Abstract
Background
The QEPS-growth-model, developed and validated in GrowUp-Gothenburg cohorts, used for developing growth references and investigating healthy/pathological growth, lacks external validation from other longitudinal cohorts of healthy individuals.
Aim
To investigate if the QEPS-model can fit the longitudinal Edinburgh growth study of another design than GrowUp-Gothenburg cohorts, and to compare growth patterns in the individuals born in mid-1970s in North-Western Europe.
Methods
Longitudinal growth data were obtained from the Edinburgh and the GrowUp1974Gothenburg cohorts. The QEPS-model was used to describe length/height from birth to adult height with confidence interval, and the multivariable regression model for estimating the contribution of the different QEPS-functions to adult height.
Results
The QEPS-model fitted the Edinburgh cohort well, with high accuracy, and low confidence intervals indicating high precision. Despite 3 cm shorter stature (less QE-function growth) in Scottish children, the growth patterns of the cohorts were similar, especially for specific pubertal growth. The contribution to adult height from different QEPS functions was similar.
Conclusion
The QEPS-model is validated for the first time in a longitudinal study of healthy individuals of another design and found to fit with high accuracy and precision. The Scottish and Western-Swedish cohorts born in mid-1970s showed similar growth patterns for both sexes, especially pubertal growth.
Impact
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For the first time, the QEPS height model was used and found to fit another longitudinal cohort of healthy individuals other than the Swedish longitudinal cohorts.
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With large numbers of individual measurements in each growth phase, the QEPS model calculates growth estimates with narrow confidence intervals (high precision) and high accuracy.
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The two different cohorts born in the mid-1970s from Scotland and Western Sweden have similar growth patterns, despite a 3 cm difference in adult height.
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Acknowledgements
The authors are grateful for all contributing study subjects and the study teams for the measurements, collections, and computerizing of the original growth data.
Funding
The authors acknowledge financial support from the governmental grants under the ALF agreement, ALFGBG-719041 and ALFGBG-812951 (to K.A.-W.), the Region Halland Grants (to A.H.), and the Foundation Växthuset for children (to K.A.-W.)
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All five authors developed the study concept and design. K.A.-W. and G.B. are principal investigators of the study populations used. A.F.M.N. performed the QEPS-analyses and made Fig. 2. A.N. made the other figures and performed the statistical analyses. A.H. made the tables and wrote the first draft of the paper. All five authors critically revised the paper for important intellectual content and approved the final manuscript to be submitted for publication.
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A.F.M.N. works for Muvara, Multivariate Analysis of Research Data, Statistical Consultation, the Netherlands. The authors declare no competing interests.
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All study subjects and their parents or guardians gave informed written consent to participate in research studies as required by the local ethics committees.
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Holmgren, A., Niklasson, A., Nierop, A.F.M. et al. Growth pattern evaluation of the Edinburgh and Gothenburg cohorts by QEPS height model. Pediatr Res 92, 592–601 (2022). https://doi.org/10.1038/s41390-021-01790-2
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DOI: https://doi.org/10.1038/s41390-021-01790-2
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