Knemometry and the assessment of growth in premature babies.

Gibson, Alan T.; Pearse, R G; Wales, J.

doi:10.1136/adc.69.5_spec_no.498

Cited by 61 publications

(63 citation statements)

References 15 publications

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“…For the Raven rollameter® it was 2.4% at a mean length of 44.8 cm. LLL was measured with a neonatal knemometer using the technique described by Gibson and colleagues (13). Both legs were measured and the mean of the two was recorded as the LLL.…”

Section: Study Populationmentioning

confidence: 99%

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The Contributions of Plasma IGF-I, IGFBP-3 and Leptin to Growth in Extremely Premature Infants During the First Two Years

et al. 2007

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ABSTRACT:We determined the contributions of IGF-I, IGFBP-3 and leptin to growth in -extremely premature infants over the first two years. Weight (Wt), crown-to heel length (CHL), plasma IGF-I, IGFBP-3 and leptin were measured in infants (gestation 24 -33 wk) at birth (n ϭ 54), expected date of delivery (EDD) and 6, 12 and 24 mo post-EDD (n ϭ 29). Area under the curve (AUC) for hormone levels was calculated over 4 periods: birth-EDD, EDD-200 d, EDD-350 d and EDD-700 d. IGFBP-3, but not IGF-I or leptin, on day 1 correlated with birth Wt SD scores (SDS) (r ϭ 0.46, p ϭ 0.002) and CHL SDS (r ϭ 0.41, p ϭ 0.01). Wt SDS at EDD correlated with AUC IGF-I, IGFBP-3 and leptin (birth-EDD), but leptin was the best predictor in multiple regression(r ϭ 0.65, p Ͻ 0.0001). Wt at EDD ϩ 700 d correlated with AUC leptin (EDD-700 d) (r ϭ 0.62, p ϭ 0.002). CHL SDS at EDD correlated with AUC IGFBP-3 and leptin (birth-EDD), but IGFBP-3 was the best predictor (r ϭ 0.55, p Ͻ 0.0001). CHL at EDD ϩ 700 d correlated with AUC IGF-I and IGFBP-3 (EDD-700 d), but IGFBP-3 was the best predictor (r ϭ 0.47, p ϭ 0.01). Wt and CHL at birth were associated with IGFBP-3 levels in these infants. Wt at EDD and EDD ϩ 700 d was predicted by concurrent leptin output while linear growth at EDD and EDD ϩ P reterm birth interrupts the physiologic fetal phase of growth when growth velocity is highest. Infants born at gestational age (GA) Ͻ32 wk have a different pattern of postnatal growth than those born moderately premature (GA Ն32 wk) or at term (1,2) and often exhibit growth failure, particularly over the first months of life. Signs of catch-up growth in weight and length can be observed by expected date of delivery (EDD) in infants born at GA 29 -31 wk but are not seen until after one year corrected age for more premature infants Ͻ29 wk gestation (2). Growth restriction, especially if associated with later catch-up, is of particular concern in such infants owing to the association with cardiovascular disease in adulthood (3). Life-long programming of the insulin like growth factor-I (IGF-I) system by intrauterine and postnatal hormonal and nutritional environment has been suggested to be a key mediator of this association (4,5).Nutrition is a key regulator of pre-and early postnatal somatic growth. Other factors thought to be important include IGF-I, its principal binding protein insulin like growth factor binding protein-3 (IGFBP-3) and leptin. Leger et al. (6) examined growth hormone (GH), IGF-I and IGFBP-3 levels in relation to growth over the 1 st 24 mo in 254 growth retarded children (birth weight Ͻ3 rd percentile; 81 born at GA 29 -37 wk) and 84 appropriate-for-GA (AGA) controls (40 born at GA 29 -37 wk). The growth retarded infants had high GH but low IGF-I and IGFBP-3 levels at birth. However, these biologic parameters were not predictive of later growth or of short stature at 2 y of age, and levels over 24 mo did not correlate with weight or length gain. A number of studies have characterized longitudinal growth in very preterm children (7-9) and...

