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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La talla&#44; la velocidad de crecimiento&#44; el peso y el &#237;ndice de masa corporal &#40;IMC&#41; son marcadores biol&#243;gicos de la salud del ni&#241;o y del bienestar de la comunidad<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1&#8211;3</span></a>&#46; Tras el nacimiento tiene lugar una deceleraci&#243;n progresiva del crecimiento hasta el inicio del brote de crecimiento puberal&#44; que ocurre dentro de un per&#237;odo de 5 a&#241;os en ambos sexos &#40;mujeres&#58; 8-13 a&#241;os de edad&#59; varones&#58; 10-15 a&#241;os de edad&#41;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los estudios longitudinales permiten establecer claramente la edad de inicio del crecimiento puberal&#46; No obstante&#44; debido al escaso n&#250;mero de ni&#241;os que incluyen&#44; estos estudios tienden a presentar los datos sobre el crecimiento puberal como si se refiriesen a un &#250;nico grupo&#44; sin tener en cuenta la variedad existente entre individuos en su <span class="elsevierStyleItalic">tempus</span> madurativo<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; El uso de un solo grupo puberal de referencia da lugar a errores en la pr&#225;ctica cl&#237;nica&#44; por lo que se ha propuesto el uso de m&#225;s de un grupo de referencia<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;5&#44;8&#8211;10</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El estudio longitudinal de crecimiento desarrollado previamente por nuestro grupo &#40;1978-2000&#41; present&#243; datos sobre el crecimiento puberal de 259 mujeres y 281 varones&#44; clasificados de acuerdo con la edad de inicio del brote de crecimiento puberal en 5 grupos maduradores &#40;muy tempranos&#44; tempranos&#44; intermedios&#44; tard&#237;os&#44; y muy tard&#237;os&#41; definidos en intervalos de un a&#241;o<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a>&#46; Como el n&#250;mero de sujetos en cada grupo fue limitado&#44; en 1995 comenzamos un nuevo estudio longitudinal con el objetivo de obtener un m&#237;nimo de 100 sujetos sanos y no obesos de cada sexo en cada uno de los 5 grupos para confirmar o refutar la existencia de diferencias cl&#237;nicamente significativas en el patr&#243;n de crecimiento puberal entre los 5 grupos maduradores&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Sujetos y m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio comprendi&#243; 1&#46;908 ni&#241;os sanos de un barrio de clase media-alta de Barcelona&#46; Se excluyeron sujetos con patolog&#237;a o medicaci&#243;n cr&#243;nica o con un IMC &#8804;<span class="elsevierStyleHsp" style=""></span>&#8722;2&#44;0<span class="elsevierStyleHsp" style=""></span>SDS &#40;ajustado por edad y sexo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a>&#41;&#46; Durante el per&#237;odo de estudio &#40;enero 1995-marzo 2017&#41;&#44; se excluyeron 132 ni&#241;os por obesidad &#40;examen f&#237;sico e IMC &#62;<span class="elsevierStyleHsp" style=""></span>2&#44;0<span class="elsevierStyleHsp" style=""></span>SDS ajustado por edad y sexo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a>&#41; y hubo 323 p&#233;rdidas&#46; Por lo tanto&#44; 1&#46;453 sujetos &#40;743 mujeres&#44; 710 varones&#41; que alcanzaron la talla adulta entre enero de 2012 y marzo de 2017 completaron el estudio&#44; analiz&#225;ndose los datos correspondientes a las medidas de sus tallas y pesos &#40;mujeres de 6 a 18 a&#241;os de edad&#44; varones de 6 a 19 a&#241;os de edad&#41;&#46; Se incluyeron 2 poblaciones&#44; una con seguimiento en 4 cl&#237;nicas pedi&#225;tricas &#40;poblaci&#243;n A&#44; 239 mujeres y 238 varones&#41; y otra en 4 colegios &#40;poblaci&#243;n B&#44; 504 mujeres y 472 varones&#41;&#46; Todos los sujetos de la poblaci&#243;n A nacieron a t&#233;rmino con peso y longitud normales<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">12</span></a>&#59; estos datos no se obtuvieron para la poblaci&#243;n B&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La medici&#243;n de la talla y del peso de los sujetos fue realizada cada 6-12 meses por 4 investigadores en la poblaci&#243;n A&#44; y una vez al a&#241;o por uno de estos 4 investigadores en la poblaci&#243;n B&#46; La talla se midi&#243; con un tall&#237;metro r&#237;gido de pared en la poblaci&#243;n A y con el mismo tall&#237;metro en formato transportable en la poblaci&#243;n B&#46; Los tall&#237;metros se calibraron de manera similar durante todo el estudio&#46; El peso se cuantific&#243; mediante b&#225;sculas de suelo &#40;poblaci&#243;n A&#44; en ropa interior&#59; poblaci&#243;n B&#44; en camiseta y falda&#47;pantal&#243;n&#44; descont&#225;ndose el peso estimado de la ropa del valor obtenido&#41;&#46; Las medidas se realizaron con una precisi&#243;n de 0&#44;1<span class="elsevierStyleHsp" style=""></span>cm para la talla y 0&#44;1<span class="elsevierStyleHsp" style=""></span>kg para el peso&#46; Se recogieron los estadios de Tanner y el volumen testicular cada 6 meses en la poblaci&#243;n A&#44; pero no en la B por motivos &#233;ticos&#46; Se recogi&#243; la edad de la menarquia en ambas poblaciones&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se utiliz&#243; el programa de c&#225;lculo auxol&#243;gico &#171;Auxolog&#187;&#44; elaborado con datos de nuestro estudio longitudinal previo<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5&#44;13</span></a>&#44; para generar gr&#225;ficas de crecimiento de la talla&#44; la velocidad de crecimiento y el peso de cada sujeto seg&#250;n la edad&#46; La edad de inicio del brote de crecimiento puberal se determin&#243; por medio de los criterios de Tanner<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;7</span></a>&#44; y con base en ella<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a> se clasific&#243; a los sujetos como maduradores muy tempranos &#40;mujeres&#58; 8-9 a&#241;os&#59; varones&#58; 10-11 a&#241;os&#41;&#44; tempranos &#40;mujeres&#58; 9-10 a&#241;os&#59; varones&#58; 11-12 a&#241;os&#41;&#44; intermedios &#40;mujeres&#58; 10-11 a&#241;os&#59; varones&#58; 12-13 a&#241;os&#41;&#44; tard&#237;os &#40;mujeres&#58; 11-12 a&#241;os&#59; varones&#58; 13-14 a&#241;os&#41; y muy tard&#237;os &#40;mujeres&#58; 12-13 a&#241;os&#59; varones&#58; 14-15 a&#241;os&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Se calcularon los valores medios de la talla por edades &#40;cm&#41;&#44; la velocidad de crecimiento por edades &#40;cm&#47;a&#241;o&#41;&#44; el peso por edades &#40;kg&#41;&#44; la talla adulta &#40;velocidad de crecimiento &#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm&#47;a&#241;o en 2 intervalos consecutivos de 6-12 meses&#41;&#44; ganancia total de talla durante la pubertad &#40;cm&#41; &#40;diferencia entre la talla al inicio de la pubertad y la talla adulta&#41;&#44; edad de la menarquia &#40;a&#241;os&#41; y ganancia de talla &#40;cm&#41; desde la menarquia hasta la talla adulta para cada uno de los 5 grupos de maduraci&#243;n puberal y para la poblaci&#243;n total &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1-3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Aspectos &#233;ticos</span><p id="par0035" class="elsevierStylePara elsevierViewall">El estudio fue aprobado por el Comit&#233; de &#201;tica del Hospital Universitario Vall d&#8217;Hebron&#44; Barcelona&#46; Se obtuvo el consentimiento de los ni&#241;os y de sus padres o tutores legales&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">An&#225;lisis estad&#237;stico</span><p id="par0040" class="elsevierStylePara elsevierViewall">Los resultados se expresan como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#46; La relaci&#243;n lineal entre los valores medios de las medidas antropom&#233;tricas a distintas edades y los grupos maduradores se evalu&#243; mediante regresi&#243;n lineal&#46; Se utiliz&#243; la <span class="elsevierStyleItalic">t</span> de Student para una muestra para la comparaci&#243;n de las medias de las distintas medidas antropom&#233;tricas para cada edad en la poblaci&#243;n total con las medias de cada uno de los 5 grupos maduradores&#46; Las diferencias entre los grupos maduradores puberales en la ganancia media de talla durante la pubertad&#44; la edad de la menarquia y la ganancia de talla desde la menarquia hasta la talla adulta se evaluaron mediante an&#225;lisis de varianza de un factor&#44; y se realiz&#243; la prueba de Bonferroni para la comparaci&#243;n de pares de subgrupos&#46; El an&#225;lisis de datos se realiz&#243; con el software SAS<span class="elsevierStyleSup">&#174;</span> 9&#46;3 &#40;SAS Institute Inc&#46;&#44; Cary&#44; NC&#44; EE&#46;<span class="elsevierStyleHsp" style=""></span>UU&#46;&#41;&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">De entre las 743 ni&#241;as&#44; el inicio del brote de crecimiento puberal ocurri&#243; a la edad de 8-9 a&#241;os en 119&#44; 9-10 a&#241;os en 157&#44; 10-11 a&#241;os en 238&#44; 11-12 a&#241;os en 127 y 12-13 a&#241;os en 102&#44; correspondiendo a maduradoras muy tempranas&#44; tempranas&#44; intermedias&#44; tard&#237;as y muy tard&#237;as&#44; respectivamente&#46; De los 710 varones&#44; la edad al inicio del crecimiento puberal fue de 10-11 a&#241;os en 110&#44; 11-12 a&#241;os en 139&#44; 12-13 a&#241;os en 225&#44; 13-14 a&#241;os en 133 y 14-15 a&#241;os en 103&#44; los cuales se consideraron maduradores muy tempranos&#44; tempranos&#44; intermedios&#44; tard&#237;os y muy tard&#237;os&#44; respectivamente &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1-3</a>&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En ambos sexos&#44; los valores medios de cada una de las variables antropom&#233;tricas a todas las edades &#40;desde los 6 a&#241;os hasta alcanzar