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Biomedical subjects

J Karlberg

Publications and source records attributed to J Karlberg.

At least 37 records · Page 2Linked to original sources
PubMed2000

Critical growth phases for adult shortness.

Previous growth studies have not explored how different growth phases-the fetal, infancy, childhood, and puberty phases-interact with each other in the development of adult shortness. In this paper, the authors attempt to describe the importance of each growth phase for adult shortness and the effect of growth in one phase on other, subsequent phases. The authors analyzed data from a longitudinal population-based growth study of 2,850 healthy, full term Swedish children born between 1973 and 1975. The height values were transformed into a centimeter score (CMS) by subtracting the raw values from the reference mean values for a particular age and sex. Subnormal growth in any growth phase, as defined by a decrease of 3 CMS or more during a growth phase, was associated with significant increased risk for final heights below 0, -6, and -12 CMS. For children with subnormal growth during one, two, and three phases, the percentages for final height below -12 CMS (a standard deviation score of approximately -2) were 0.5%, 9.4%, and 75%, respectively. Most children (57/62) with a final height below -12 CMS had subnormal growth in two or three phases. Height gains during the four growth phases were interdependent. The infancy phase was negatively associated with fetal growth (r = -0.33, p < 0.01); the childhood phase was positively associated with infancy growth (r = 0.21, p < 0.01); and the puberty phase was negatively associated with childhood growth (r = -0.10, p < 0.01).

Adolescent↗
PubMed2000

Risk factors of obesity in preschool children in China: a population-based case--control study.

OBJECTIVE: To identify the risk factors of obesity in preschool children in China. DESIGN: A nationwide case-control study in eight cities in China. SUBJECTS: A total of 748 boys and 574 girls (age 0.1 - 6.9 y), including the obese and non-obese. One obese child was matched with one non-obese child by sex and age. MEASUREMENTS: Weight, height and other measurements were taken for all the subjects. The information on child activity, feeding pattern and family background was collected by our study team from the parents and the kindergarten teacher. RESULTS: Birth weight > or =4.0 kg, high eating speed, obesity among the child's relatives > or =25%, mother's body mass index (BMI) > 25 kg/m2 and father's BMI > 25 kg/m2 were identified as the major significant (P < 0.05) risk factors of obesity in preschool children in China. CONCLUSION: Family history of obesity, high birth weight and eating speed were identified as the risk factors of obesity in preschool children in China. Our results show the need for family therapy as part of an intervention program for childhood obesity, which includes behavior modification.

Birth Weight↗
PubMed2000

Prevalence of childhood asthma, allergic rhinitis and eczema in Urumqi and Beijing.

OBJECTIVE: To assess the prevalence of asthma and other allergies in children in Urumqi and Beijing, compared with that in Hong Kong. METHODS: A total of 7754 primary school students were randomly selected to participate in the study. Data were collected in 1995-96 using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol for 6- and 7-year-olds. The study design and data quality assurance in all aspects followed the protocol, including the double entry of data. RESULTS: The questionnaire response rate was high (98.9%). Beijing children reported significantly more asthma than those living in Urumqi in three categories: wheezing or whistling in the chest in the past year (6.0%, 95% confidence interval (CI): 5.1-6.9% vs 2.9%, 2.3-3.5%, P < 0.001), sleeping disturbed due to wheezing (1.3%, 0.9-1.7% vs 0.6%, 0.3-0.9%, P < 0. 03) and having experienced asthma ever (10.7%, 9.6-11.8% vs 7.6%, 6. 6-8.6%, P < 0.001). The prevalence of allergic rhinitis (30.0% vs 31. 1% estimated as 12-month nasal symptoms in Beijing and Urumqi, respectively) and eczema (2.8% vs 2.0% recorded as 12-month itchy rash) in the two cities were not significantly different. A similar study was also performed in Hong Kong in 1995 using the same ISAAC protocol. The children in Urumqi and Beijing had fewer (P < 0.05) allergic symptoms compared to those living in Hong Kong (n = 3618). The 12-month prevalence of wheezing, nasal symptoms and itchy rash found in Hong Kong were 9.2% (95% CI: 8.2-10.2%), 35.1% (33.5-36.7%) and 4.2% (3.5-4.9%), respectively. CONCLUSION: : Urumqi, Beijing and Hong Kong represent communities at different stages of westernization and the results from these three cities reflect a worldwide trend for an increasing prevalence of allergies along with westernization. These three cities could assist in identifying risk factors involved in the increase in asthma, allergic rhinitis and eczema.