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Section: Study Populationmentioning

confidence: 99%

“…Values for Wt, CHL and HC were expressed as SDS using the standards from Keen and Pearse (15) and Freeman et al (16). For LLL the data from Gibson et al (13) were used. To better represent the exposure to hormones over a prolonged period we calculated the area under the curve (AUC) between the 5 time points using the trapezium rule.…”

Section: Study Populationmentioning

confidence: 99%

The Contributions of Plasma IGF-I, IGFBP-3 and Leptin to Growth in Extremely Premature Infants During the First Two Years

et al. 2007

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“…Postnatal growth velocity was measured using change in lower leg length as monitored by knemometry (8). The knemometer is an electronic caliper that measures the distance between two plates.…”

Section: Linear Growthmentioning

confidence: 99%

Plasma Amino-Terminal Pro C-Type Natriuretic Peptide in the Neonate: Relation to Gestational Age and Postnatal Linear Growth

Prickett

Dixon

Frampton

et al. 2008

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: C-type natriuretic peptide (CNP) plays an essential role in endochondral bone growth. Insight into CNP's paracrine actions is possible using plasma measurements of the amino-terminal pro C-type natriuretic peptide (NTproCNP). Whether correlations of NTproCNP with linear growth, as found in children and lambs, apply in neonates is unknown. Objectives:Our objective was to determine the effects of prematurity, gender, and antenatal steroids on plasma NTproCNP at birth, and serial changes in hormone concentrations, linear growth, and markers of bone turnover in the first month of postnatal life. Design and Setting:This is a prospective study of newborn infants admitted to an intensive care unit.Subjects: A total of 48 infants (four gestation groups) were enrolled. Umbilical cord samples were also obtained from 39 healthy term infants. Main Outcome Measures:Plasma NTproCNP and CNP were measured in cord plasma. In enrolled neonates, serial measurements of hormone concentrations and markers of bone turnover were related to tibial growth velocity as measured by knemometry.Results: Cord plasma NTproCNP was inversely related to gestational age (r ϭ Ϫ0.35; P ϭ 0.003) and was higher in males (P Ͻ 0.001). Plasma NTproCNP (P ϭ 0.016) and CNP (P Ͻ 0.001) increased within the first week of life, the increase relating inversely to gestational age (r ϭ Ϫ0.64; P Ͻ 0.001). Plasma NTproCNP at 1 wk was strongly correlated with linear growth velocity (r ϭ 0.49; P Ͻ 0.001), and also at 2-4 wk, the relation being stronger than observed between bone turnover markers and growth velocity. Conclusions:In neonates with diverse disorders affecting growth and nutrition, plasma NTproCNP was strongly correlated with linear growth during the first 4 wk of postnatal life and may prove to be a novel marker of growth plate activity in neonates.

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“…Differences were more marked in weight than in leg length, providing evidence for a different behavior of both parameters. Leg length represents a dose-dependent, GH-stimulated longitudinal growth in a long bone [26], whereas body weight can be affected by soft tissue hydration, fat deposits [27]and muscle mass development.…”

Section: Discussionmentioning

confidence: 99%

Sexual Dimorphism in Growth as Measured by Microknemometry: Different Responses to GH Deficiency and Exogenous GH Administration

Rol

Perez-Romero²,

Hermanussen³

et al. 1998

Neuroendocrinology

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To monitor growth, a novel noninvasive leg length measurement technique, called microknemometry, which allows daily observation of tibial growth rate, was used. The rat exhibits a striking sex-related difference in postpubertal growth. Exogenous GH administration results in a sexually dimorphic response, affecting growth in normal young female rats but not in males. Here we investigated how chronic GH deficiency affects male and female rat growth patterns. The degree of growth rate recovery was investigated after exogenous GH administration to chronically deficient males and females. The deficiency was induced by neonatal monosodium glutamate (MSG) treatment. Since the neonatal gonadal environment plays an important role in the dimorphic growth pattern, neonatal androgenization of female rats with testosterone or neonatal feminization of male rats by castration was performed and the growth pattern monitored. MSG treatment decreased pituitary GH content and plasma IGF I levels in both sexes, but caused a less marked reduction of female rat tibial growth and body weight gain than in males. Additionally, only MSG-treated males showed decreased pituitary LH content, so that the dimorphic action of MSG on the gonadal axis may contribute to the observed differences in growth rate. GH administration was able to increase leg length in all MSG-treated rats but was more effective in females, despite a similar restoration of plasma IGF I levels in both sexes. Although neonatal castration of male rats resulted in a reduction of tibial growth rate and body weight, and neonatal testosterone administration to female rats caused a slight increase in body weight, a complete modification of the gender-dependent growth pattern was not achieved, indicating that appropriate steroid environment is also needed in puberty and adulthood.

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Knemometry and the assessment of growth in premature babies.

Cited by 61 publications

References 15 publications

The Contributions of Plasma IGF-I, IGFBP-3 and Leptin to Growth in Extremely Premature Infants During the First Two Years

The Contributions of Plasma IGF-I, IGFBP-3 and Leptin to Growth in Extremely Premature Infants During the First Two Years

Plasma Amino-Terminal Pro C-Type Natriuretic Peptide in the Neonate: Relation to Gestational Age and Postnatal Linear Growth

Sexual Dimorphism in Growth as Measured by Microknemometry: Different Responses to GH Deficiency and Exogenous GH Administration

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