la talla adulta&#41; en cada uno de los 5 grupos y en la poblaci&#243;n total fueron similares&#44; sin diferencias significativas entre las poblaciones A y B&#46; Por lo tanto&#44; los datos de ambas poblaciones se fusionaron y se analizaron como una &#250;nica poblaci&#243;n diferenciando por sexo&#46;</p><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Talla</span><p id="par0055" class="elsevierStylePara elsevierViewall">Los valores medios de la talla seg&#250;n la edad en los 5 grupos maduradores y en la poblaci&#243;n total se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> y en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Aunque los valores fueron similares en los 5 grupos al nacimiento &#40;poblaci&#243;n A&#44; datos no mostrados&#41; y al alcanzarse la talla adulta en ambos sexos&#44; se observ&#243; una relaci&#243;n lineal estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 5 grupos de maduraci&#243;n puberal entre los 6 y los 15 a&#241;os en las ni&#241;as y entre los 6 y los 18 a&#241;os en los varones&#46; Las diferencias fueron m&#237;nimas cuando todos los sujetos en cada grupo eran prep&#250;beres &#40;edad &#60;<span class="elsevierStyleHsp" style=""></span>8 a&#241;os en ni&#241;as y &#60;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os en varones&#41;&#44; para luego aumentar considerablemente de acuerdo con la edad de inicio del crecimiento puberal&#44; y desaparecer al alcanzarse la talla adulta&#46; Encontramos las mayores diferencias entre los grupos maduradores muy tempranos y muy tard&#237;os &#40;11&#44;9<span class="elsevierStyleHsp" style=""></span>cm a los 12 a&#241;os en las ni&#241;as&#59; 16&#44;6<span class="elsevierStyleHsp" style=""></span>cm a los 14 a&#241;os en los ni&#241;os&#41;&#46; La ganancia media de talla en ambos sexos y la edad de la menarquia y la ganancia de talla entre la menarquia y la talla adulta difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; entre cada grupo madurador puberal y los 4 grupos restantes &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">En las ni&#241;as&#44; los valores medios de la talla para la edad de la poblaci&#243;n total difirieron significativamente de los valores medios de las maduradoras muy tempranas&#44; tempranas y muy tard&#237;as entre los 6 y los 15 a&#241;os&#44; de los de las maduradoras tard&#237;as de los 7 a los 14 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0189 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y de los de las maduradoras intermedias de los 10 a los 11 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; En los varones&#44; estas diferencias se observaron entre los 6 y los 16 a&#241;os con el grupo madurador muy temprano&#44; los 7 y los 16 a&#241;os en el temprano&#44; los 7 y los 15 a&#241;os con el tard&#237;o&#44; los 6 y los 17 a&#241;os en el muy tard&#237;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0081 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y a los 12 y 13 a&#241;os con el intermedio &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; Las diferencias aumentaron considerablemente de acuerdo con la edad de inicio del brote de crecimiento puberal y decrecieron al alcanzarse la talla adulta&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Dentro de cada uno de los grupos maduradores&#44; las ni&#241;as y los ni&#241;os ten&#237;an valores medios similares de talla seg&#250;n la edad hasta los 8 a&#241;os&#44; aunque la talla tend&#237;a a ser mayor en varones que en ni&#241;as&#46; A partir de entonces&#44; las diferencias aumentaron de acuerdo con la edad de inicio del crecimiento puberal&#44; y al alcanzarse la talla adulta oscilaban entre los 13&#44;5 y los 12&#44;6<span class="elsevierStyleHsp" style=""></span>cm&#44; con una diferencia de 13&#44;0<span class="elsevierStyleHsp" style=""></span>cm para el total de la muestra &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Velocidad de crecimiento</span><p id="par0070" class="elsevierStylePara elsevierViewall">Los valores medios de la velocidad de crecimiento seg&#250;n la edad en los 5 grupos maduradores y en la poblaci&#243;n total se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> y en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Se observ&#243; una relaci&#243;n lineal estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 5 grupos maduradores en ambos sexos&#44; excepto entre los 7-8 a&#241;os en las ni&#241;as &#40;ns&#41;&#46; Las diferencias fueron menos marcadas cuando todas las ni&#241;as o todos los varones en los 5 grupos eran prepuberales&#44; aumentaron considerablemente a partir de ese momento de acuerdo con la edad de inicio del brote de crecimiento puberal&#44; y tendieron a desaparecer con la talla adulta&#46; Observamos las mayores diferencias entre los grupos maduradores muy tempranos y muy tard&#237;os &#40;5&#44;1<span class="elsevierStyleHsp" style=""></span>cm&#47;a&#241;o a los 13-14 a&#241;os en ni&#241;as y 6&#44;0<span class="elsevierStyleHsp" style=""></span>cm&#47;a&#241;o a los 15-16 a&#241;os en varones&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">En las mujeres&#44; los valores medios de la velocidad de crecimiento seg&#250;n la edad para la poblaci&#243;n total difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0197 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; de los valores medios en los grupos maduradores muy temprano&#44; temprano&#44; tard&#237;o y muy tard&#237;o de los 6-7 a&#241;os a los 16-17 a&#241;os&#44; y de los valores medios del grupo intermedio &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; de los 8-9 a&#241;os a los 13-14 a&#241;os&#46; En los varones se encontraron diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0069 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; con respecto a los grupos maduradores muy temprano&#44; temprano&#44; tard&#237;o y muy tard&#237;o entre los 8-9 a&#241;os y los 18-19 a&#241;os&#44; y al grupo intermedio &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 11-12 a&#241;os y los 17-18 a&#241;os&#46; Las diferencias aumentaron considerablemente de acuerdo con la edad de inicio del brote de crecimiento puberal y decrecieron al alcanzar la talla adulta&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Peso</span><p id="par0080" class="elsevierStylePara elsevierViewall">Los valores medios de peso seg&#250;n la edad de los 5 grupos maduradores y la poblaci&#243;n total se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#46; Aunque estos valores fueron similares al nacimiento &#40;poblaci&#243;n A&#44; datos no mostrados&#41;&#44; se observ&#243; una relaci&#243;n lineal estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0168 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 5 grupos maduradores de los 6 a los 18 a&#241;os en las ni&#241;as y de los 6 a los 19 a&#241;os en los varones&#46; Las diferencias aumentaron considerablemente de acuerdo con la edad de inicio del brote de crecimiento puberal y decrecieron al alcanzarse la talla adulta&#46; Las mayores diferencias se encontraron entre el grupo madurador muy temprano y el muy tard&#237;o &#40;10&#44;2<span class="elsevierStyleHsp" style=""></span>kg a los 12 a&#241;os en ni&#241;as y 11&#44;4<span class="elsevierStyleHsp" style=""></span>kg a los 14 a&#241;os en varones&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">En las mujeres&#44; los valores medios del peso seg&#250;n la edad para la poblaci&#243;n total difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0374 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; de los del grupo madurador muy temprano de los 6 a los 18 a&#241;os y de los grupos temprano&#44; tard&#237;o y muy tard&#237;o de los 6 a los 16 a&#241;os&#46; En los varones&#44; se observaron diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0126 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; con respecto al grupo madurador muy temprano entre los 6 y los 18 a&#241;os&#44; al grupo temprano de los 12 a los 14 a&#241;os&#44; al grupo tard&#237;o de los 10 a los 16 a&#241;os y al grupo muy tard&#237;o de los 10 a los 17 a&#241;os&#46; Las diferencias aumentaron de manera sustancial de acuerdo con el inicio del brote de crecimiento puberal y decrecieron en la talla adulta&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Desarrollo puberal</span><p id="par0090" class="elsevierStylePara elsevierViewall">En las ni&#241;as&#44; el valor medio del IMC a la edad de inicio del crecimiento puberal de los grupos maduradores muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o fueron 17&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;0&#44; 17&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1&#44; 17&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2&#44; 17&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;3 y 18&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&#44; respectivamente&#44; sin observarse diferencias significativas entre grupos&#46; El estadio<span class="elsevierStyleHsp" style=""></span>II de Tanner del desarrollo mamario se objetiv&#243; a los 4-6 meses del inicio del brote de crecimiento puberal&#44; y el estadio<span class="elsevierStyleHsp" style=""></span>IV o V al alcanzarse la talla adulta&#46; El pico de la velocidad de crecimiento se alcanz&#243; entre los estadios<span class="elsevierStyleHsp" style=""></span>II y III de Tanner del desarrollo mamario&#46; Hubo diferencias significativas en la edad media de la menarquia &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; entre cada grupo madurador y cada uno de los 4 grupos restantes &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Los valores del IMC en el momento de la menarquia fueron 19&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;3&#44; 