Asthma↗
PubMed2000

Foetal size to final height.

UNLABELLED: It is well known that some adult diseases, such as cardiovascular diseases, may be programmed during foetal life. It is not clear, however, whether final height may be predicted from foetal growth. A longitudinal cohort of full-term healthy Swedish babies (n = 3,650) was followed up from birth to maturity in a population-based growth study. Length or height and its changes were analysed from birth to 18 y of age; 2,807 children, with data available on birth length, final height and parental height, were included in this analysis. The result clearly shows that length at birth relates to final height. In terms of standard deviation scores (SDS), the mean difference in length at birth from the mean was greatly decreased in final height, but retained the same order as was seen at birth. In terms of centimeter difference from the reference mean values, the difference in length at birth remained roughly stable into final height. For instance, babies 5 cm above or below the mean birth length will end up approximately 5 cm above or below the mean in final height. Parental height-a surrogate value of the genetic final height potential of an individual-is shown to influence postnatal growth in height strongly. However, the difference from the mean in length at birth remained into adulthood within the same midparental height group. CONCLUSION: This study reveals that trends in foetal linear growth continue into maturity. Foetal growth is a significant predictor of postnatal growth. Final height is dependent on both the magnitude of foetal growth and the genetic potential in stature, and appears to some extent to be programmed from foetal growth.

Adolescent↗
PubMed2000

New reference for the age at childhood onset of growth and secular trend in the timing of puberty in Swedish.

UNLABELLED: The objectives of the present work were to present a new reference for the age at childhood onset of growth and to investigate the secular trend in the timing of puberty in a community-based normal population in Sweden. A total of 2,432 children with longitudinal length/height data from birth to adulthood were used to determine the two measures by visual inspection of the measured attained length/height and the change in growth velocity displayed on a computer-generated infancy-childhood-puberty (ICP) based growth chart. The series represents a sample of normal full-term children born around 1974 in Göteborg, Sweden. We found about 10% of children were delayed (>12 mo of age) in the childhood onset of growth based on the previous reported normal range, i.e. 14% in boys and 8% in girls. Distribution of the age at childhood onset of growth was skewed. The medians were 10 and 9 mo for boys and girls, respectively. After natural logarithmic transformation, the mean and standard deviation (SD) were 2.29 (anti-log 9.9 mo) and 0.226 for boys, 2.23 (anti-log 9.3 mo) and 0.220 for girls, respectively. The 95% normal ranges were 6.3-15.4 and 6.0-14.3 for boys and girls, respectively. The distribution of the timing of PHV was close to the normal distribution. The mean values were 13.5 y for boys and 11.6 y for girls with 1 y SD for both sexes. CONCLUSION: A downward secular trend in the onset of puberty was clearly shown in the population. The age at childhood onset of growth did not correlate with the timing of puberty (r = -0.01 and 0.05, p > 0.7 and 0.1 in boys and girls, respectively). Normal ranges of the age at childhood onset of growth are in need of revise, as this study indicates. The new reference presented here could be a reliable indicator in further studies.

Adolescent↗
PubMed2000

Blood pressure is associated with body mass index in both normal and obese children.

