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Mansukoski L, Qamar H, Perumal N, Aimone A, Bassani DG, Roth DE. Growth delay: an alternative measure of population health based on child height distributions. Ann Hum Biol 2022; 49:100-108. [PMID: 35736806 DOI: 10.1080/03014460.2022.2091794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Indicators of child height, such as mean height-for-age Z-scores (HAZ), height-for-age difference (HAD) and stunting prevalence, do not account for differences in population-average bone developmental stage. AIM Propose a measure of child height that conveys the dependency of linear growth on stage rather than chronological age. SUBJECTS AND METHODS Using Demographic and Health Surveys (2000-2018; 64 countries), we generated: 1) predicted HAZ at specific ages (HAZ regressed on age); 2) height-age (age at which mean height matches the WHO Growth Standards median); 3) Growth delay (GD), the difference between chronological age and height-age; 4) HAD; and 5) stunting prevalence. Metrics were compared based on secular trends within countries and age-related trajectories within surveys. RESULTS In the most recent surveys (N = 64), GDs ranged from 1.9 to 19.1 months at 60 months chronological age. Cross-sectionally, HAZ, HAD and GD were perfectly correlated, and showed similar secular trends. However, age-related trajectories differed across metrics. Accumulating GD with age demonstrated growth faltering as slower than expected growth for children of the same height-age. Resumption of growth at the median for height-age was rarely observed. CONCLUSION GD is a population-level measure of child health that reflects the role of delayed skeletal development in linear growth faltering.
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Affiliation(s)
- Liina Mansukoski
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Huma Qamar
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Nandita Perumal
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, United States
| | - Ashley Aimone
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Diego G Bassani
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Daniel E Roth
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
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Dhivakar CP, Govindasamy BR, Pandian DS, Vishnu RA. Inflammatory myofibroblastic tumor of gingiva in a patient with constitutional growth delay: A rare case report. J Indian Soc Periodontol 2021; 25:250-253. [PMID: 34158693 PMCID: PMC8177183 DOI: 10.4103/jisp.jisp_279_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/18/2020] [Accepted: 10/04/2020] [Indexed: 01/15/2023] Open
Abstract
Several disorders related to growth and development affect children during their early stages of life. One rare disorder that affects about 15% of children is constitutional growth delay (CGD). Its results in the affected individuals appear unusually short and young for their age. The individuals are otherwise normal and appear as their normal counterparts as age increases. Inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor that commonly affects the lungs, liver, and gastrointestinal tract. The occurrence of this tumor outside the aforementioned areas is very rare. It resembles a neoplastic tumor clinically and histologically. It is also referred to as inflammatory pseudotumor. Here, we report the case of an individual with CGD who also had an IMT involving the mandibular left canine region.
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Affiliation(s)
- C P Dhivakar
- Department of Periodontics, Karpaga Vinayaga Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India
| | | | - Divya Shree Pandian
- Department of Periodontics, Karpaga Vinayaga Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India
| | - R Arvinth Vishnu
- Department of Periodontics, Karpaga Vinayaga Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India
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Abstract
Constitutional delay of growth and puberty is a transient state of hypogonadotropic hypogonadism associated with prolongation of childhood phase of growth, delayed skeletal maturation, delayed and attenuated pubertal growth spurt, and relatively low insulin-like growth factor-1 secretion. In a considerable number of cases, the final adult height (Ht) does not reach the mid-parental or the predicted adult Ht for the individual, with some degree of disproportionately short trunk. In the pre-pubertal male, testosterone (T) replacement therapy can be used to induce pubertal development, accelerate growth and relieve the psychosocial complaints of the adolescents. However, some issues in the management are still unresolved. These include type, optimal timing, dose and duration of sex steroid treatment and the possible use of adjunctive or alternate therapy including: oxandrolone, aromatase inhibitors and human growth hormone.
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Affiliation(s)
- Ashraf T. Soliman
- Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar
| | - Vincenzo De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy
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Oh YJ, Yu BK, Shin JY, Lee KH, Park SH, Lee KC, Son CS. Comparison of predicted adult heights measured by Bayley-Pinneau and Tanner-Whitehouse 3 methods in normal children, those with precocious puberty and with constitutional growth delay. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.3.351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Yeon Joung Oh
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Byung Keun Yu
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Jung Yeon Shin
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Sang Hee Park
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Kwang Chul Lee
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
| | - Chang Sung Son
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
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Dempfle A, Wudy SA, Saar K, Hagemann S, Friedel S, Scherag A, Berthold LD, Alzen G, Gortner L, Blum WF, Hinney A, Nürnberg P, Schäfer H, Hebebrand J. Evidence for involvement of the vitamin D receptor gene in idiopathic short stature via a genome-wide linkage study and subsequent association studies. Hum Mol Genet 2006; 15:2772-83. [PMID: 16905557 DOI: 10.1093/hmg/ddl218] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Stature is a highly heritable trait under both polygenic and major gene control. We aimed to identify genetic regions linked to idiopathic short stature (ISS) in childhood, through a whole genome scan in 92 families each with two affected children with ISS, including constitutional delay of growth and puberty and familial short stature. Linkage analysis was performed for ISS, height and bone age retardation. Chromosome 12q11 showed significant evidence of linkage to ISS and height (maximum non-parametric multipoint LOD scores 3.18 and 2.31 at 55-58 cM, between D12S1301 and D12S1048), especially in sister-sister pairs (LOD score of 1.9 for ISS in 22 pairs). These traits were also linked to chromosomes 1q12 and 2q36. The region on chromosome 12q11 had previously shown significant linkage to adult stature in several genome scans and harbors the vitamin D receptor gene, which has been associated with variation in height. A single nucleotide polymorphism (SNP) (rs10735810, FokI), which leads to a functionally relevant alteration at the protein level, showed preferential transmission of the transcriptionally more active G-allele to affected children (P=0.04) and seems to be responsible for the observed linkage (P=0.05, GIST test). Bone age retardation showed moderate linkage to chromosomes 19p11-q11 and 7p14 (LOD scores 1.69 at 57 cM and 1.42 at 50 cM), but there was no clear overlap with linkage regions for stature. In conclusion, we identified significant linkage, which might be due to a functional SNP in the vitamin D receptor (VDR) gene and could be responsible for up to 34% of ISS cases in the population.
