Improved diagnosis of diseases in children – international reference values for children’s health care published
Whether for blood pressure, cholesterol or blood sugar, reference values which indicate risks and diseases are widely available for adults. Up to now such benchmarks were not available for children. A recent supplement published in the scientific journal International Journal of Obesity (IJO) aims to fill this gap in medical reference values for children. The values are derived from data from the EU project IDEFICS, the largest research study on diet and lifestyle-related diseases in children to date, which was coordinated by the Leibniz Institute for Prevention Research and Epidemiology – BIPS – together with the University of Bremen.
Reference values are important landmarks in medical practice. They are routinely used for adults to assess results of examinations and to aid therapeutic decisions. However, for children this is rather the exception: apart from the classical anthropometric reference values such as head circumference, body weight and height, as well as body mass index (BMI), paediatricians currently do not have clinical reference values which they can use, for example to determine the risk of cardio-vascular diseases later in life or to detect early stage diabetes. Without this knowledge it is not possible to initiate a timely and targeted intervention to prevent permanent damage in children with increased risk of disease.
Determining reference values for children and adolescence is more complex than for adults as developmental changes have to be taken into consideration. A reliable reference system can only evolve when a large healthy population is available in which the health relevant values can be determined for each age-group using standardised quality controlled methods. The IDEFICS study, in which health measurements and clinical values were obtained for more than 18,000 2-11 year old children, provided the ideal data base for this purpose. The reference values for important medical parameters were published in the recent supplement of the well-renowned scientific journal International Journal of Obesity (IJO), sponsored by the German Volkswagen Foundation, and are now also available for paediatric medical practice.
In the IJO supplement, reference values for anthropometric measures such as skinfold thickness, neck and hip circumference, for insulin and glucose, for blood lipids, cholesterol, bone stiffness and for blood pressure are listed for the age-groups 2-11 years. For the reference values for bone stiffness and blood pressure, the height of the child is taken into consideration along with age and sex. These reference values offer an excellent basis particularly for the identification of metabolic dysfunctions.
Professor Wolfgang Ahrens, coordinator of the IDEFICS study and head of the department “Epidemiological Methods and Etiologic Research” at BIPS, says: “We are pleased to contribute towards the improvement of diagnosis and treatment of children with these newly calculated reference values. Of particular note is the fact that the reference values are not only relevant for Germany but for the whole of Europe and beyond because we used IDEFICS data from eight European countries for the determination.”
Obesity determinants and reference standards for health parameters in pre-adolescent European children: Results from the IDEFICS study. Int J Obes; Vol 38 (Issue S2), September 2014. Available online at http://www.nature.com/ijo/journal/v38/n2s/index.html
IDEFICS study web page: www.ideficsstudy.eu
Leibniz Institute for Prevention Research and Epidemiology – BIPS
Prof. Dr. Wolfgang Ahrens
Press office BIPS