Obesity is associated with elevated blood pressure (BP) both in adults and children. Childhood obesity has become a severe health problem, especially during the last few decades. So far there has not been any large-scale study specifically focusing on the association between obesity and BP in early life. The aim of this study is to examine systematically the association between obesity and BP in preschool Chinese children in mainland China. In 1996, measurements of weight, height, and BP values were collected in a nationwide, case-control study of 748 boys and 574 girls who ranged in age from 0.1 to 6.9 years in 8 cities in mainland China. One obese child and 1 nonobese child were matched for gender and age. The BP differences of the mean-matched pair were approximately 5 mm Hg for systolic blood pressure (SBP) and approximately 4 mm Hg for diastolic blood pressure (DBP) (P<0.05); a higher value was noted in obese children. The BP value of 19.4% children in the obese group and 7.0% children in the nonobese group was higher than the 95th percentile value (P<0.0001), which is defined as high BP by the Task Force on Blood Pressure Control in Children. Both SBP and DBP were significantly (P<0.05) positively related to body mass index (BMI) values (P<0.05) for children in obese and nonobese groups after adjustment for age, gender, and height. To be specific, an increase of 1 BMI unit was associated with, on average, an increase of 0.56 mm Hg and 0.54 mm Hg in SBP and DBP, respectively, for obese children. In nonobese children, the increase in SBP and DBP was 1.22 mm Hg and 1.20 mm Hg, respectively. An increase in the BMI is conclusively associated with elevated SBP and DBP in nonobese children. Furthermore, an increase in the adjusted BMI was associated with an increase in SBP and DBP in obese and nonobese children.

Blood Pressure↗
PubMed2000

Fetal growth and early postnatal growth are related to blood pressure in adults.

It is commonly agreed that birth weight is associated with blood pressure in adults. However, not much is known about birth length, ponderal index, and early postnatal growth, whose effects on adult blood pressure, if any, can affect the interpretation of the birth weight-blood pressure association. This study examined the association between fetal growth, early postnatal growth, and blood pressure in Chinese adults. One hundred twenty-two subjects born in Hong Kong in 1967 were followed from birth to age 30 years. Multiple linear regression was used to analyze the association between size at birth, postnatal changes in body size, and systolic and diastolic blood pressure at age 30 years. Having adjusted for potential confounders and each other explanatory variable, it is found that birth length standard deviation score (regression coefficient or beta=-3.2), ponderal index at birth (beta=-1.8), and postnatal changes in ponderal index from age 6 months to 18 months (beta=-2.2) were inversely associated with systolic blood pressure (each P<0.05). Postnatal changes in length standard deviation score were not significantly associated with systolic blood pressure. Birth length standard deviation score was inversely associated with diastolic blood pressure at age 30 years (beta=-2.6; P<0.05). Other anthropometric variables were not associated with diastolic blood pressure. The results support the hypotheses that both fetal growth and early postnatal growth may have a long-term impact on blood pressure in adults. It also highlights the importance of differentiating length and weight for length.

Adolescent↗
PubMed2000

Long-term consequences of early linear growth retardation (stunting) in Swedish children.

Linear growth retardation (stunting) is prevalent (10-80%) in developing countries. It takes place between 6 and 18 mo of age and can be characterized by the delayed onset of the childhood phase of growth. The objective of this work was to study the existence of stunting in early life and, when present, its lifelong effects on final height in a normal healthy population in a developed country. A total of 2432 children with longitudinal height data from birth to adulthood were analyzed. The series represents a normal healthy population-based sample of full-term children born around 1974 in Göteborg, Sweden. We found the incidence of stunting to be about 10% as indicated by delayed onset of the childhood phase of growth (>12 mo of age): 14% in boys and 8% in girls. In a multiple linear regression model, final height was described by length at 6 mo of age, age at onset of the childhood phase of growth, and age at peak height velocity during puberty. All three measures contributed significantly (p < 0.05) to final height with a total R2 of 0.33. A final height difference of 5.0 cm could be explained by abnormal onset of the childhood phase of growth in this normal population. The timing of the childhood onset of growth did not correlate with the timing of puberty. For the first time, we can conclude that stunting in early life is not only a problem in developing countries. Its importance on final height achieved is clearly shown, even after controlling for the timing of puberty.

Body Height↗
PubMed2000

Fetal size to final height in Hong Kong Chinese children.

