Change in waist circumference over 3 years in Turkish children and adolescents.

AIM: To observe change in waist circumference (WC) over 3 years in children and adolescents and to compare these data with local and international references. SUBJECTS AND METHODS: The data of the second study determining the anthropometric measurements of Turkish children and adolescents (DAMTCA-II) were used to calculate WC percentiles. A total of 4234 children and adolescents aged 6-17 years (1890 boys and 2344 girls) were enrolled. The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentiles and z-scores were computed by the LMS Method. RESULTS: The mean WC was significantly higher in boys than in girls in 12.5, 13 and 15-17 year old children (p < 0.001). The prevalence of central obesity (WC ≥ 90th percentile) was 13.5% (14.3% in boys and 12.9% in girls, respectively). There was no significant difference in prevalence of abdominal obesity, between each gender (p = 0.179) and age group from 6-17 years (p = 0.590). In a comparison with the available contemporary international references, the 50th percentiles of these references were similar to those in Bulgaria, but markedly higher than those of Malaysian children and of Chinese children living in Hong Kong. CONCLUSIONS: The prominent finding of this study was the significant increase in WC percentiles in a short time in both genders. In addition, the WC references are similar to other regional references, but significantly higher than those of East Asia.

Weight for length/height percentiles in infants and young children in Kayseri/Turkey.

OBJECTIVE: To produce weight for length/height (WLH) percentiles to be used for the screening of growth and assessment of failure to thrive in infancy and early childhood. METHODS: The data (2009-2010) of the Anthropometry of Turkish Children aged 0-6 years (ATCA-06) study were used. A cross-sectional study was designed to calculate the WLH references. Reference weight values for each 5-cm LH intervals were determined using the LMS Chart Maker Pro version 2.3 software program (The Institute of Child Health, London). RESULTS: A total of 3123 children (1573 female, 1550 male) aged 0-6 years were included in the calculation of the 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th WLH percentiles. The difference between the 3rd and the 97th percentiles for males was 2.02 cm to 12.64 cm in the 50-54.99 cm and 125-130 cm LH ranges. In the girls, the differences between the 3rd-97th percentiles ranged from 2.02 cm to 12.64 cm in the 50-54.99 cm and 125-130 cm LH groups. The maximum difference between the 3rd and 97th percentiles was about half the variation of mean WLH throughout the first six years of life. The most rapid change in WLH was observed in the 0-2-year period. Turkish references for WLH were not different from the World Health Organization standards. CONCLUSIONS: This is the first study in Turkey presenting WLH references in 0-6 year old children. We suggest that the use of WLH in the first two years of life may be more useful than age-adjusted references in assessment of nutritional status and diagnosis of failure to thrive.

Interpopliteal distance percentiles to diagnose bowleg in 0-84 month-old Turkish children.

The purpose of this study was to determine the percentiles of interpopliteal distance to diagnose bowleg in 0-6 year-old children. Measurement of interpopliteal distance is a simple but valuable indicator in clinical examination to diagnose bowleg. We analyzed data from the anthropometry of Turkish children aged 0-6 years. The primary sampling unit included 21 family health centers (Aile Sagligi Merkezi) located in the city center and suburbs of Kayseri, Turkey. A total of 2,873 children and adolescents (1,419 boys, 1,454 girls), whose parents gave consent were included in the study. The smoothed percentiles and Z-scores were calculated by age and gender in 0-6 year-old children in quarter year intervals except for the 0-28-day newborn period. We found a significant correlation (r: 0.60, p < 0.001) between body weight and interpopliteal distance (after onset of walking). We consider that percentiles of interpopliteal distance can be used in the follow-up of children who may be at risk of bone and growth disorders. The zone between -2 standard deviation (SD) and +2SD values can be used to decide if the child has a normal growth pattern.

Normal standards of eye projection in Turkish children 6 to 17 years of age.