19&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1&#44; 19&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2&#44; 19&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1 y 19&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2 en los grupos maduradores muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#44; respectivamente&#44; sin diferencias estad&#237;sticamente significativas entre ellos&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En los varones&#44; los valores medios del IMC fueron 18&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;3&#44; 18&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&#44; 18&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&#44; 19&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;6 y 20&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;4 en los grupos maduradores muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#44; respectivamente&#44; sin diferencias estad&#237;sticamente significativas entre los grupos muy temprano&#44; temprano&#44; intermedio y tard&#237;o&#59; los valores del grupo madurador muy tard&#237;o difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; de los de los grupos muy temprano&#44; temprano e intermedio&#46; Se registraron vol&#250;menes testiculares de 4-6<span class="elsevierStyleHsp" style=""></span>ml al inicio del crecimiento puberal y de 20<span class="elsevierStyleHsp" style=""></span>ml al alcanzarse la talla adulta&#46; El pico de la velocidad de crecimiento ocurri&#243; entre los estadios<span class="elsevierStyleHsp" style=""></span>III-IV de Tanner&#44; y el estadio<span class="elsevierStyleHsp" style=""></span>V de Tanner cuando los sujetos hab&#237;an alcanzado la talla adulta&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">Los estudios longitudinales proporcionan valores de referencia para la evaluaci&#243;n del crecimiento puberal&#46; Como el crecimiento puberal var&#237;a dependiendo de su edad de inicio&#44; se ha propuesto el uso de m&#225;s de un patr&#243;n de referencia<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;5&#44;8&#8211;10</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En este art&#237;culo&#44; comunicamos los valores de la talla&#44; velocidad de crecimiento y peso seg&#250;n la edad desde los 6 a&#241;os hasta la talla adulta en 1&#46;453 ni&#241;os sanos no obesos de un barrio de clase media-alta de Barcelona&#44; cuyas medidas antropom&#233;tricas fueron realizadas por tan solo 4 investigadores empleando instrumentos calibrados de manera similar&#46; El objetivo del estudio era reducir la dispersi&#243;n observada en los par&#225;metros antropom&#233;tricos en estudios de crecimiento debida a la heterogeneidad de las poblaciones analizadas&#44; el n&#250;mero de investigadores involucrados y los instrumentos utilizados&#46; Los ni&#241;os se distribuyeron en 5 grupos maduradores puberales definidos a intervalos de un a&#241;o &#40;muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#41; de acuerdo con su edad al inicio del brote de crecimiento puberal&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En ambos sexos&#44; los valores medios de la longitud al nacer &#40;poblaci&#243;n A&#44; datos no mostrados&#41;&#44; el peso al nacer &#40;poblaci&#243;n A&#44; datos no mostrados&#41;&#44; la talla adulta y el peso adulto fueron similares en los 5 grupos maduradores puberales&#46; Sin embargo&#44; los valores medios de la talla para la edad&#44; velocidad de crecimiento para la edad y peso para la edad difirieron entre los grupos a partir de los 6 a&#241;os&#46; Las diferencias fueron peque&#241;as y de escasa relevancia cl&#237;nica cuando todas las ni&#241;as &#40;edad &#60;<span class="elsevierStyleHsp" style=""></span>8 a&#241;os&#41; y todos los varones &#40;edad &#60;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os&#41; eran prep&#250;beres&#46; No obstante&#44; a partir de estas edades las diferencias aumentaron y adquirieron relevancia cl&#237;nica seg&#250;n la edad de inicio del crecimiento puberal&#44; para luego desaparecer al alcanzarse la talla adulta&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En ambos sexos&#44; el inicio del brote de crecimiento puberal es un hito cr&#237;tico que determina la velocidad de crecimiento &#40;ganancias de talla y peso&#41; durante la pubertad&#44; la maduraci&#243;n sexual a trav&#233;s de los estadios de Tanner y&#44; en las mujeres&#44; la edad de la menarquia y la ganancia de talla entre la menarquia y la talla adulta&#46; Cada grupo madurador puberal tiene un patr&#243;n de desarrollo puberal caracter&#237;stico que&#44; adem&#225;s&#44; se diferencia del de la poblaci&#243;n total&#46; En la pr&#225;ctica cl&#237;nica&#44; la evaluaci&#243;n del crecimiento puberal &#40;talla&#44; velocidad de crecimiento y peso&#41; y el desarrollo sexual individuales con referencia al patr&#243;n de maduraci&#243;n correspondiente &#40;muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#41; puede contribuir a evitar los errores que se cometen actualmente con el empleo exclusivo del patr&#243;n de la poblaci&#243;n total como referencia&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Aunque no podemos descartar completamente la presencia de sesgos en nuestros resultados&#44; en ambos sexos los valores correspondientes a las tallas para la edad en individuos prep&#250;beres &#40;ni&#241;as &#60;<span class="elsevierStyleHsp" style=""></span>8 a&#241;os&#44; varones &#60;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os&#41; y la talla adulta fueron similares a los comunicados en estudios transversales realizados recientemente en Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a>&#44; Europa<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">14&#8211;20</span></a> &#40;excepto por la poblaci&#243;n holandesa&#44; con una talla adulta de 5&#44;9<span class="elsevierStyleHsp" style=""></span>cm mayor en ambos sexos&#41; y Am&#233;rica<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">21&#44;22</span></a>&#44; lo que sugiere que nuestros datos para los 5 grupos maduradores puberales tambi&#233;n podr&#237;an resultar de utilidad en la evaluaci&#243;n del crecimiento puberal en estas poblaciones&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En ni&#241;as&#44; las diferencias en los valores del IMC al inicio del crecimiento puberal entre los 5 grupos maduradores no fueron estad&#237;sticamente significativas&#44; ni tampoco a la edad de la menarquia&#46; Tampoco lo fueron en los varones al inicio del crecimiento puberal&#44; exceptuando las diferencias entre el grupo muy tard&#237;o y los grupos muy temprano&#44; temprano e intermedio&#44; aunque estas diferencias fueron de escasa relevancia cl&#237;nica&#46; Estos datos sugieren que en ambos sexos el inicio de la pubertad requiere una masa corporal similar en todos los individuos&#44; y en las mujeres la aparici&#243;n de la menarquia&#44; independientemente de la edad a la que ocurra&#46; Adem&#225;s&#44; la edad de la menarquia en la poblaci&#243;n total fue similar a la descrita recientemente por otros autores&#44; lo que concuerda con la aceleraci&#243;n secular observada en los &#250;ltimos a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">23&#8211;25</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">En resumen&#44; se obtuvieron datos antropom&#233;tricos &#40;talla&#44; velocidad de crecimiento y peso&#44; todos seg&#250;n la edad&#41; correspondientes al per&#237;odo de crecimiento puberal para ambos sexos de un estudio longitudinal de crecimiento que incluy&#243; 1&#46;453 ni&#241;os sanos de la generaci&#243;n del milenio&#44; clasificados en 5 grupos de acuerdo con la edad de inicio del brote de crecimiento puberal&#46; Estos datos pueden contribuir a mejorar la evaluaci&#243;n cl&#237;nica del crecimiento teniendo en cuenta el <span class="elsevierStyleItalic">tempus</span> madurativo de cada ni&#241;o&#44; evit&#225;ndose los errores que se cometen actualmente con el uso de un &#250;nico patr&#243;n de referencia&#46; Tambi&#233;n se comunican datos sobre el desarrollo sexual y&#44; en ni&#241;as&#44; la edad de la menarquia&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Adenda</span><p id="par0135" class="elsevierStylePara elsevierViewall">Gr&#225;ficas para la talla&#44; velocidad de crecimiento&#44; peso e IMC&#44; todas seg&#250;n la edad&#44; obtenidas por el m&#233;todo LMS &#40;centiles y SDS&#41; estar&#225;n disponibles para su descarga gratuita a partir de febrero de 2018 en el sitio web&#58; http&#58;&#47;&#47;<a id="intr0005" class="elsevierStyleInterRef" href="http://www.millennialsgrowth.com/">www&#46;millennialsgrowth&#46;com</a> &#40;Cole TJ&#46; The LMS method for constructing normalized growth standards&#46; Eur J Clin Nutr 1990&#59;44&#58;45-60&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0145" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El patr&#243;n de crecimiento puberal var&#237;a seg&#250;n la edad de inicio del brote de crecimiento puberal&#44; que ocurre dentro de un per&#237;odo de 5 a&#241;os &#40;mujeres&#58; 8-13 a&#241;os&#59; varones&#58; 10-15 a&#241;os&#41;&#46; Se ha propuesto la necesidad de utilizar m&#225;s de un patr&#243;n de referencia puberal&#46; Nuestro objetivo fue obtener 5 patrones puberales a intervalos de un a&#241;o&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Sujetos y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio longitudinal &#40;6 a&#241;os de edad-talla adulta&#41; de crecimiento en 1&#46;453 ni&#241;os sanos con evaluaci&#243;n de valores de talla&#44; velocidad de crecimiento y peso para la edad&#46; Seg&#250;n la edad de inicio del brote de crecimiento puberal&#44; las mujeres se consideraron&#58; maduradoras muy tempranas &#40;8-9 