Abstract
Humans are one of the few species undergoing an adolescent growth spurt. Because children enter the spurt at different ages making age a poor maturity measure, longitudinal studies are necessary to identify the growth patterns and identify commonalities in adolescent growth. The standard maturity determinant, peak height velocity (PHV) timing, is difficult to estimate in individuals due to diurnal, postural, and measurement variation. Using prospective longitudinal populations of healthy children from two North American populations, we compared the timing of the adolescent growth spurt’s peak height velocity to normalized heights and hand skeletal maturity radiographs. We found that in healthy children, the adolescent growth spurt is standardized at 90% of final height with similar patterns for children of both sexes beginning at the initiation of the growth spurt. Once children enter the growth spurt, their growth pattern is consistent between children with peak growth at 90% of final height and skeletal maturity closely reflecting growth remaining. This ability to use 90% of final height as easily identified important maturity standard with its close relationship to skeletal maturity represents a significant advance allowing accurate prediction of future growth for individual children and accurate maturity comparisons for future studies of children’s growth.
Highlights
Predicting children’s future growth, while important for many specialties, remains challenging
Our present study’s hypotheses are that (1) timing relative to the growth spurt, the peak growth age (PGA), is highly correlated with growth remaining, and (2) that skeletal maturity using previously described, reliable methods from hand radiographs accurately predicts growth remaining. We tested these hypotheses via longitudinal analyses of two prospective studies, comparing the PGA to percentage of final height and skeletal maturation and identify a uniform pattern of growth during the human adolescent growth spurt closely related to skeletal maturity to providing future growth predictions by percentage of adult height achieved
Standard height prediction methods in children take into consideration current height and either chronological or skeletal maturity percentiles with the assumption that the child will remain a similar percentile through growth
Summary
Predicting children’s future growth, while important for many specialties, remains challenging. Our present study’s hypotheses are that (1) timing relative to the growth spurt, the PGA, is highly correlated with growth remaining, and (2) that skeletal maturity using previously described, reliable methods from hand radiographs accurately predicts growth remaining. We tested these hypotheses via longitudinal analyses of two prospective studies, comparing the PGA to percentage of final height and skeletal maturation and identify a uniform pattern of growth during the human adolescent growth spurt closely related to skeletal maturity to providing future growth predictions by percentage of adult height achieved
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