

    Article  CAS  Google Scholar 

  31. Dahly D, Rudolf M . Identifying obesity risk in the early years: report on the completion of a project funded by the cross government obesity unit, 2010. (http://www.noo.org.uk/).

  32. Ihmels MA, Welk GJ, Eisenmann JC, Nusser SM, Myers EF . Prediction of BMI change in young children with the family nutrition and physical activity (FNPA) screening tool. Ann Behav Med 2009; 38: 60–68.

    Article  Google Scholar 

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Acknowledgements

This study was supported by National Institutes of Health Grants R01-HD012252 and R01-HD053685. We acknowledge the life-long contributions of the Fels Longitudinal Study participants, and the study staff members, without whose commitment and enthusiasm the work of the study could never have been completed. In particular, we would like to thank Frances Tyleshevski for her help in the creation of the data set, Carol Cottom for the skeletal age assessments, and the past and present Lifespan Health Research Center data collection team for their contributions. We also acknowledge Peter Hannan from the University of Minnesota for providing statistical consultation and advice.

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Authors and Affiliations

  1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    W Johnson & E W Demerath

  2. Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN, USA

    S D Stovitz

  3. Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA

    A C Choh, S A Czerwinski & B Towne

  4. Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA

    S A Czerwinski & B Towne

Authors
  1. W Johnson
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  2. S D Stovitz
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  4. S A Czerwinski
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  5. B Towne
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  6. E W Demerath
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Correspondence to E W Demerath.

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Johnson, W., Stovitz, S., Choh, A. et al. Patterns of linear growth and skeletal maturation from birth to 18 years of age in overweight young adults. Int J Obes 36, 535–541 (2012). https://doi.org/10.1038/ijo.2011.238

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  • DOI: https://doi.org/10.1038/ijo.2011.238

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