Author:
Walters William A.,Ley Catherine,Hastie Trevor,Ley Ruth E.,Parsonnet Julie
Abstract
Abstract
Background
Standard pediatric growth curves cannot be used to impute missing height or weight measurements in individual children. The Michaelis–Menten equation, used for characterizing substrate-enzyme saturation curves, has been shown to model growth in many organisms including nonhuman vertebrates. We investigated whether this equation could be used to interpolate missing growth data in children in the first three years of life and compared this interpolation to several common interpolation methods and pediatric growth models.
Methods
We developed a modified Michaelis–Menten equation and compared expected to actual growth, first in a local birth cohort (N = 97) then in a large, outpatient, pediatric sample (N = 14,695).
Results
The modified Michaelis–Menten equation showed excellent fit for both infant weight (median RMSE: boys: 0.22 kg [IQR:0.19; 90% < 0.43]; girls: 0.20 kg [IQR:0.17; 90% < 0.39]) and height (median RMSE: boys: 0.93 cm [IQR:0.53; 90% < 1.0]; girls: 0.91 cm [IQR:0.50;90% < 1.0]). Growth data were modeled accurately with as few as four values from routine well-baby visits in year 1 and seven values in years 1–3; birth weight or length was essential for best fit. Interpolation with this equation had comparable (for weight) or lower (for height) mean RMSE compared to the best performing alternative models.
Conclusions
A modified Michaelis–Menten equation accurately describes growth in healthy babies aged 0–36 months, allowing interpolation of missing weight and height values in individual longitudinal measurement series. The growth pattern in healthy babies in resource-rich environments mirrors an enzymatic saturation curve.
Funder
Max Plank Institute
National Institutes of Health
Publisher
Springer Science and Business Media LLC
Subject
Health Informatics,Epidemiology
Reference27 articles.
1. WHO, https://www.who.int/tools/child-growth-standards/standards/weightt-for-age, https://www.who.int/tools/child-growth-standards/standards/length-height-for-age. Accessed Dec 14 2022.
2. CDC, https://www.cdc.gov/growthcharts/clinical_charts.htm. Accessed Dec 14 2022.
3. Thalange NK, Foster PJ, Gill MS, Price DA, Clayton PE. Model of normal prepubertal growth. Arch Dis Child. 1996;75(5):427–31. https://doi.org/10.1136/adc.75.5.427.
4. Lampl M, Veldhuis JD, Johnson ML. Saltation and stasis: a model of human growth. Science. 1992;258(5083):801–3. https://doi.org/10.1126/science.1439787.
5. Lampl M, Johnson ML, Frongillo EA Jr. Mixed distribution analysis identifies saltation and stasis growth. Ann Hum Biol. 2001;28(4):403–11. https://doi.org/10.1080/03014460010016662.