OBJECTIVES: It has been known that size at birth is important for postnatal growth and final height. However, there are few data in the literature on the difference in height growth patterns from fetal size to final height between less privileged and more privileged populations. The aim of this study was to describe the important features in height growth from birth to maturity in an underprivileged Hong Kong Chinese cohort in comparison to a more privileged Swedish cohort. METHODS: The longitudinal height growth data from birth to maturity in full-term healthy Hong Kong Chinese children (n=132) who were born in 1967 were analyzed, and compared with those for Swedish children who were born in 1973-75 (n=3650). RESULTS: Children with longer birth length achieved taller adult stature with respect to their target height. The mean final height retained the same order as that of the mean length at birth for various birth length groups. All children in the Hong Kong Chinese series showed catch-down height growth during the first 2 years of life, in contrast to the catch-up in smaller babies and catch-down in larger babies for the Swedish series. The growth deficit for the Hong Kong Chinese was -0.9 SDS at birth, -1.8 SDS at 2.0 years of age, -2.1 SDS at 8 years of age, and -1.7 SDS at final height. CONCLUSIONS: Fetal size is important for postnatal growth and attained final height with respect to a child's familial genetic potential in stature, not only for privileged populations, but also for underprivileged populations. However, children in underprivileged populations experience a persistent increasing growth deficit during infancy and childhood. Special attention should be given to monitor their growth status in early years and to institute appropriate intervention programs.

Adult↗
PubMed2000

Population-based body mass index reference values from Göteborg, sweden: birth to 18 years of age.

UNLABELLED: The body mass index or BMI (weight/height2) is a somewhat crude estimate of nutritional status. However, due to its simplicity and high correlation with total body fat, it has been the method of choice in both paediatric clinics and research over the years. Since BMI is not an equivalent measure of the percentage of body fat in different ethnic groups and in the two sexes, population-specific BMI reference data is needed. Several BMI reference values have been published for French, American, British and Hong Kong children in recent years. In Sweden, weight-for-age and height-for-age reference values, which were published in 1976, are still used as the current national growth reference values. Updated growth reference values are needed for assessing nutritional status due to the secular trend toward and increasing prevalence of childhood obesity. The aim of this study was to produce BMI reference values for Swedish children of paediatric age. The series came from a large Swedish population-based longitudinal growth study of 3650 full-term babies followed from birth to 18 y of age. The children in this data set were born in the early 1970s. The pattern and level of 50th centile BMI values presented here are quite similar to those of the Swedish cohort study in the 1950s. In comparison with the US BMI reference values, the Swedish values are much lower, especially for the higher centile values. CONCLUSION: The new Swedish BMI chart from our study may provide a useful tool for paediatricians to assess body fat, and consequently nutritional status, in Swedish children.

Adolescent↗
PubMed1999

Early linear growth retardation in Chongqing, China.

OBJECTIVES: The objectives of this study were to investigate early linear growth retardation and to identify potential risk factors for it. METHODOLOGY: A community-based prospective study was performed in Chongqing, China, with infants being examined at 12 and 15 months of age. A total of 101 infants were examined twice. Supine length, bodyweight, lower leg length, head circumference, middle upper arm circumference and biceps skinfold thickness were measured. RESULTS: The prevalence of short stature (length-for-age standard deviation score, < -2) was 22% and 23% at 12 and 15 months of age, respectively, while the incidence of growth stunting (low growth velocity) between 12 and 15 months of age was 24%, using the stunting screening method. A mother having a history of abortion and infants having current episodes of diarrhoea were identified as risk factors for growth stunting. CONCLUSIONS: We conclude that both short stature and growth stunting are common in the population studied. The stunting screening method used is applicable in developing communities.

Anthropometry↗
PubMed1999

A comparison of target height estimated and final height attained between Swedish and Hong Kong Chinese children.

Target height, the genetic potential in stature, is commonly estimated by the corrected midparental height (CMH) method. A new model for estimating target height has recently been introduced based on a large, Swedish, population-based study. The aim of this study was to compare the validity of the two methods for estimating target height in Hong Kong Chinese children. The Hong Kong Chinese were more than 10 cm shorter than the Swedes in stature. The secular increase in height over the two generations, however, was 4.2-4.8 cm for the Hong Kong Chinese, much larger than that of the Swedes (0.7-1.0 cm). The two populations are thus at different stages in the secular trend. The new model derived from Swedish population for estimating target height was shown to be applicable to Hong Kong Chinese children; the mean of residual final height values was close to zero (-0.15 cm, p = 0.74). However, the mean of residual final height was significantly above the expected value of zero (4.5 cm, p<0.0001) when the CMH method was applied to the data, which implies an underestimation bias of 4.5 cm. Consequently, if the CMH method is used to estimate target height and evaluate growth hormone treatment responses in short children, it may inflate the treatment response by 4.5 cm. In conclusion, the recently proposed model for target height estimation offers a better alternative for estimating target height in Hong Kong Chinese children and for assessing growth-promoting treatments.

