Personalized medicine: Enhancing our understanding of pediatric growth with analytic morphomics

J Pediatr Surg. 2017 May;52(5):837-842. doi: 10.1016/j.jpedsurg.2017.01.030. Epub 2017 Jan 29.

Abstract

Background/purpose: Analytic morphomics is being used to identify 3-D biologic measures with superior clinical utility and risk stratification over traditional factors such as age, height, and weight. The purpose of this study is to define age and gender specific Pediatric Reference Analytic Morphomics Population (PRAMP™) growth charts.

Methods: This retrospective study population contains 2591 individual CT scans of a normative reference population of males and females (1-20years old). Growth curves were constructed at the 5th, 25th, 50th, 75th, and 95th quantiles for morphomic variables, including psoas muscle area, trabecular bone density, and visceral fat area by age and gender.

Results: Total psoas muscle area increases over time until late adolescence. Trabecular bone density remains stable until adolescence, decreases during adolescence, and increases in young adulthood. Visceral fat area increases over time with greater variation between the 5th and 95th percentile with increasing age.

Conclusions: The PRAMP™ data have been used to construct age- and sex-specific reference growth curves. This may be used to better define "abnormal" in efforts to create unique risk-categorization algorithms specific to particular clinical and global health investigations.

Level of evidence: Level II.

Keywords: Analytic morphomics; Cross-sectional imaging; Growth charts.

MeSH terms

  • Adolescent
  • Age Factors
  • Body Composition*
  • Child
  • Child, Preschool
  • Female
  • Growth Charts*
  • Humans
  • Imaging, Three-Dimensional*
  • Infant
  • Male
  • Precision Medicine / methods*
  • Reference Values
  • Retrospective Studies
  • Sex Factors
  • Tomography, X-Ray Computed*
  • Young Adult