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#41;&#44; maduradoras tempranas &#40;9-10 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&#41;&#44; maduradoras intermedias &#40;10-11 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&#41;&#44; maduradoras tard&#237;as &#40;11-12 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&#41; y maduradoras muy tard&#237;as &#40;12-13 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&#41;&#59; los varones se consideraron&#58; maduradores muy tempranos &#40;10-11 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&#41;&#44; maduradores tempranos &#40;11-12 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&#41;&#44; maduradores intermedios &#40;12-13 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&#41;&#44; maduradores tard&#237;os &#40;13-14 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&#41; y maduradores muy tard&#237;os &#40;14-15 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&#41;&#46; Se registr&#243; la edad de la menarquia y el crecimiento desde esta hasta alcanzar la talla adulta&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En ambos sexos se observaron diferencias estad&#237;sticamente significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y cl&#237;nicamente relevantes en el patr&#243;n de crecimiento puberal &#40;valores medios de talla para la edad&#44; velocidad de crecimiento para la edad y ganancia de talla puberal&#41; entre los 5 grupos maduradores y entre cada uno de ellos y la poblaci&#243;n total&#44; a pesar de que los valores de la talla adulta fueron similares en todos los grupos&#46; Se observ&#243; la misma tendencia en relaci&#243;n con la edad de la menarquia y la ganancia de talla desde la menarquia hasta la talla adulta &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En ambos sexos&#44; el inicio del brote de crecimiento puberal es un hito cr&#237;tico que determina el crecimiento puberal y el desarrollo sexual&#46; Nuestros datos contribuyen a una mejor evaluaci&#243;n cl&#237;nica del crecimiento de acuerdo con el <span class="elsevierStyleItalic">tempus</span> madurativo de cada ni&#241;o&#44; obviando los errores que se cometen con el uso de un &#250;nico patr&#243;n de referencia puberal&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pubertal growth pattern differs according to age at pubertal growth spurt onset which occurs over a five years period &#40;girls&#58; 8-13 years&#44; boys&#58; 10-15 years&#41;&#46; The need for more than one pubertal reference pattern has been proposed&#46; We aimed to obtain five 1-year-age-interval pubertal patterns&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Subjects and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Longitudinal &#40;6 years of age-adult height&#41; growth study of 1&#44;453 healthy children to evaluate height-for-age&#44; growth velocity-for-age and weight-for-age values&#46; According to age at pubertal growth spurt onset girls were considered&#58; very-early matures &#40;8-9 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#41;&#44; early matures &#40;9-10 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&#41;&#44; intermediate matures &#40;10-11 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&#41;&#44; late matures &#40;11-12 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&#41; and very-late matures &#40;12-13 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&#41;&#44; and boys&#58; very-early matures &#40;10-11 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&#41;&#44; early matures &#40;11-12 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&#41;&#44; intermediate matures &#40;12-13 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&#41;&#44; late matures &#40;13-14 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&#41; and very-late matures &#40;14-15 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&#41;&#46; Age at menarche and growth up to adult height were recorded&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In both sexes&#44; statistically-significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; and clinically-pertinent differences in pubertal growth pattern &#40;mean height-for-age&#44; mean growth velocity-for-age and mean pubertal height gain&#44; values&#41; were found among the five pubertal maturity groups and between each group and the whole population&#44; despite similar adult height values&#46; The same occurred for age at menarche and growth from menarche to adult height &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In both sexes&#44; pubertal growth spurt onset is a critical milestone determining pubertal growth and sexual development&#46; The contribution of our data to better clinical evaluation of growth according to the pubertal maturity tempo of each child will obviate the mistakes made when only one pubertal growth reference is used&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Subjects and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Valores medios de talla y velocidad de crecimiento seg&#250;n la edad de los 5 grupos maduradores puberales&#46; Se encontraron diferencias estad&#237;sticamente significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y relevantes para la pr&#225;ctica cl&#237;nica seg&#250;n la edad de inicio del brote de crecimiento puberal&#46;</p>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">En negrita&#44; talla a la edad de inicio del brote de crecimiento puberal &#40;IBCP&#41;&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de tendencia lineal de los valores medios de talla para la edad entre los 5 grupos maduradores puberales&#58; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 de los 6 a los 15 a&#241;os en mujeres y de los 6 a los 18 a&#241;os en varones&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mujeres</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Varones</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>743&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>710&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">123&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">127&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">126&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;0&nbsp;\t\t\t\t\t\t\n
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              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Ganancia de talla puberal&#44; edad de la menarquia y ganancia de talla entre la menarquia y la talla adulta&#58; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 entre cada grupo madurador y cada uno de los otros 4 grupos&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Talla para la edad &#40;cm&#41;&#44; ganancia de talla puberal &#40;cm&#41; y&#44; en mujeres&#44; edad de la menarquia &#40;a&#241;os&#41; y ganancia de talla &#40;cm&#41; desde la menarquia a la talla adulta en los 5 grupos maduradores puberales y en la poblaci&#243;n total &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
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        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">En negrita&#44; edades al inicio del brote de crecimiento puberal&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de tendencia lineal de los valores medios de velocidad de crecimiento para la edad entre los 5 grupos maduradores puberales&#58; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 a todas las edades en ambos sexos&#44; excepto a los 7-8 a&#241;os en mujeres &#40;ns&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mujeres</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Varones</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>743&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>710&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6-7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7-8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">6&#44;8</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8-9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;4</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9-10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;4</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;6</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10-11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">7&#44;0</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;7</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;2</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;6</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11-12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;7</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;7</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">5&#44;8</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12-13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;7</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;8</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13-14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;7</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;7</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14-15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;5</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;6</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15-16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16-17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2&nbsp;\t\t\t\t\t\t\n
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Original
Crecimiento puberal de 1.453 niños sanos según la edad de inicio de la pubertad. Estudio longitudinal de Barcelona
Pubertal growth of 1,453 healthy children according to age at pubertal growth spurt onset. The Barcelona longitudinal growth study
Antonio Carrascosaa,b,
Autor para correspondencia
ancarrascosa@vhebron.net

Autor para correspondencia.
