Using large cohorts of well-characterized subjects from different centers allowed construction of robust reference ranges for a new automated IGF-I assay. The strict adherence to recent consensus criteria for IGF-I assays might facilitate clinical application of the results.

Methods: Anthropometric data from three contemporary Danish population-based studies were combined. References for height were based on healthy Caucasian children born at term. A total of 12 671 height measurements (8055 in boys and 4616 in girls) were included. Reference charts were developed using the generalised additive models for location, scale and shape.Results: From prepubertal ages, a secular increase in height was observed for both genders. The differences were most pronounced in puberty, and final heights were increased by 1.4 cm in boys and 2.9 cm in girls compared to 1982 references. In boys, but not girls an upward shift in body mass index (BMI) above median levels was found. Reference curves for height were superimposable with standard curves based on the selective WHO criteria. Danish children were longer/taller and heavier and they had larger head circumferences than those reported in the recent multiethnic WHO standards.

No abstract

Serum total ADPN levels decrease through puberty in males. Also, a reduced HMW ratio is seen in males at the onset of puberty. We speculate that the suppression of HMW ADPN may be caused by testosterone.

Patients and methods When planning the study we estimated the SD of the mean lower leg growth rate to be 0-20 mm! week.36 On this assumption we calculated that 12 patients would be sufficient for a power of >0 90 to detect a 50% reduction in growth rate, which was considered a clinically relevant difference.9 As some withdrawals were to be expected the study population was increased by seven patients.Nineteen children, outpatients in a secondary referral centre, entered the study. All had mild asthma requiring only treatment as needed with inhaled 132 stimulants. None had received treatment with glucocorticosteroids either inhaled or by mouth for two months before the study and no other drug was taken during the study period. Two girls and one boy were stage 2 according to Tanner's rating of puberty."' The other children were preadolescents without any signs of puberty. Table 1 gives the patient data. The study was approved by the local ethics committee and informed consent was obtained from all children and their parents.The study design was a double blind, crossover trial with three active treatment periods and two wash out periods. After a run in period of four days (period 1) during which the children took no treatment except inhaled 12 agonists they were randomised to treatment with fluticasone propionate 200 rig/day and beclomethasone dipropionate 400 and 800 ,ug/day in periods 2, 4, and 6. Treatment order was allocated by a computerised randomisation scheme prepared in balanced blocks. In periods 3 and 5 (wash out periods) placebo was given. Periods 2-6 were each 15 days long. The drug was taken in the morning and in the evening as one blister from a dry powder Diskhaler (Glaxo). The Diskhalers, identical in size and appearance, were delivered in identical boxes labelled with case number, period number, and prescription. During the run in period a placebo Diskhaler was used by the children so that they would become used to inhaling from the device. The inhalation technique was checked at each visit. To ensure optimum compliance the number of consumed blisters was counted at every visit. Mean (range) age (years) 10-7 (7-14) Mean (range) height (cm) 142 7 (116-160) Mean (range) height SD score -0-39 (-3 58 to +2-76) Mean (range) statural growth velocity (cm/year)* 6-0 (4 0-9-5) Mean (range) weight (kg) 33-7 (21-48) Mean (range) body surface area (i2)1-16 (0-87-1 39) Mean (range) duration of asthma (years) 4 (2-8)

We present an extensive set of assay-specific age- and sex-adjusted normative data for concentrations of IGFBP-3 and the molar IGF-I to IGFBP-3 ratio and demonstrate distinct sex specific differences across the life span.

No abstract

Aims-To determine eVects on short term growth and collagen turnover of adding formoterol (Eformoterol) to half the glucocorticoid dose in children with asthma, treated with inhaled budesonide (Pulmicort Turbuhaler). Design-A randomised double blind, placebo controlled crossover study with two six-week periods. Setting-Outpatient clinic in secondary referral centre. Subjects-A total of 27 prepubertal children aged 6-13 years. Interventions-Formoterol 12 µg and dry powder budesonide 100 µg twice daily in one period; placebo and dry powder budesonide 200 µg twice daily in the other. Outcome measures-Primary outcome measures were lower leg growth rate, and serum and urine markers of type I and type III collagen turnover. Secondary outcome measures were inflammation markers in serum, and parameters of asthma control. Results-During budesonide 200 µg twice daily treatment, mean lower leg growth rate was 0.14 mm/week (p = 0.02) lower than during the formoterol and budesonide period. Similar statistically significant eVects on markers of collagen turnover were found, whereas inflammation markers and asthma control did not vary statistically significantly between the two periods. Conclusions-In children treated with inhaled glucocorticoids, halving the dose and adding formoterol is associated with faster short term growth and an increase in markers of collagen turnover, with no loss of asthma control.