Estadios de Tanner y orquidometría de Prader en varones adolescentes. Estudio descriptivo transversal / Tanner stages and Prader orchidometry in male adolescents. A descriptive, cross-sectional study

Introducción. La escala de Tanner y el orquidómetro de Prader son los instrumentos más utilizados para evaluar el desarrollo puberal en los niños. La evaluación de la pubertad en la clínica solo es útil si se dispone de datos de referencia recientes y confiables de la misma población para comparar. Objetivo: evaluar la correlación entre los estadios de Tanner y el volumen testicular (VT) en adolescentes argentinos. Población y métodos. Diseño descriptivo transversal, realizado con varones saludables de 9 a 20 años de edad. Se excluyeron varones con patología urogenital y enfermedades que afectan el crecimiento testicular. La correlación entre estadios de Tanner y VT fue evaluada con pruebas no paramétricas. Resultados. Se evaluaron 367 varones con una edad de 13,8 ± 2,5 años. El VT aumentó en correlación a los estadios de Tanner (Spearman 0,943; p <0,001) con volúmenes significativamente diferentes, salvo en los estadios iniciales genital 1-2 (p 0,343) y vello púbico 1-2 (p 0,447). El 16 % (intervalo de confianza del 95 % 9,6-24,4 %; n = 17/106) de los varones peripuberales fue clasificado erróneamente basado en los estadios de Tanner. Conclusiones. Durante la pubertad masculina, el VT aumentó en correlación con los estadios de Tanner, pero no presentó diferencias significativas entre los estadios 1 y 2 de Tanner. Es fundamental el uso del orquidómetro de Prader para detectar el inicio puberal en varones.

Introduction. The Tanner scale and the Prader orchidometer are the instruments most commonly used to assess pubertal development in children. The assessment of puberty in the clinic is only useful if recent and reliable references in the same population are available for comparison. Objective: to assess the correlation between Tanner stages and testicular volume (TV) in Argentine adolescents. Population and methods. Study with a descriptive, cross-sectional design conducted in healthy boys aged 9­20 years. Male children and adolescents with urogenital conditions and disorders affecting testicular growth were excluded. The correlation between Tanner stages and TV was assessed using non-parametric tests. Results. A total of 367 male adolescents with an average age of 13.8 ± 2.5 years were assessed. TV increased in correlation to Tanner stages (Spearman: 0.943, p < 0.001) with significantly different volumes, except in the early genital 1-2 stages (p 0.343) and pubic hair 1-2 stages (p 0.447). Among peripubertal boys, 16% (95% confidence interval: 9.6­24.4%, n = 17/106) were wrongly classified based on Tanner stages. Conclusions. During male puberty, TV increased in correlation to Tanner stages, but no significant differences were observed between Tanner stages 1 and 2. Using the Prader orchidometer is critical to establish the onset of puberty in boys

Growth and Nutritional Status of Kandra (Fisherman) Adolescent Girls from Ganjam, Odisha, India.

Introduction: The National Family Health Survey-4 data from Odisha shows, adolescent growth spurt and nutritional level needs to be studied comprehensively for designing appropriate policies. Kandra community of Odisha is a Schedule Caste (SC) community with low socio-economic status. No study has been done on growth spurt of girls from this community. Hence, the paper examined growth and nutritional trend and test for significant difference on height, weight, and Body Mass Index (BMI). Methodology: Cross-sectional study with 78 sample were collected from one Gram Panchayat of Ganjam district, India. Somatometric measurements i.e., height, weight, chest, and calf circumference were collected from school-going adolescent, randomly. Mean difference between early and middle adolescent were seen through Levene's Test for equality of variances and independent sample-t-test. Result: Findings say, adolescent growth spurt was highest at age 13-14 years. The overall median height and weight were reported less than Indian and National Center for Health Statistics (NCHS) standards. The difference between 12-13 years and 14-16 years were significant at p<.001 for BMI. Conclusion: Findings were like the gaps reported in NFHS-4 nutritional indictors and is a concern as the girls are going to be future mother, and deficiency may pull their life into risk.