, Diego Yestea,b, Antonio Moreno-Galdób,c, Miquel Gussinyéa, Ángel Ferrándezd, María Clementea,b, Mónica Fernández-Cancioa,b
a Servicio de Endocrinología Pediátrica, Hospital Universitario Materno-Infantil Vall d’Hebron, Universidad Autónoma de Barcelona, Barcelona, España
b CIBER de Enfermedades Raras (CIBERER) ISCIII, España
c Sección de Neumología Pediátrica, Hospital Universitario Materno-Infantil Vall d’Hebron, Universidad Autónoma de Barcelona, Barcelona, España
d Centro Andrea Prader, Zaragoza, España
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Valores medios de talla y velocidad de crecimiento seg&#250;n la edad de los 5 grupos maduradores puberales&#46; Se encontraron diferencias estad&#237;sticamente significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y relevantes para la pr&#225;ctica cl&#237;nica seg&#250;n la edad de inicio del brote de crecimiento puberal&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La talla&#44; la velocidad de crecimiento&#44; el peso y el &#237;ndice de masa corporal &#40;IMC&#41; son marcadores biol&#243;gicos de la salud del ni&#241;o y del bienestar de la comunidad<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1&#8211;3</span></a>&#46; Tras el nacimiento tiene lugar una deceleraci&#243;n progresiva del crecimiento hasta el inicio del brote de crecimiento puberal&#44; que ocurre dentro de un per&#237;odo de 5 a&#241;os en ambos sexos &#40;mujeres&#58; 8-13 a&#241;os de edad&#59; varones&#58; 10-15 a&#241;os de edad&#41;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los estudios longitudinales permiten establecer claramente la edad de inicio del crecimiento puberal&#46; No obstante&#44; debido al escaso n&#250;mero de ni&#241;os que incluyen&#44; estos estudios tienden a presentar los datos sobre el crecimiento puberal como si se refiriesen a un &#250;nico grupo&#44; sin tener en cuenta la variedad existente entre individuos en su <span class="elsevierStyleItalic">tempus</span> madurativo<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; El uso de un solo grupo puberal de referencia da lugar a errores en la pr&#225;ctica cl&#237;nica&#44; por lo que se ha propuesto el uso de m&#225;s de un grupo de referencia<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;5&#44;8&#8211;10</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El estudio longitudinal de crecimiento desarrollado previamente por nuestro grupo &#40;1978-2000&#41; present&#243; datos sobre el crecimiento puberal de 259 mujeres y 281 varones&#44; clasificados de acuerdo con la edad de inicio del brote de crecimiento puberal en 5 grupos maduradores &#40;muy tempranos&#44; tempranos&#44; intermedios&#44; tard&#237;os&#44; y muy tard&#237;os&#41; definidos en intervalos de un a&#241;o<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a>&#46; Como el n&#250;mero de sujetos en cada grupo fue limitado&#44; en 1995 comenzamos un nuevo estudio longitudinal con el objetivo de obtener un m&#237;nimo de 100 sujetos sanos y no obesos de cada sexo en cada uno de los 5 grupos para confirmar o refutar la existencia de diferencias cl&#237;nicamente significativas en el patr&#243;n de crecimiento puberal entre los 5 grupos maduradores&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Sujetos y m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio comprendi&#243; 1&#46;908 ni&#241;os sanos de un barrio de clase media-alta de Barcelona&#46; Se excluyeron sujetos con patolog&#237;a o medicaci&#243;n cr&#243;nica o con un IMC &#8804;<span class="elsevierStyleHsp" style=""></span>&#8722;2&#44;0<span class="elsevierStyleHsp" style=""></span>SDS &#40;ajustado por edad y sexo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a>&#41;&#46; Durante el per&#237;odo de estudio &#40;enero 1995-marzo 2017&#41;&#44; se excluyeron 132 ni&#241;os por obesidad &#40;examen f&#237;sico e IMC &#62;<span class="elsevierStyleHsp" style=""></span>2&#44;0<span class="elsevierStyleHsp" style=""></span>SDS ajustado por edad y sexo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a>&#41; y hubo 323 p&#233;rdidas&#46; Por lo tanto&#44; 1&#46;453 sujetos &#40;743 mujeres&#44; 710 varones&#41; que alcanzaron la talla adulta entre enero de 2012 y marzo de 2017 completaron el estudio&#44; analiz&#225;ndose los datos correspondientes a las medidas de sus tallas y pesos &#40;mujeres de 6 a 18 a&#241;os de edad&#44; varones de 6 a 19 a&#241;os de edad&#41;&#46; Se incluyeron 2 poblaciones&#44; una con seguimiento en 4 cl&#237;nicas pedi&#225;tricas &#40;poblaci&#243;n A&#44; 239 mujeres y 238 varones&#41; y otra en 4 colegios &#40;poblaci&#243;n B&#44; 504 mujeres y 472 varones&#41;&#46; Todos los sujetos de la poblaci&#243;n A nacieron a t&#233;rmino con peso y longitud normales<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">12</span></a>&#59; estos datos no se obtuvieron para la poblaci&#243;n B&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La medici&#243;n de la talla y del peso de los sujetos fue realizada cada 6-12 meses por 4 investigadores en la poblaci&#243;n A&#44; y una vez al a&#241;o por uno de estos 4 investigadores en la poblaci&#243;n B&#46; La talla se midi&#243; con un tall&#237;metro r&#237;gido de pared en la poblaci&#243;n A y con el mismo tall&#237;metro en formato transportable en la poblaci&#243;n B&#46; Los tall&#237;metros se calibraron de manera similar durante todo el estudio&#46; El peso se cuantific&#243; mediante b&#225;sculas de suelo &#40;poblaci&#243;n A&#44; en ropa interior&#59; poblaci&#243;n B&#44; en camiseta y falda&#47;pantal&#243;n&#44; descont&#225;ndose el peso estimado de la ropa del valor obtenido&#41;&#46; Las medidas se realizaron con una precisi&#243;n de 0&#44;1<span class="elsevierStyleHsp" style=""></span>cm para la talla y 0&#44;1<span class="elsevierStyleHsp" style=""></span>kg para el peso&#46; Se recogieron los estadios de Tanner y el volumen testicular cada 6 meses en la poblaci&#243;n A&#44; pero no en la B por motivos &#233;ticos&#46; Se recogi&#243; la edad de la menarquia en ambas poblaciones&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se utiliz&#243; el programa de c&#225;lculo auxol&#243;gico &#171;Auxolog&#187;&#44; elaborado con datos de nuestro estudio longitudinal previo<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5&#44;13</span></a>&#44; para generar gr&#225;ficas de crecimiento de la talla&#44; la velocidad de crecimiento y el peso de cada sujeto seg&#250;n la edad&#46; La edad de inicio del brote de crecimiento puberal se determin&#243; por medio de los criterios de Tanner<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;7</span></a>&#44; y con base en ella<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a> se clasific&#243; a los sujetos como maduradores muy tempranos &#40;mujeres&#58; 8-9 a&#241;os&#59; varones&#58; 10-11 a&#241;os&#41;&#44; tempranos &#40;mujeres&#58; 9-10 a&#241;os&#59; varones&#58; 11-12 a&#241;os&#41;&#44; intermedios &#40;mujeres&#58; 10-11 a&#241;os&#59; varones&#58; 12-13 a&#241;os&#41;&#44; tard&#237;os &#40;mujeres&#58; 11-12 a&#241;os&#59; varones&#58; 13-14 a&#241;os&#41; y muy tard&#237;os &#40;mujeres&#58; 12-13 a&#241;os&#59; varones&#58; 14-15 a&#241;os&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Se calcularon los valores medios de la talla por edades &#40;cm&#41;&#44; la velocidad de crecimiento por edades &#40;cm&#47;a&#241;o&#41;&#44; el peso por edades &#40;kg&#41;&#44; la talla adulta &#40;velocidad de crecimiento &#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm&#47;a&#241;o en 2 intervalos consecutivos de 6-12 meses&#41;&#44; ganancia total de talla durante la pubertad &#40;cm&#41; &#40;diferencia entre la talla al inicio de la pubertad y la talla adulta&#41;&#44; edad de la menarquia &#40;a&#241;os&#41; y ganancia de talla &#40;cm&#41; desde la menarquia hasta la talla adulta para cada uno de los 5 grupos de maduraci&#243;n puberal y para la poblaci&#243;n total &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1-3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Aspectos &#233;ticos</span><p id="par0035" class="elsevierStylePara elsevierViewall">El estudio fue aprobado por el Comit&#233; de &#201;tica del Hospital Universitario Vall d&#8217;Hebron&#44; Barcelona&#46; Se obtuvo el consentimiento de los ni&#241;os y de sus padres o tutores legales&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">An&#225;lisis estad&#237;stico</span><p id="par0040" class="elsevierStylePara elsevierViewall">Los resultados se expresan como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#46; La relaci&#243;n lineal entre los valores medios de las medidas antropom&#233;tricas a distintas edades y los grupos maduradores se evalu&#243; mediante regresi&#243;n lineal&#46; Se utiliz&#243; la <span class="elsevierStyleItalic">t</span> de Student para una muestra para la comparaci&#243;n de las medias de las distintas medidas antropom&#233;tricas para cada edad en la poblaci&#243;n total con las medias de cada uno de los 5 grupos maduradores&#46; Las diferencias entre los grupos maduradores puberales en la ganancia media de talla durante la pubertad&#44; la edad de la menarquia y la ganancia de talla desde la menarquia hasta la talla adulta se evaluaron mediante an&#225;lisis de varianza de un factor&#44; y se realiz&#243; la prueba de Bonferroni para la comparaci&#243;n de pares de subgrupos&#46; El an&#225;lisis de datos se realiz&#243; con el software SAS<span class="elsevierStyleSup">&#174;</span> 9&#46;3 &#40;SAS Institute Inc&#46;&#44; Cary&#44; NC&#44; EE&#46;<span class="elsevierStyleHsp" style=""></span>UU&#46;&#41;&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">De entre las 743 ni&#241;as&#44; el inicio del brote de crecimiento puberal ocurri&#243; a la edad de 8-9 a&#241;os en 119&#44; 9-10 a&#241;os en 157&#44; 10-11 a&#241;os en 238&#44; 11-12 a&#241;os en 127 y 12-13 a&#241;os en 102&#44; correspondiendo a maduradoras muy tempranas&#44; tempranas&#44; intermedias&#44; tard&#237;as y muy