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Affiliation(s)
- Astrid Dempfle
- Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Germany.
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Wudy SA, Hagemann S, Dempfle A, Ringler G, Blum WF, Berthold LD, Alzen G, Gortner L, Hebebrand J. Children with idiopathic short stature are poor eaters and have decreased body mass index. Pediatrics 2005; 116:e52-7. [PMID: 15995019 DOI: 10.1542/peds.2004-1684] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In children with idiopathic short stature (ISS), studies investigating body mass index (BMI) or parameters of satiety regulation are scarce, and studies analyzing eating behavior are lacking. METHODS We recruited 214 children (123 index cases and 91 siblings) with ISS from 123 families. Affected children had to have a body height <5th percentile, or, in the case of siblings, the body height of 1 child had to be <5th percentile and the other <15th percentile. Medical histories were recorded by using structured and standardized interviews. Eating behavior was assessed by using the Child Eating Behavior Questionnaire. Percent energy intake as fat was assessed by using the Leeds Food Frequency Questionnaire. Endocrine markers of body weight regulation (leptin, ghrelin) were determined in serum. RESULTS Compared with population norms, BMI was significantly lower (mean: -0.33 standard deviation score). Furthermore, there was decreased food responsiveness (mean Child Eating Behavior Questionnaire score: 1.9; population mean: 2.4), reduced enjoyment of food (3.2 vs 3.9), emotional undereating (2.6 vs 3.0), lower desire to drink (2.0 vs 2.8), and increased fussiness over food (3.2 vs 2.9). When the sample was subdivided into the 2 groups of "good" and "poor" eaters according to the mothers' assessment of the current eating behavior, reduction in BMI as well as the behavioral characteristics already delineated in the total sample were found to be even more consistent in the subgroup of poor eaters. In the total sample of our children, as well as in both subgroups, serum leptin (adjusted for gender, BMI, and Tanner stage) was found to be moderately raised but did not differ between poor and good eaters. Total serum ghrelin was not different between poor and good eaters. CONCLUSIONS Our clinical, behavioral, and endocrinologic findings in patients with ISS point to an altered eating behavior that possibly contributes to their short stature.
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Affiliation(s)
- Stefan A Wudy
- Department of General Pediatrics, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany.
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Sperlich M, Butenandt O, Schwarz HP. Final height and predicted height in boys with untreated constitutional growth delay. Eur J Pediatr 1995; 154:627-32. [PMID: 7588962 DOI: 10.1007/bf02079065] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report on 49 boys with constitutional growth delay (CGD) who were initially seen in our clinic at a mean chronological age of 13.3 years (range, 7.3-16.4) and a bone age of 11.1 years (range, 6.0-13.5). All were below the 5th height percentile for chronological age. A positive family history with delayed growth and puberty in one or both parents could be elicited in 75%. All 49 patients were re-examined at a mean age of 22.9 years (range, 20.4-31.2). Measured final height was 171.3 cm (range, 161.2-181.7), which was slightly, but significantly lower than mean target height of 173.0 cm. Final height expressed as standard deviation score (SDS) of a male adult population standard was -1.0 (range, -2.4 to 5), also significantly lower than initial height SDS related to bone age (SDSBA) of -0.5 (range, -1.6 to 2). If related to target height (Tanner), final height was found to correlate positively with the initial bone age deficit and the initial height SDSBA. Observed final height was also compared with the predicted adult height by the methods of Bayley-Pinneau (BP), Tanner-Whitehouse Mark II (TW II) and Roche-Wainer-Thissen. Regression equations between all three prediction methods and final height showed an excellent correlation (P < 0.0001). However, only by the BP method was predicted height very close to and no different from measured final height (paired t-test). Despite this, final height in 16 of 49 patients (32.6%) differed by more than 5.0 cm from BP predicted height.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Sperlich
- Universitäts-Kinderklinik, München, Germany
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