Concordancia en la medición testicular de varones adolescentes con 3 métodos de orquidometría / Concordance of testicular measurement in male adolescents with three methods of orchidometry

Introducción. El orquidómetro de Prader es el método estándar para medir el volumen testicular (VT) en niños y adolescentes. Objetivo. Evaluar la concordancia en la estimación del VT y del inicio puberal con las técnicas de orquidometría de Prader, Chipkevitch y Sotos. Métodos. Diseño descriptivo transversal realizado en varones de entre 9 y 20 años. Se midió el VT (ml) en cada adolescente con las técnicas de Prader (método de referencia), Chipkevitch (modelo gráfico) y Sotos (medición de ancho testicular con regla plástica y fórmula equivalente a ecuación elipsoide). Se excluyeron varones con patología urogenital y enfermedades que afectan el crecimiento testicular. Para la concordancia entre métodos, se utilizó kappa para el inicio puberal, y coeficiente de correlación intraclase (CCI) y gráficos de Bland-Altman (GBA) para el VT. Resultados. Se incluyeron 377 varones sanos. Para la concordancia en VT (ml), la comparación Prader-Chipkevitch obtuvo CCI: 0,994 y p < 0,001; y de CCI; 0,312 y p < 0,001 para la de Prader-Sotos. En los GBA se halló una media de las diferencias cercana a 0 ml en la comparación Prader-Chipkevitch y cercana a 8 ml en la de Prader-Sotos. El acuerdo en el inicio puberal obtuvo un valor de kappa 0,93 en la comparación Prader-Chipkevitch y de 0,75 en la de Prader-Sotos. Conclusión. Los orquidómetros de Prader y Chipkevitch tienen una excelente concordancia en la estimación del VT y el inicio puberal; por lo tanto, podrían intercambiarse en la atención diaria de varones adolescentes. El método de Sotos mostró una concordancia buena en la estimación del inicio puberal, pero baja en la medición del VT

Introduction. The Prader orchidometer is the standard method used to measure testicular volume (TV) in children and adolescents. Objective. To assess the concordance in the estimation of TV and puberty onset with the Prader, Chipkevitch, and Sotos orchidometric techniques. Methods. Cross-sectional descriptive study conducted among male children and adolescents aged 9-20 years. For each adolescent, TV was measured with the methods by Prader (gold standard), Chipkevitch (graphic model), and Sotos (measurement of testicular width with a plastic ruler and use of a formula equivalent to the ellipsoid equation). Male children and adolescents with urogenital conditions and disorders affecting testicular growth were excluded. Kappa statistics was used to determine concordance among methods for puberty onset, and intraclass correlation coefficient (ICC) and Bland-Altman (B&A) plots for TV. Results. In total, 377 healthy males were included. Regarding the concordance for TV (mL), the Prader-Chipkevitch comparison obtained an ICC of 0.994 and a p < 0.001; while the Prader-Soto comparison obtained an ICC of 0.312 and a p < 0.001. With the B&A plots, mean differences were close to 0 mL in the Prader-Chipkevitch comparison and close to 8 mL in the Prader-Sotos comparison. Concordance for puberty onset obtained a kappa value of 0.93 and 0.75 in the Prader-Chipkevitch and Prader-Sotos comparisons, respectively. Conclusion. The Prader and Chipkevitch orchidometers show an excellent concordance in estimating TV and puberty onset; therefore, both methods could be used interchangeably in the daily care of male adolescents. The Sotos method showed a high concordance in estimating pubertal onset, but low in measuring TV.

Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents / Associação entre índice de massa de gordura e índice de massa livre de gordura e risco cardiovascular em adolescentes

To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Methods: Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Results: Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective.

Descrever a relação entre valores de índice de massa de gordura e índice de massa livre de gordura e fatores associados a risco cardiovascular em adolescentes de Juiz de Fora (MG). Métodos: Estudo transversal feito com 403 adolescentes de 10-14 anos, de escolas públicas e privadas. Avaliaram-se medidas antropométricas, clínicas, bioquímicas, autorrelato do tempo dedicado ao exercício físico, atividades sedentárias e estágio de maturação sexual. Resultados: Quanto ao estado nutricional, 66,5% dos adolescentes estavam eutróficos, 19,9% com sobrepeso e 10,2% obesos. Para ambos os sexos, o índice de massa de gordura foi maior nos adolescentes que estavam com triglicerídeos séricos, índice de massa corporal e circunferência da cintura elevados. Conclusões: Os adolescentes que tinham características antropométricas, clínicas e bioquímicas consideradas de risco para o desenvolvimento de doenças cardiovasculares apresentaram maiores valores do índice de massa de gordura. Metodologias diferenciadas para avaliação da composição corporal tornam a promoção da saúde e a prevenção de agravos futuros mais eficazes.