tard&#237;as&#44; respectivamente&#46; De los 710 varones&#44; la edad al inicio del crecimiento puberal fue de 10-11 a&#241;os en 110&#44; 11-12 a&#241;os en 139&#44; 12-13 a&#241;os en 225&#44; 13-14 a&#241;os en 133 y 14-15 a&#241;os en 103&#44; los cuales se consideraron maduradores muy tempranos&#44; tempranos&#44; intermedios&#44; tard&#237;os y muy tard&#237;os&#44; respectivamente &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1-3</a>&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En ambos sexos&#44; los valores medios de cada una de las variables antropom&#233;tricas a todas las edades &#40;desde los 6 a&#241;os hasta alcanzar la talla adulta&#41; en cada uno de los 5 grupos y en la poblaci&#243;n total fueron similares&#44; sin diferencias significativas entre las poblaciones A y B&#46; Por lo tanto&#44; los datos de ambas poblaciones se fusionaron y se analizaron como una &#250;nica poblaci&#243;n diferenciando por sexo&#46;</p><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Talla</span><p id="par0055" class="elsevierStylePara elsevierViewall">Los valores medios de la talla seg&#250;n la edad en los 5 grupos maduradores y en la poblaci&#243;n total se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> y en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Aunque los valores fueron similares en los 5 grupos al nacimiento &#40;poblaci&#243;n A&#44; datos no mostrados&#41; y al alcanzarse la talla adulta en ambos sexos&#44; se observ&#243; una relaci&#243;n lineal estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 5 grupos de maduraci&#243;n puberal entre los 6 y los 15 a&#241;os en las ni&#241;as y entre los 6 y los 18 a&#241;os en los varones&#46; Las diferencias fueron m&#237;nimas cuando todos los sujetos en cada grupo eran prep&#250;beres &#40;edad &#60;<span class="elsevierStyleHsp" style=""></span>8 a&#241;os en ni&#241;as y &#60;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os en varones&#41;&#44; para luego aumentar considerablemente de acuerdo con la edad de inicio del crecimiento puberal&#44; y desaparecer al alcanzarse la talla adulta&#46; Encontramos las mayores diferencias entre los grupos maduradores muy tempranos y muy tard&#237;os &#40;11&#44;9<span class="elsevierStyleHsp" style=""></span>cm a los 12 a&#241;os en las ni&#241;as&#59; 16&#44;6<span class="elsevierStyleHsp" style=""></span>cm a los 14 a&#241;os en los ni&#241;os&#41;&#46; La ganancia media de talla en ambos sexos y la edad de la menarquia y la ganancia de talla entre la menarquia y la talla adulta difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; entre cada grupo madurador puberal y los 4 grupos restantes &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">En las ni&#241;as&#44; los valores medios de la talla para la edad de la poblaci&#243;n total difirieron significativamente de los valores medios de las maduradoras muy tempranas&#44; tempranas y muy tard&#237;as entre los 6 y los 15 a&#241;os&#44; de los de las maduradoras tard&#237;as de los 7 a los 14 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0189 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y de los de las maduradoras intermedias de los 10 a los 11 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; En los varones&#44; estas diferencias se observaron entre los 6 y los 16 a&#241;os con el grupo madurador muy temprano&#44; los 7 y los 16 a&#241;os en el temprano&#44; los 7 y los 15 a&#241;os con el tard&#237;o&#44; los 6 y los 17 a&#241;os en el muy tard&#237;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0081 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y a los 12 y 13 a&#241;os con el intermedio &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; Las diferencias aumentaron considerablemente de acuerdo con la edad de inicio del brote de crecimiento puberal y decrecieron al alcanzarse la talla adulta&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Dentro de cada uno de los grupos maduradores&#44; las ni&#241;as y los ni&#241;os ten&#237;an valores medios similares de talla seg&#250;n la edad hasta los 8 a&#241;os&#44; aunque la talla tend&#237;a a ser mayor en varones que en ni&#241;as&#46; A partir de entonces&#44; las diferencias aumentaron de acuerdo con la edad de inicio del crecimiento puberal&#44; y al alcanzarse la talla adulta oscilaban entre los 13&#44;5 y los 12&#44;6<span class="elsevierStyleHsp" style=""></span>cm&#44; con una diferencia de 13&#44;0<span class="elsevierStyleHsp" style=""></span>cm para el total de la muestra &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Velocidad de crecimiento</span><p id="par0070" class="elsevierStylePara elsevierViewall">Los valores medios de la velocidad de crecimiento seg&#250;n la edad en los 5 grupos maduradores y en la poblaci&#243;n total se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> y en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Se observ&#243; una relaci&#243;n lineal estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 5 grupos maduradores en ambos sexos&#44; excepto entre los 7-8 a&#241;os en las ni&#241;as &#40;ns&#41;&#46; Las diferencias fueron menos marcadas cuando todas las ni&#241;as o todos los varones en los 5 grupos eran prepuberales&#44; aumentaron considerablemente a partir de ese momento de acuerdo con la edad de inicio del brote de crecimiento puberal&#44; y tendieron a desaparecer con la talla adulta&#46; Observamos las mayores diferencias entre los grupos maduradores muy tempranos y muy tard&#237;os &#40;5&#44;1<span class="elsevierStyleHsp" style=""></span>cm&#47;a&#241;o a los 13-14 a&#241;os en ni&#241;as y 6&#44;0<span class="elsevierStyleHsp" style=""></span>cm&#47;a&#241;o a los 15-16 a&#241;os en varones&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">En las mujeres&#44; los valores medios de la velocidad de crecimiento seg&#250;n la edad para la poblaci&#243;n total difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0197 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; de los valores medios en los grupos maduradores muy temprano&#44; temprano&#44; tard&#237;o y muy tard&#237;o de los 6-7 a&#241;os a los 16-17 a&#241;os&#44; y de los valores medios del grupo intermedio &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; de los 8-9 a&#241;os a los 13-14 a&#241;os&#46; En los varones se encontraron diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0069 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; con respecto a los grupos maduradores muy temprano&#44; temprano&#44; tard&#237;o y muy tard&#237;o entre los 8-9 a&#241;os y los 18-19 a&#241;os&#44; y al grupo intermedio &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 11-12 a&#241;os y los 17-18 a&#241;os&#46; Las diferencias aumentaron considerablemente de acuerdo con la edad de inicio del brote de crecimiento puberal y decrecieron al alcanzar la talla adulta&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Peso</span><p id="par0080" class="elsevierStylePara elsevierViewall">Los valores medios de peso seg&#250;n la edad de los 5 grupos maduradores y la poblaci&#243;n total se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#46; Aunque estos valores fueron similares al nacimiento &#40;poblaci&#243;n A&#44; datos no mostrados&#41;&#44; se observ&#243; una relaci&#243;n lineal estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0168 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; entre los 5 grupos maduradores de los 6 a los 18 a&#241;os en las ni&#241;as y de los 6 a los 19 a&#241;os en los varones&#46; Las diferencias aumentaron considerablemente de acuerdo con la edad de inicio del brote de crecimiento puberal y decrecieron al alcanzarse la talla adulta&#46; Las mayores diferencias se encontraron entre el grupo madurador muy temprano y el muy tard&#237;o &#40;10&#44;2<span class="elsevierStyleHsp" style=""></span>kg a los 12 a&#241;os en ni&#241;as y 11&#44;4<span class="elsevierStyleHsp" style=""></span>kg a los 14 a&#241;os en varones&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">En las mujeres&#44; los valores medios del peso seg&#250;n la edad para la poblaci&#243;n total difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0374 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; de los del grupo madurador muy temprano de los 6 a los 18 a&#241;os y de los grupos temprano&#44; tard&#237;o y muy tard&#237;o de los 6 a los 16 a&#241;os&#46; En los varones&#44; se observaron diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0126 a p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; con respecto al grupo madurador muy temprano entre los 6 y los 18 a&#241;os&#44; al grupo temprano de los 12 a los 14 a&#241;os&#44; al grupo tard&#237;o de los 10 a los 16 a&#241;os y al grupo muy tard&#237;o de los 10 a los 17 a&#241;os&#46; Las diferencias aumentaron de manera sustancial de acuerdo con el inicio del brote de crecimiento puberal y decrecieron en la talla adulta&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Desarrollo puberal</span><p id="par0090" class="elsevierStylePara elsevierViewall">En las ni&#241;as&#44; el valor medio del IMC a la edad de inicio del crecimiento puberal de los grupos maduradores muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o fueron 17&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;0&#44; 17&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1&#44; 17&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2&#44; 17&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;3 y 18&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&#44; respectivamente&#44; sin observarse diferencias significativas entre grupos&#46; El estadio<span class="elsevierStyleHsp" style=""></span>II de Tanner del desarrollo mamario se objetiv&#243; a los 4-6 meses del inicio del brote de crecimiento puberal&#44; y el estadio<span class="elsevierStyleHsp" style=""></span>IV o V al alcanzarse la talla adulta&#46; El pico de la velocidad de crecimiento se alcanz&#243; entre los estadios<span