Background:Records show that mean height in The Netherlands has increased since 1858. This study looks at whether this trend in the world's tallest nation is continuing, and we consider the... Show moreBackground:Records show that mean height in The Netherlands has increased since 1858. This study looks at whether this trend in the world's tallest nation is continuing, and we consider the influence of the geographical region, and of child and parental education, on changes in height.Methods:We compared the height of young Dutch people aged 0-21 years as determined on the basis of the growth study of 2009 with the height data from growth studies conducted in 1955, 1965, 1980, and 1997.Results:The analysis sample included 5,811 boys and 6,194 girls. Height by age was the same as in 1997. Mean final height was 183.8 cm (SD=7.1 cm) in boys and 170.7 cm (SD=6.3 cm) in girls. The educational levels of both children and their parents are positively correlated with mean height. Since 1997, differences between geographical regions have decreased but not vanished, with the northern population being the tallest.Conclusion:The world's tallest population has stopped growing taller after a period of 150 years. The cause is unclear. The Dutch may have reached the optimal height distribution. Alternatively, growth-promoting environmental factors may have stabilised in the last decade, preventing the population from attaining its full growth potential.Pediatric Research (2012); doi:10.1038/pr.2012.189. Show less
Teune, M.J.; Wassenaer, A.G. van; Buuren, S. van; Mol, B.J.; Opmeer, B.C.; Dutch POPS Collaborative Study Grp 2012
BACKGROUND: Clark and Watson developed the tripartite model in which a symptom dimension of 'negative affect' covers common psychological distress that is typically seen in anxious and depressed... Show moreBACKGROUND: Clark and Watson developed the tripartite model in which a symptom dimension of 'negative affect' covers common psychological distress that is typically seen in anxious and depressed patients. The 'positive affect' and 'somatic arousal' dimensions cover more specific symptoms. Although the model has met much support, it does not cover all relevant anxiety symptoms and its negative affect dimension is rather unspecific. Therefore, we aimed to extend the tripartite model in order to describe more specific symptom patterns with unidimensional measurement scales. METHOD: 1333 outpatients provided self report data. To develop an extended factor model, exploratory factor analysis (EFA) was conducted in one part of the data (n=578). Confirmatory factor analysis (CFA) was conducted in the second part (n=755), to assess model-fit and comparison with other models. Rasch analyses were done to investigate the unidimensionality of the factors. RESULTS: EFA resulted in a 6-factor model: feelings of worthlessness, fatigue, somatic arousal, anxious apprehension, phobic fear and tension. CFA in the second sample showed that a 6-factor model with a hierarchical common severity factor fits the data better than alternative 1- and 3-factor models. Rasch analyses showed that each of the factors and the total of factors can be regarded as unidimensional measurement scales. LIMITATIONS: The model is based on a restricted symptom-pool: more dimensions are likely to exist. CONCLUSION: The extended tripartite model describes the clinical state of patients more specifically. This is relevant for both clinical practice and research. Show less
Geraedts, E.J.; Dommelen, P. van; Caliebe, J.; Visser, R.; Ranke, M.B.; Buuren, S. van; ... ; Oostdijk, W. 2011
Background/Aims: Studies on the association between head circumference (HC) and height or weight have shown variable results. Methods: Using data from the Dutch nationwide survey performed in 1997 ... Show moreBackground/Aims: Studies on the association between head circumference (HC) and height or weight have shown variable results. Methods: Using data from the Dutch nationwide survey performed in 1997 (n = 14,500), we calculated correlations for different ages, and fitted a regression model for the estimation of HC. HC versus height charts were created for different age groups. Data from children from other ethnic groups and children with various growth disorders were plotted on the charts and compared with reference data. Results: Correlations between HC and height or weight showed similar patterns: highest at birth, followed by a rapid decline to a stable level and a peak in adolescence. On charts containing the regression line ±2 standard deviations for subjects aged 0-2 months and 2 months to 21 years, Turkish and Moroccan children, as well as children with idiopathic short stature and small for gestational age, had a normal HC for height, whereas children with an insulin-like growth factor 1 receptor defect or Sotos syndrome showed trends towards a smaller or larger HC for height, respectively. Conclusion: HC correlates strongly with height and weight. The charts of HC for height may serve as an additional tool to interpret HC in short or tall children. Show less
Context and Objective: GH therapy increases growth and adult height in Turner syndrome (TS). The benefit to risk ratio of adding the weak androgen oxandrolone (Ox) to GH is unclear. Design and... Show moreContext and Objective: GH therapy increases growth and adult height in Turner syndrome (TS). The benefit to risk ratio of adding the weak androgen oxandrolone (Ox) to GH is unclear. Design and Participants: A randomized, placebo-controlled, double-blind, dose-response study was performed in 10 centers in The Netherlands. One hundred thirty-three patients with TS were included in age group 1 (2-7.99 yr), 2 (8-11.99 yr), or 3 (12-15.99 yr). Patients were treated with GH (1.33 mg/m(2) . d) from baseline, combined with placebo(Pl) or Oxin low (0.03 mg/kg . d) or conventional (0.06 mg/kg . d) dose from the age of 8 yr and estrogens from the age of 12 yr. Adult height gain (adult height minus predicted adult height) and safety parameters were systematically assessed. Results: Compared with GH + Pl, GH + Ox 0.03 increased adult height gain in the intention-to-treat analysis (mean +/- SD, 9.5 +/- 4.7 vs. 7.2 +/- 4.0 cm, P < 0.02) and per-protocol analysis (9.8 +/- 4.9 vs. 6.8 +/- 4.4 cm, P = 0.02). Partly due to accelerated bone maturation (P < 0.001), adult height gain on GH + Ox 0.06 was not significantly different from that on GH + Pl (8.3 +/- 4.7 vs. 7.2 +/- 4.0 cm, P = 0.3). Breast development was slower on GH + Ox (GH + Ox 0.03, P = 0.02; GH + Ox 0.06, P = 0.05), and more girls reported virilization on GH + Ox 0.06 than on GH + Pl (P < 0.001). Conclusions: In GH-treated girls with TS, we discourage the use of the conventional Ox dosage (0.06 mg/kg . d) because of its low benefit to risk ratio. The addition of Ox 0.03 mg/kg . d modestly increases adult height gain and has a fairly good safety profile, except for some deceleration of breast development. (J Clin Endocrinol Metab 95: 1151-1160, 2010) Show less