Somatic maturation and body composition in female healthy adolescents with or without adjustment for body fat / Maturacion somatica y composicion corporal en adolescentes eutroficos del sexo femenino con o sin adecuacion de grasa corporal / Maturacao somatica e composicao corporal em adolescentes eutroficos do sexo feminino com ou sem adequacao de gordura corporal

Objective: To evaluate the relationship between the stages of somatic maturation and body composition in eutrophic female adolescents with or without excessive body fat. Methods: Cross-sectional study of 118 female adolescents, from 14 to 19 years-old, in Viçosa, Minas Gerais, Southeast Brazil. The adolescents were divided in two groups: Group 1 (G1), eutrophic with adequate body fat percentage, and Group 2 (G2), eutrophic with high body fat percentage. The somatic maturation was assessed by the formula for estimating the Peak Height Velocity (PHV). Results: The PHV had higher average score in G1 adolescents compared to G2 (0.26 versus 0.05; p=0.032). There was an association between G1, G2 and the somatic maturation (p=0.049). The female adolescents before and during PHV presented higher values of fat body BMI (p=0.034) and percentage of central fat (p=0.039) compared to the adolescents after PHV. There was a correspondence between before PHV stage and the excess of body fat (α=0.751). Conclusions: There was an association between somatic maturation and body composition in eutrophic female adolescents. Length, BMI and fat percentage were different among the somatic maturation stages. It is relevant to evaluate the somatic maturation and the changes occurring in the body composition during adolescence in order to better evaluate and manage the nutritional status and the body fat excess. .

Objetivo: Evaluar la relación entre las etapas de maturación somática y de composición corporal en adolescentes del sexo femenino eutróficas, con o sin exceso de grasa. Métodos: Estudio transversal con 118 adolescentes del sexo femenino, de 14 a 19 años, en Viçosa, Minas Gerais (Brasil), divididas en dos grupos: Grupo 1 (G1) - eutróficas con porcentaje elevado de grasa corporal - y Grupo 2 (G2) - eutrófica con porcentaje adecuado de grasa. Se evaluó la maturación somática por la fórmula de estimativa del Pico de Velocidad de Crecimiento (PVC). Resultados: El PVC tuvo mayor escore mediano en las adolescentes del G1 en comparación al G2 (0,26 versus 0,05; p=0,032). Hubo asociación entre G1, G2 y las etapas de maturación somática (p=0,049). Las adolescentes en las etapas pre y durante PVC presentaron valores mayores de IMC, de grasa (p=0,034) y porcentaje de grasa central (p=0,039) que las adolescentes post-PVC. Hubo correspondencia entre la etapa pre-PVC y el exceso de grasa corporal con poder discriminatorio satisfactorio (α=0,751). Conclusiones: Los resultados mostraron asociación entre la maturación somática y la composición corporal de adolescentes eutróficas del sexo femenino. Variables como estatura, IMC y porcentaje de grasa fueron distintos entre las etapas de clasificación de la maturación somática. Así, es relevante evaluar la maturación somática y las alteraciones que tienen lugar con la composición corporal durante la adolescencia, visando a evaluar y a controlar mejor el estado nutricional y la acumulación de grasa corporal. .

Objetivo: Avaliar a relação entre os estágios de maturação somática e de composição corporal em adolescentes do sexo feminino eutróficas, com ou sem excesso de gordura. Métodos: Estudo transversal com 118 adolescentes do sexo feminino, de 14 a 19 anos, em Viçosa, Minas Gerais, divididas em dois grupos: Grupo 1 (G1) - eutróficas com percentual adequado gordura corporal - e Grupo 2 (G2) - eutróficas com percentual elevado de gordura. Avaliou-se a maturação somática pela fórmula de estimativa do Pico de Velocidade de Crescimento (PVC). Resultados: O PVC teve maior escore médio nas adolescentes do G1 em comparação ao G2 (0,26 versus 0,05; p=0,032). Houve associação entre G1, G2 e os estágios de maturação somática (p=0,049). As adolescentes nos estágios pré e durante PVC apresentaram maiores valores de IMC de gordura (p=0,034) e percentual de gordura central (p=0,039) do que as adolescentes pós-PVC. Houve correspondência entre o estágio pré-PVC e o excesso de gordura corporal com poder discriminatório satisfatório (α=0,751). Conclusões: Os resultados mostraram associação entre a maturação somática e a composição corporal de adolescentes eutróficas do sexo feminino. Variáveis como estatura, IMC e percentual de gordura foram diferentes entre os estágios de classificação da maturação somática. Assim, é relevante analisar a maturação somática e as alterações que ocorrem com a composição corporal durante a adolescência, visando avaliar e controlar o estado nutricional e o acúmulo de gordura corporal. .