class="elsevierStyleHsp" style=""></span>II y III de Tanner del desarrollo mamario&#46; Hubo diferencias significativas en la edad media de la menarquia &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; entre cada grupo madurador y cada uno de los 4 grupos restantes &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Los valores del IMC en el momento de la menarquia fueron 19&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;3&#44; 19&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1&#44; 19&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2&#44; 19&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1 y 19&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2 en los grupos maduradores muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#44; respectivamente&#44; sin diferencias estad&#237;sticamente significativas entre ellos&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En los varones&#44; los valores medios del IMC fueron 18&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;3&#44; 18&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&#44; 18&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&#44; 19&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;6 y 20&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;4 en los grupos maduradores muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#44; respectivamente&#44; sin diferencias estad&#237;sticamente significativas entre los grupos muy temprano&#44; temprano&#44; intermedio y tard&#237;o&#59; los valores del grupo madurador muy tard&#237;o difirieron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; de los de los grupos muy temprano&#44; temprano e intermedio&#46; Se registraron vol&#250;menes testiculares de 4-6<span class="elsevierStyleHsp" style=""></span>ml al inicio del crecimiento puberal y de 20<span class="elsevierStyleHsp" style=""></span>ml al alcanzarse la talla adulta&#46; El pico de la velocidad de crecimiento ocurri&#243; entre los estadios<span class="elsevierStyleHsp" style=""></span>III-IV de Tanner&#44; y el estadio<span class="elsevierStyleHsp" style=""></span>V de Tanner cuando los sujetos hab&#237;an alcanzado la talla adulta&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">Los estudios longitudinales proporcionan valores de referencia para la evaluaci&#243;n del crecimiento puberal&#46; Como el crecimiento puberal var&#237;a dependiendo de su edad de inicio&#44; se ha propuesto el uso de m&#225;s de un patr&#243;n de referencia<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;5&#44;8&#8211;10</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En este art&#237;culo&#44; comunicamos los valores de la talla&#44; velocidad de crecimiento y peso seg&#250;n la edad desde los 6 a&#241;os hasta la talla adulta en 1&#46;453 ni&#241;os sanos no obesos de un barrio de clase media-alta de Barcelona&#44; cuyas medidas antropom&#233;tricas fueron realizadas por tan solo 4 investigadores empleando instrumentos calibrados de manera similar&#46; El objetivo del estudio era reducir la dispersi&#243;n observada en los par&#225;metros antropom&#233;tricos en estudios de crecimiento debida a la heterogeneidad de las poblaciones analizadas&#44; el n&#250;mero de investigadores involucrados y los instrumentos utilizados&#46; Los ni&#241;os se distribuyeron en 5 grupos maduradores puberales definidos a intervalos de un a&#241;o &#40;muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#41; de acuerdo con su edad al inicio del brote de crecimiento puberal&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En ambos sexos&#44; los valores medios de la longitud al nacer &#40;poblaci&#243;n A&#44; datos no mostrados&#41;&#44; el peso al nacer &#40;poblaci&#243;n A&#44; datos no mostrados&#41;&#44; la talla adulta y el peso adulto fueron similares en los 5 grupos maduradores puberales&#46; Sin embargo&#44; los valores medios de la talla para la edad&#44; velocidad de crecimiento para la edad y peso para la edad difirieron entre los grupos a partir de los 6 a&#241;os&#46; Las diferencias fueron peque&#241;as y de escasa relevancia cl&#237;nica cuando todas las ni&#241;as &#40;edad &#60;<span class="elsevierStyleHsp" style=""></span>8 a&#241;os&#41; y todos los varones &#40;edad &#60;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os&#41; eran prep&#250;beres&#46; No obstante&#44; a partir de estas edades las diferencias aumentaron y adquirieron relevancia cl&#237;nica seg&#250;n la edad de inicio del crecimiento puberal&#44; para luego desaparecer al alcanzarse la talla adulta&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En ambos sexos&#44; el inicio del brote de crecimiento puberal es un hito cr&#237;tico que determina la velocidad de crecimiento &#40;ganancias de talla y peso&#41; durante la pubertad&#44; la maduraci&#243;n sexual a trav&#233;s de los estadios de Tanner y&#44; en las mujeres&#44; la edad de la menarquia y la ganancia de talla entre la menarquia y la talla adulta&#46; Cada grupo madurador puberal tiene un patr&#243;n de desarrollo puberal caracter&#237;stico que&#44; adem&#225;s&#44; se diferencia del de la poblaci&#243;n total&#46; En la pr&#225;ctica cl&#237;nica&#44; la evaluaci&#243;n del crecimiento puberal &#40;talla&#44; velocidad de crecimiento y peso&#41; y el desarrollo sexual individuales con referencia al patr&#243;n de maduraci&#243;n correspondiente &#40;muy temprano&#44; temprano&#44; intermedio&#44; tard&#237;o y muy tard&#237;o&#41; puede contribuir a evitar los errores que se cometen actualmente con el empleo exclusivo del patr&#243;n de la poblaci&#243;n total como referencia&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Aunque no podemos descartar completamente la presencia de sesgos en nuestros resultados&#44; en ambos sexos los valores correspondientes a las tallas para la edad en individuos prep&#250;beres &#40;ni&#241;as &#60;<span class="elsevierStyleHsp" style=""></span>8 a&#241;os&#44; varones &#60;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os&#41; y la talla adulta fueron similares a los comunicados en estudios transversales realizados recientemente en Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a>&#44; Europa<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">14&#8211;20</span></a> &#40;excepto por la poblaci&#243;n holandesa&#44; con una talla adulta de 5&#44;9<span class="elsevierStyleHsp" style=""></span>cm mayor en ambos sexos&#41; y Am&#233;rica<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">21&#44;22</span></a>&#44; lo que sugiere que nuestros datos para los 5 grupos maduradores puberales tambi&#233;n podr&#237;an resultar de utilidad en la evaluaci&#243;n del crecimiento puberal en estas poblaciones&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En ni&#241;as&#44; las diferencias en los valores del IMC al inicio del crecimiento puberal entre los 5 grupos maduradores no fueron estad&#237;sticamente significativas&#44; ni tampoco a la edad de la menarquia&#46; Tampoco lo fueron en los varones al inicio del crecimiento puberal&#44; exceptuando las diferencias entre el grupo muy tard&#237;o y los grupos muy temprano&#44; temprano e intermedio&#44; aunque estas diferencias fueron de escasa relevancia cl&#237;nica&#46; Estos datos sugieren que en ambos sexos el inicio de la pubertad requiere una masa corporal similar en todos los individuos&#44; y en las mujeres la aparici&#243;n de la menarquia&#44; independientemente de la edad a la que ocurra&#46; Adem&#225;s&#44; la edad de la menarquia en la poblaci&#243;n total fue similar a la descrita recientemente por otros autores&#44; lo que concuerda con la aceleraci&#243;n secular observada en los &#250;ltimos a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">23&#8211;25</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">En resumen&#44; se obtuvieron datos antropom&#233;tricos &#40;talla&#44; velocidad de crecimiento y peso&#44; todos seg&#250;n la edad&#41; correspondientes al per&#237;odo de crecimiento puberal para ambos sexos de un estudio longitudinal de crecimiento que incluy&#243; 1&#46;453 ni&#241;os sanos de la generaci&#243;n del milenio&#44; clasificados en 5 grupos de acuerdo con la edad de inicio del brote de crecimiento puberal&#46; Estos datos pueden contribuir a mejorar la evaluaci&#243;n cl&#237;nica del crecimiento teniendo en cuenta el <span class="elsevierStyleItalic">tempus</span> madurativo de cada ni&#241;o&#44; evit&#225;ndose los errores que se cometen actualmente con el uso de un &#250;nico patr&#243;n de referencia&#46; Tambi&#233;n se comunican datos sobre el desarrollo sexual y&#44; en ni&#241;as&#44; la edad de la menarquia&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Adenda</span><p id="par0135" class="elsevierStylePara elsevierViewall">Gr&#225;ficas para la talla&#44; velocidad de crecimiento&#44; peso e IMC&#44; todas seg&#250;n la edad&#44; obtenidas por el m&#233;todo LMS &#40;centiles y SDS&#41; estar&#225;n disponibles para su descarga gratuita a partir de febrero de 2018 en el sitio web&#58; http&#58;&#47;&#47;<a id="intr0005" class="elsevierStyleInterRef" href="http://www.millennialsgrowth.com/">www&#46;millennialsgrowth&#46;com</a> &#40;Cole TJ&#46; The LMS method for constructing normalized growth standards&#46; Eur J Clin Nutr 1990&#59;44&#58;45-60&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0145" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El patr&#243;n de crecimiento puberal var&#237;a seg&#250;n la edad de inicio del brote de crecimiento puberal&#44; que ocurre dentro de un per&#237;odo de 5 a&#241;os &#40;mujeres&#58; 8-13 a&#241;os&#59; varones&#58; 10-15 a&#241;os&#41;&#46; Se ha propuesto la necesidad de utilizar m&#225;s de un patr&#243;n de referencia puberal&#46; Nuestro objetivo fue obtener 5 patrones puberales a intervalos de un a&#241;o&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Sujetos y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio longitudinal &#40;6 a&#241;os de edad-talla adulta&#41; de crecimiento en 1&#46;453 ni&#241;os