The relationship between short-term changes in weight and lower leg length in children and young adults
ABSTRACT As the knemometer is increasingly being used to study changes in lower leg length in conditions associated with weight changes it is important to clearly delineate the relationship between these two variables. Lower leg length and weight were measured in 26 children and nine adults including one pregnant woman. There was a weak but positive relationship between lower leg length and weight fluctuation in children. Daily fluctuations in weight as well as lower leg length were higher in women than men; median lower leg length fluctuation: women, 0.16 mm (P5-0, P95-0.7); men, 0.1 mm (P5-0, P95-0.48) p approximately 0.02, Wilcoxon signed-rank test. Median weight fluctuation: women 0.15 kg (P5-0, P95-0.54); men, 0.1 kg (P5-0, P95-0.5) p = 0.94 (Wilcoxon signed-rank test). Sustained weight gain in pregnancy led to a reduction in lower leg length followed by an increase which was coincident with the appearance of dependent oedema. Lower leg length changes are likely to be positively related to changes in weight when the latter are only modest in magnitude. However, greater sustained increases in weight are likely to have an opposite effect on lower leg length due to direct compression of the lower leg. Due consideration of weight is essential in longitudinal studies of lower leg length changes, especially in conditions which are associated with significant changes in weight.
SourceAvailable from: Eilin Jopp[Show abstract] [Hide abstract]
ABSTRACT: We examined the final period of tibial growth in late adolescent males. Forty-one healthy male subjects, aged 15.7 to 19.8 years participated in a study on lower leg length (LLL) growth, body height and weight increments. All subjects were measured and weighed at weekly intervals over a period of one year. Body height was determined by an anthropometer, body weight by conventional scales, and LLL was measured by a hand-held knemometer. The state of maturity of the proximal tibial epiphyses was determined by magnetic resonance imaging (MRI). Skeletal maturity was independently assessed by two radiologists. The growth plates were categorized as being open (category I), centrally but not completely fused (category II), or completely fused (category III). Our findings demonstrate that in these adolescents, final tibial growth is characterized by longitudinal shrinkage. As shown in the MRI, when the proximal tibial growth plates have fused (i.e., at an age when lower leg growth is commonly believed to have completed), the lower leg of healthy adolescent males begins to shrink with a negative growth rate of -2.4 (SD 2.1) mm/year. Apart from sporadic observations in anorectic girls, longitudinal shrinkage in LLL has not been previously documented. We assume that the final period of growth includes small reductions in bone length, possibly due to stabilization and rearrangements in the formerly growing cartilaginous tissues.Anthropologischer Anzeiger 01/2012; 69(1):107-15. DOI:10.1127/0003-5548/2011/0115 · 0.54 Impact Factor
Article: The analysis of short-term growth.[Show abstract] [Hide abstract]
ABSTRACT: The analysis of short-term growth needs repetitive measurements of body stature or of segments of the body. When body stature is measured at monthly intervals, an irregular incremental pattern becomes obvious with a number of large-scale components such as series of prepubertal and pubertal growth spurts, seasonal influences on height gain, and influences of the psychosocial and economic background. When measurement intervals decrease, incremental patterns appear even more irregular, and a number of short-scale components become apparent that are distinct from measurement error. The review summarizes the analysis of short-term growth, and presents the current findings supporting different views on how growth progresses at short term. In particular, observations are presented that suggest growth being a pulsatile, a periodic, a saltatory, and a chaotic event. Some recent animal studies and studies in human newborns are added in detail as they illustrate short-term growth on the basis of accurate 24-hour measurements of the lower leg. The latter investigations support the idea of short-term growth being characterized by chaotic series of'mini growth spurts' that occur at intervals of approximately 4-5 days, not only in human neonates, but also in rats. The amplitude of mini growth spurts ranges between 2 and some 10 mm, and growth velocity of each spurt also varies considerably so that one spurt needs between less than 1 and up to several days for completion.Hormone Research 02/1998; 49(2):53-64. DOI:10.1159/000023127 · 2.48 Impact Factor
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ABSTRACT: To investigate the effects of disease and intensive chemotherapy on bone turnover and growth in children with acute lymphoblastic leukemia (ALL), a longitudinal prospective study was carried out in 22 children, aged 1.2-13.5 yr, enrolled in the Medical Research Council-funded randomized trial of childhood ALL treatment in the UK. We measured lower leg length and markers of bone formation [bone alkaline phosphatase (ALP) and procollagen type I C-terminal propeptide (PICP)], bone resorption [pyridinoline, deoxypyridinoline, and carboxyl-terminal telopeptide of type I collagen (ICTP)], soft tissue turnover [procollagen type III N-terminal propeptide (P3NP)], and the GH axis [IGF-I, IGF-binding protein-3 (IGFBP-3), IGFBP-2, and urinary GH] at 1- to 4-week intervals from diagnosis to week 27 of treatment. In addition, GH-binding protein was measured at diagnosis. At diagnosis, mean SD scores were: bone ALP, -1.84; PICP -1.77; pyridinoline, -1.42; deoxypyridinoline, -1.66; ICTP, -0.42; P3NP, +1.45; GH, +24.4; IGF-I, -1.70; IGFBP-3, -0.88; IGFBP-2, +2.42; and GH-binding protein, -0.69. Bone ALP, PICP, and IGFBP-3 were all correlated (P < or = 0.03). During induction and intensification, there was shrinkage of the lower leg, with decreases in PICP, pyridinoline, ICTP, and P3NP (P < 0.05), whereas IGF-I and IGFBP-3 increased (P < 0.05). After prednisolone was discontinued, bone ALP and collagen markers increased markedly (P < 0.01), but there was no significant change in IGF-I and IGFBP-3. In 12 children who received high dose i.v. methotrexate, postglucocorticoid increases in bone ALP and PICP were less, whereas those in ICTP and P3NP were greater, compared to levels in children who did not receive methotrexate (P < 0.05). We conclude that ALL itself caused GH resistance and low bone turnover. During early intensive chemotherapy, further suppression of osteoblast proliferation and osteoclast activity occurred, not mediated through the systemic GH axis, probably by the direct action of prednisolone on bone. The postglucocorticoid increase in bone turnover was also independent of the GH axis and was modulated by high dose i.v. methotrexate, which depressed osteoblast recovery and enhanced osteoclast activity.Journal of Clinical Endocrinology & Metabolism 10/1998; 83(9):3121-9. DOI:10.1210/jcem.83.9.5133 · 6.31 Impact Factor