Menarcheal timing and growth curve shape during the adolescent growth spurt / 대한치과교정학회지

OBJECTIVE: This study investigated the onset, peak height velocity (PHV) and end of adolescent growth spurt as well as menarcheal timing deduced from surveying accumulative height growth over many years. METHODS: Ninety six students of Samgoe high school between 1st and 3rd grade that were in good health participated in the research. A survey questionnaire was distributed to examine the students' health status and menarche timing. RESULTS: Adolescent growth spurt typically began at the age of 9.9 and reached a PHV at the age of 11.6. The growth spurt ended at the age of 14.1 on average. The average age of menarche was 12.6 years, which was about one year after the PHV of adolescent growth spurt. In most cases, menarche came after PHV. But in 24% of the students, menarche and PHV was nearly coincident or menarche preceded PHV. The growth curves were classified into four types. A typical adolescent growth spurt showed one PHV on graph that drastically drops after the PHV. However, there were cases with two PHVs. CONCLUSIONS: The results indicate that individual growth patterns show large individual differences, however the categorization into the various growth curves may aid in predicting individual growth patterns.

Adolescent nutrition and growth / 소아과

Nutrition is an essential component of total adolescent health care. Two important changes occurring during adolescence can cause a crisis in the teenager's nutritional needs. First, growth in height, weight, and body component is greater and more rapid than at any time since infancy. Second, an adolescent's eating habits may change from regular meals prepared at home to irregular meals, skipped meals, and nutrition-poor snacks and fast-food meals. Adolescents have been found to have the highest prevalence of any age group of an unsatisfactory nutritional status. To understand the nutritional requirements of the adolescent, health practitioners should be aware of the intensity and timing of the adolescent growth spurt, the differences in the growth spurt between males and females, and the individual variation in timing of the growth spurt from teenager to teenager.

Serum leptin levels in healthy adolescents: Effects of gender and growth

<p><b>OBJECTIVES</b>The purposes of this paper were to evaluate the serum leptin levels in healthy adolescents and to establish standard age variation curves.</p><p><b>METHODS</b>Nine hundred six (414 boys and 492 girls) healthy adolescents were investigated. The maximum increment age in height (MIA) was identified in 124 boys and 130 girls. The menarcheal age (MA) was obtained for 130 girls. Fasting leptin levels were measured by enzyme immunoassay. The MIA was calculated by proportional allotment of yearly height increments.</p><p><b>RESULTS</b>Serum leptin levels did not change in boys and girls from the ages of 9 to 11. They decreased after the age of 11 in boys, while they increased in girls. Stepwise multiple regression analysis revealed that serum leptin levels were closely related to pubertal stage. The levels decreased remarkably after MIA in boys and increased remarkably after MA in girls. We drew standard age variation curves of serum leptin levels by calculating the 25th, 50th and 75th percentiles for each age in both boys and girls. The percentile curves for boys were divided into pre-MIA and post-MIA curves. Those for girls were divided into pre-MA and post-MA curves.</p><p><b>CONCLUSION</b>We have devised a potentially useful method for evaluating serum leptin levels in adolescents considering the effects of gender and growth.</p>

Serum Leptin Levels in Healthy Adolescents: Effects of Gender and Growth

Objectives: The purposes of this paper were to evaluate the serum leptin levels in healthy adolescents and to establish standard age variation curves. Methods: Nine hundred six (414 boys and 492 girls) healthy adolescents were investigated. The maximum increment age in height (MIA) was identified in 124 boys and 130 girls. The menarcheal age (MA) was obtained for 130 girls. Fasting leptin levels were measured by enzyme immunoassay. The MIA was calculated by proportional allotment of yearly height increments. Results: Serum leptin levels did not change in boys and girls from the ages of 9 to 11. They decreased after the age of 11 in boys, while they increased in girls. Stepwise multiple regression analysis revealed that serum leptin levels were closely related to pubertal stage. The levels decreased remarkably after MIA in boys and increased remarkably after MA in girls. We drew standard age variation curves of serum leptin levels by calculating the 25th, 50th and 75th percentiles for each age in both boys and girls. The percentile curves for boys were divided into pre-MIA and post-MIA curves. Those for girls were divided into pre-MA and post-MA curves. Conclusion: We have devised a potentially useful method for evaluating serum leptin levels in adolescents considering the effects of gender and growth.