sanos con evaluaci&#243;n de valores de talla&#44; velocidad de crecimiento y peso para la edad&#46; Seg&#250;n la edad de inicio del brote de crecimiento puberal&#44; las mujeres se consideraron&#58; maduradoras muy tempranas &#40;8-9 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#41;&#44; maduradoras tempranas &#40;9-10 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&#41;&#44; maduradoras intermedias &#40;10-11 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&#41;&#44; maduradoras tard&#237;as &#40;11-12 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&#41; y maduradoras muy tard&#237;as &#40;12-13 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&#41;&#59; los varones se consideraron&#58; maduradores muy tempranos &#40;10-11 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&#41;&#44; maduradores tempranos &#40;11-12 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&#41;&#44; maduradores intermedios &#40;12-13 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&#41;&#44; maduradores tard&#237;os &#40;13-14 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&#41; y maduradores muy tard&#237;os &#40;14-15 a&#241;os&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&#41;&#46; Se registr&#243; la edad de la menarquia y el crecimiento desde esta hasta alcanzar la talla adulta&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En ambos sexos se observaron diferencias estad&#237;sticamente significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y cl&#237;nicamente relevantes en el patr&#243;n de crecimiento puberal &#40;valores medios de talla para la edad&#44; velocidad de crecimiento para la edad y ganancia de talla puberal&#41; entre los 5 grupos maduradores y entre cada uno de ellos y la poblaci&#243;n total&#44; a pesar de que los valores de la talla adulta fueron similares en todos los grupos&#46; Se observ&#243; la misma tendencia en relaci&#243;n con la edad de la menarquia y la ganancia de talla desde la menarquia hasta la talla adulta &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En ambos sexos&#44; el inicio del brote de crecimiento puberal es un hito cr&#237;tico que determina el crecimiento puberal y el desarrollo sexual&#46; Nuestros datos contribuyen a una mejor evaluaci&#243;n cl&#237;nica del crecimiento de acuerdo con el <span class="elsevierStyleItalic">tempus</span> madurativo de cada ni&#241;o&#44; obviando los errores que se cometen con el uso de un &#250;nico patr&#243;n de referencia puberal&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Sujetos y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pubertal growth pattern differs according to age at pubertal growth spurt onset which occurs over a five years period &#40;girls&#58; 8-13 years&#44; boys&#58; 10-15 years&#41;&#46; The need for more than one pubertal reference pattern has been proposed&#46; We aimed to obtain five 1-year-age-interval pubertal patterns&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Subjects and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Longitudinal &#40;6 years of age-adult height&#41; growth study of 1&#44;453 healthy children to evaluate height-for-age&#44; growth velocity-for-age and weight-for-age values&#46; According to age at pubertal growth spurt onset girls were considered&#58; very-early matures &#40;8-9 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#41;&#44; early matures &#40;9-10 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&#41;&#44; intermediate matures &#40;10-11 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&#41;&#44; late matures &#40;11-12 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&#41; and very-late matures &#40;12-13 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&#41;&#44; and boys&#58; very-early matures &#40;10-11 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&#41;&#44; early matures &#40;11-12 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&#41;&#44; intermediate matures &#40;12-13 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&#41;&#44; late matures &#40;13-14 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&#41; and very-late matures &#40;14-15 years&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&#41;&#46; Age at menarche and growth up to adult height were recorded&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In both sexes&#44; statistically-significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; and clinically-pertinent differences in pubertal growth pattern &#40;mean height-for-age&#44; mean growth velocity-for-age and mean pubertal height gain&#44; values&#41; were found among the five pubertal maturity groups and between each group and the whole population&#44; despite similar adult height values&#46; The same occurred for age at menarche and growth from menarche to adult height &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In both sexes&#44; pubertal growth spurt onset is a critical milestone determining pubertal growth and sexual development&#46; The contribution of our data to better clinical evaluation of growth according to the pubertal maturity tempo of each child will obviate the mistakes made when only one pubertal growth reference is used&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Subjects and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
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        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Valores medios de talla y velocidad de crecimiento seg&#250;n la edad de los 5 grupos maduradores puberales&#46; Se encontraron diferencias estad&#237;sticamente significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y relevantes para la pr&#225;ctica cl&#237;nica seg&#250;n la edad de inicio del brote de crecimiento puberal&#46;</p>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">En negrita&#44; talla a la edad de inicio del brote de crecimiento puberal &#40;IBCP&#41;&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de tendencia lineal de los valores medios de talla para la edad entre los 5 grupos maduradores puberales&#58; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001 de los 6 a los 15 a&#241;os en mujeres y de los 6 a los 18 a&#241;os en varones&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mujeres</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Varones</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>743&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>710&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">118&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">116&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">114&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">116&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">121&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">123&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>Ganancia de talla de la menarquia a la talla adulta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mujeres</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>238&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>743&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Temprano n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>139&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intermedio n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Muy tard&#237;o n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>Poblaci&#243;n total n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>710&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7-8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">6&#44;8</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;4</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9-10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;4</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;6</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10-11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">7&#44;0</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;7</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;2</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;6</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11-12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;7</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;7</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">5&#44;8</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12-13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;7</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;8</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13-14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;7</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;7</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14-15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">6&#44;5</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;6</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15-16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;5&nbsp;\t\t\t\t\t\t\n
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        "texto" => "<p id="par0155" class="elsevierStylePara elsevierViewall">A los ni&#241;os&#44; padres&#44; colegios y profesores que hicieron posible este estudio&#46; Tambi&#233;n a las sociedades cient&#237;ficas &#40;Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a&#44; Sociedad Catalana de Pediatr&#237;a&#44; Sociedad Espa&#241;ola de Endocrinolog&#237;a Pedi&#225;trica&#41; e instituciones que apoyan este trabajo&#46; A Juan Bosch-Casta&#241;&#233;&#44; m&#233;dico<span class="elsevierStyleSup">&#8224;</span>&#44; y a la Dra&#46; Ariadna Campos por su contribuci&#243;n a este trabajo&#46; A Christine O&#8217;Hara y Fidelma Greaves por su ayuda en la elaboraci&#243;n de la versi&#243;n en ingl&#233;s del manuscrito&#46;</p>"
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Información del artículo
ISSN: 16954033
Idioma original: Español
DOI:10.1016/j.anpedi.2017.11.018
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