Bias↗
PubMed1999

Prediction of adult overweight during the pediatric years.

Obesity in adults is associated with an increased mortality rate from various diseases. Childhood overweight or obesity may persist into adulthood, and for this reason it is important to identify such children at risk. The data were taken from a larger longitudinal growth study of 3650 full-term and healthy Swedish babies followed from birth to 18 y of age. Body mass index (BMI) was used to estimate (during the pediatric years) the risk of obesity at 18 y of age. A probability chart for becoming overweight (>25 kg/m2) by 18 y of age was constructed, For example, in girls, a BMI of 16 kg/m2 at 4 y of age is associated with a 20% risk of attaining a BMI value over 25 kg/m2 at 18 y, and in boys at 4 y of age, a BMI of 19 kg/m2 leads to a 60% risk that they will have a BMI value over 25 kg/m2 at 18 y. The probability risk charts for adult overweight developed here is the first one presented. They provide an easy and novel instrument to use to identify those children who are at high risk of becoming obese adults, so that they may have clinical intervention at younger ages.

Adolescent↗
PubMed1998

Prevalence and risk factors of childhood asthma, rhinitis and eczema in Hong Kong.

OBJECTIVE: To assess the prevalence and risk factors of childhood asthma and allergies in Hong Kong and compare with that in Singapore and Great Britain. METHODOLOGY: Parents of 3618 randomly selected 6- to 7-year-old children responded to a questionnaire prepared by the International Study of Asthma and Allergies in Childhood (ISAAC) together with supplementary questions on risk factors. RESULTS: The 12-month prevalences of wheezing, rhinitis symptoms and itchy rash were 9.2%, 35.1% and 4.2%, respectively. Wheezing in the past year was significantly associated with rhinitis symptoms in the past year, itchy rash in the past year, rhinitis interfering with daily activities moderately or severely, kept awake by itchy rash in the past year, parental wheezing (one or both parents), frequent upper respiratory tract infections (URTI), born in Hong Kong and male sex. For girls, the prevalence of wheezing in the past year was lowest when they were born in July/August and highest when born in January/February. CONCLUSIONS: The prevalence of allergic disorders in Hong Kong was comparable to that in Singapore and Great Britain. Several potential risk factors such as parental wheezing, frequent URTI, born in Hong Kong, male sex and month of birth in girls were identified.

Asthma↗
PubMed1998

Risk factors for impaired length growth in early life viewed in terms of the infancy-childhood-puberty (ICP) growth model.

A difference in length or height growth is observed between populations in developing and developed countries and, within a country, between well-off and poor subpopulations. The aim of this community-based study was to identify possible risk factors for growth stunting in early life using the infancy-childhood-puberty (ICP) growth model. A periurban slum, a village and an urban slum, plus a local control group in Lahore, Pakistan, were investigated. In total, there were 425 infants born from September 1984 to March 1987 in the study. Children were followed from birth to 24 months and anthropometric data were recorded at each examination. A well-designed questionnaire was used to collect background information to identify risk factors for growth faltering over this period. The age at onset of the childhood component was determined individually using the ICP growth model. A late onset was defined as onset after 12 months. Univariate odds ratio analysis identified 20 significant risk factors for a delayed childhood onset in the total sample. Backward logistical analysis showed that only six variables were significant, i.e. small number of rooms in a household, episode(s) of diarrhoeal diseases, poor house structure, low body mass index, early end of breastfeeding and birth in warm season. Stratified analysis showed that episode(s) of diarrhoeal diseases and birth in warm season were the only significant risk factors in the two poor areas. This study also found that the impact of diarrhoeal diseases on length growth persisted after allowing for birth season. Seasonal variation in length growth was seen in the age at onset of the childhood component. General socioeconomic status was found to be a risk factor for growth faltering in early life. Diarrhoeal diseases and being born in a warm season are particular risk factors for growth faltering in early life.

Adolescent↗