BACKGROUND: There are a few international and Turkish reports on children's eye projection references. METHODS: This is a cross-sectional study. Data were obtained from the second study of the Determination of Anthropometric Measurements of Turkish Children and Adolescents study group (DAMTCA II).The study population was 4,533 primary and secondary school students aged 6 to 18 years (2,512 girls, 2,021 boys). A Hertel exophthalmometer was used; age- and gender-specific means and standard deviations and percentiles were calculated for eye projection. RESULTS: The 3rd, 5th, 10th, 25th, 50th, 75th, 80th, 85th, 90th, 95th, and 97th percentiles of right and left eye projection, and the mean and standard deviation for each age and gender were calculated. In 6-year-old children, the smoothed eye projection of the 3rd-97th percentiles for the right and left eye in boys were detected as 11.2 mm-17.0 mm for right eye and 11.1 mm-17.0 mm for left eye. In 17-year-old male adolescents, the 3rd-97th percentiles were detected as 11.9 mm-19.5 mm for the right eye and 11.8 mm-19.2 mm for the left eye. The 3rd-97th percentiles in 6-year-old girls were detected as 11.1 mm-17.1 mm for the right eye and 10.9 mm-17.1 mm for the left eye. In 17-year-old girls, the 3rd-97th percentiles were detected as 11.7 mm-19.4 mm for the right eye and 11.8-19.2 mm for the left eye. CONCLUSIONS: Age- and gender-specific references for exophthalmos provide important information both for the clinical decision-making process, and screening in the diagnosis of abnormal or pathological conditions which result in exophthalmos.

Percentiles and mean values for neck circumference in Turkish children aged 6-18 years.

AIM: To provide neck circumference (NC) percentiles and mean values for Turkish children and to investigate their significance in clinical and epidemiological use. METHODS: Data were obtained from a cross-sectional screening study; DAMTCA II (Determination of Anthropometric Measurements in Turkish Children and Adolescents) in which 5481 subjects from 17 primary, secondary and high schools were included. NC percentiles were produced using the LMS method, and NC was compared with other parameters which define body fat distribution. RESULTS: The smoothed NC curves of 3rd, 5th, 15th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentiles were constructed by age and gender. The descriptive characteristics of collected data were presented as mean (SD: standard deviation) and median (Min-Max: minimum-maximum) to provide detailed information other than smoothed values. The most prominent finding of this study was that the NC of boys was greater, but not significantly higher, than that of girls until the age of 12 but later a prominent increase in the NC of boys is observed compared with girls. We compared obese and non-obese children in the 6-10, 11-13, 14-18 age groups, NC was found to be an important parameter to define obesity. CONCLUSIONS: This study provides NC percentiles, means and medians values and analyses their significance in obesity evaluation in clinical practice.

Anthropometric risk factors for elevated blood pressure in adolescents in Turkey aged 11-17.

To investigate the relationship between anthropometric parameters and elevated blood pressure in adolescents, we measured blood pressure (BP), height, weight, triceps skinfold (TSF) thickness, waist circumference (WC), and mid-upper-arm circumference (MUAC) in 2,860 student volunteers aged 11-17 years in Kayseri, Turkey. Waist-to-height ratio (WHtR), waist-to-arm-span ratio (WASR), body mass index (BMI), arm-fat area (AFA), and fat percentage (FP) were also calculated. Participants were divided into two groups: hypertensive [systolic blood pressure (SBP) or diastolic blood pressure (DBP) ≥ 95th percentiles, n = 246] and normotensives (SBP or DBP < 95th percentiles, n = 2614). Multiple logistic regression models were produced within these groups for the examined risk factors, and cutoff points were investigated for SBP or DBP ≥ 95th percentiles using receiver operating characteristics (ROC) analysis. BMI, WC, WHtR, WASR, MUAC, and BMI had statistically significant cutoffs among boys. Whereas BMI, WHtR, WASR, WC, MUAC, AFA, and TSF were statistically significant for girls younger than 15, only BMI and WC were statistically significant for participants older than 15. The independent risk factors for elevated BP were determined according to BMI and WC. Although several anthropometric measurements were significant in our participants, BMI and WC were significant among all participants irrespective of age and sex.

Body fat reference curves for healthy Turkish children and adolescents.

UNLABELLED: Childhood obesity is a major worldwide health problem. In addition to body mass index (BMI), body fat percentiles may be used to predict future cardiovascular and metabolic health risks. The aim of this study is to define new age- and gender-specific body fat centiles for Turkish children and adolescents. A total of 4,076 (2,276 girls, 1,800 boys) children and adolescents aged 6-18 years were recruited for this study. Total body fat was measured by a bioelectrical impedance noninvasive method. Body fat percentiles were produced by the LMS method. The body fat percentile curves of boys appear to rise from age 6 to 12 years and then slope downwards to age 15 years and then flatten off. The body fat % percentiles of girls increased until 14 years of age through 75th to 97th percentiles and then slope downwards, but through the third to 50th percentiles, they showed a downward slope after 14 years old. CONCLUSIONS: Since BMI may not always reflect body fat content, direct assessment of adiposity by a practical method would be significantly useful for clinical decisions. Therefore, this study provides normative data for body fat percentage in healthy Turkish children and adolescents. To this goal we used a practical and clinically applicable method. These references can be useful for evaluation of overweight and obesity.

Exophthalmometric references of 7-18 year-old children in Kayseri, Turkey.

AIM: To produce age and gender specific exophthalmos references for Turkish children aged 7-18 years old. STUDY DESIGN: This was a preliminary cross-sectional study. Data were obtained from the second study of the Determination of Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA II). A Hertel exophthalmometer was used and age and gender specific standard deviations (SD) and percentiles were calculated. RESULTS: The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th 97th percentiles of right and left eye protrusion, and the mean and SD for each age and gender were calculated. In comparison of eyes and genders: Protrusion in the right eye was 14.81 (1.68), and 14.65 (1.67) in the left eye for boys. Protrusion in the right eye was 14.95 (1.68) and 14.75 (1.67) in the left eye of girls. In both genders the difference in protrusion of the two eyes was statistically significant (p <0.001). Exophthalmometric measurements were compared for pubertal periods by one-way analysis of variance and a significant difference was found in exophthalmos between pubertal periods for both eyes and gender (p <0.001). CONCLUSIONS: Age and gender specific references for exophthalmia provide information for both clinical decision process and screening in describing abnormal or pathological conditions resulting in exophthalmos.

Age references for the arm span and stature of Turkish children and adolescents.

BACKGROUND: Arm span reference values need to be determined in screening for certain clinical conditions. AIM: To determine arm span reference values for screening purposes in children and adolescents. SUBJECTS AND METHODS: Children and adolescents aged 6-17 were selected according to socio-economic levels. Age, pubertal period and sex-specific height and arm span are presented as means and standard deviation. Construction of the centile curves was performed using LMS software; the 3rd, 50th and 97th percentiles of each sex were compared. RESULTS: A total of 5358 primary and secondary school students (2737 girls, 2621 boys) were sampled for this study. Centile curves for both genders and linear regression equations to predict height from arm span were produced (height = 13.4396 + 0.9037(arm span); r =0.95 for boys and height = 16.4181 + 0.8865 (arm span); r =0.93 for girls). The correlation between arm span and height (r =0.83 p=0.001) was high and significant through ages 6-17. CONCLUSION: The findings provide a comparison of height and arm span for clinical purposes in critical percentiles (3rd, 50th and 97th), although these findings suffer from a lack of longitudinal examination to show the progress of these two anthropometric measurements.

Cutaneous manifestations in childhood staphylococcal sepsis.

In this article, the clinical and laboratory findings of six (15%) cases of cutaneous manifestations of 39 patients with sepsis caused by Staphylococcus aureus (S. aureus) were reviewed retrospectively. Our purpose was to determine the cutaneous manifestations in patients with sepsis caused by S. aureus. In our study, four patients had maculopapular and/or petechial/purpuric rashes, and two had erythematous lesions (one of them also had pustular lesions, and the other had furuncles). Aside from these, all patients had one or more systemic involvement such as bronchopneumonia, arthritis, osteomyelitis, or cardiac involvement. In conclusion, our findings suggest that there are no skin findings specific to staphylococcal sepsis and that pulmonary infections appear to have a high correlation with cutaneous findings, because all of our patients had evidence of bronchopneumonia. The mortality of staphylococcal sepsis associated with cutaneous findings appears to be high.