Short Adult Stature Research Articles

Deciphering short stature in children.

Short stature is a common reason for referral to pediatric endocrinologists. Multiple factors, including genetic, prenatal, postnatal, and local environmental factors, can impair growth. The majority of children with short stature, which can be defined as a height less than 2 standard deviation score below the mean, are healthy. However, in some cases, they may have an underlying relevant disease; thus, the aim of clinical evaluation is to identify the subset of children with pathologic conditions, for example growth hormone deficiency or other hormonal abnormalities, Turner syndrome, inflammatory bowel disease, or celiac disease. Prompt identification and management of these children can prevent excessive short stature in adulthood. In addition, a thorough clinical assessment may allow evaluation of the severity of short stature and likely growth trajectory to identify the most effective interventions. Consequently, appropriate diagnosis of short stature should be performed as early as possible and personalized treatment should be started in a timely manner. An increase in knowledge and widespread availability of genetic and epigenetic testing in clinical practice in recent years has empowered the diagnostic process and appropriate treatment for short stature. Furthermore, novel treatment approaches that can be used both as diagnostic tools and as therapeutic agents have been developed. This article reviews the diagnostic approach to children with short stature, discusses the main causes of short stature in children, and reports current therapeutic approaches and possible future treatments.

Growth status of children and adolescents born small for gestational age at full term in Korea: data from the KNHANES-V.

Objectives Small for gestational age (SGA) status is known to show stunted growth and results in short stature in adults. The aim of this study was to describe the current short stature in subjects born SGA in Korea and to assess catch-up growth (CUG) or non-CUG. Methods We analyzed data from 3,524 subjects (1,831 male) aged 1-18 years who were born as full-term singletons and who participated in the Fifth Korean National Health and Nutrition Examination Survey (2010-2011). Results The prevalence of SGA was 13.4% (n=471). Subjects born SGA had fathers with shorter height, shorter mother's height, and mid-parental height than non-SGA subjects (p<0.05 for all). The odds ratios (ORs) for SGA birth of a short statured father and a short statured mother were 2.00 (95% CI; 1.15-3.47) and 2.11 (95% CI; 1.30-3.40), respectively. Among 471 SGA subjects, 28 subjects (5.9%) were non-CUG, which made up 36.4% of all subjects with short stature. The CUG subjects had a higher father's height, mother's height, mid-parental height, and current BMI (p<0.05 for all). The non-CUG subjects had a higher percentage of fathers being near-short stature (height<10th percentile; 33.3 vs. 12.7%; p=0.008) and mothers being near-short stature (39.3 vs. 13.9%; p<0.001). Conclusion Korean subjects born SGA had a higher risk of current short stature. This population-based nationwide survey also showed that both father's and mother's short stature are risk factors of not only SGA birth but also non-CUG in their children.

Phenotype of genetically confirmed Silver-Russell syndrome beyond childhood

BackgroundSilver-Russell syndrome is an imprinting disorder that restricts growth, resulting in short adult stature that may be ameliorated by treatment. Approximately 50% of patients have loss of methylation of the...

Predictive outcome measures of adult short stature in patients with severe acquired autoimmune hypothyroidism.

Hypothyroidism caused by Hashimoto's thyroiditis is the most common reason for thyroid dysfunction in children. Our objective was to analyze its impact on final stature in relation to height and pubertal stage at the time of diagnosis in children younger than 18 years with severe autoimmune hypothyroidism. Out of 79 patients, 78.5 % were girls. Those with goiter (56 %) had a better height at diagnosis than those without goiter (mean standard deviation score for height: 0.2 versus -2.42; p < 0.0001). Five girls (6.3 %) had precocious puberty. When considering the final stature of patients (n: 33), among those with short stature at the time of diagnosis, pubertal children had a significantly shorter final stature than prepubertal children (mean standard deviation score for height: -2.82 versus -1.52; p = 0.0311). The late diagnosis of severe hypothyroidism in pediatrics has a negative impact on final stature, especially in those who were pubertal patients at the time of diagnosis.

PMU142 ASSESSING THE HUMAN AND ECONOMIC BURDEN OF SHORT STATURE: A SYSTEMATIC LITERATURE REVIEW

We sought to better understand the human and economic burden of short stature (SS) using a systematic literature review. Studies of the human and economic burden of SS in adults and children, due to any cause, were searched using Embase, MEDLINE and Cochrane databases in December 2018, capturing publications from 2008 onwards. Case series and populations with adult-onset growth hormone deficiency (GHD) were excluded. Of 1239 publications identified, 26 studies (17 in children, 9 in adults) met inclusion criteria, with sample sizes of the SS populations ranging from 15 to 285. Thirteen studies were in mixed populations, four in GHD only, four in chronic kidney disease (CKD), and one each in Turner syndrome, Prader-Willi syndrome, skeletal dysplasia, congenital adrenal hyperplasia, and childhood-onset multiple pituitary hormone deficiency. No economic studies were identified. Twelve studies compared quality of life (QoL) in children with SS and those with normal height; 10 found that QoL was significantly poorer in children with SS and two (both in CKD populations) found no association. Of five studies that investigated height as a predictor of QoL among children with SS, all found greater height was associated with better QoL. One study highlighted negative social experiences in children with SS. Two studies evaluated cognitive function, finding cognitive scores were significantly poorer in children with SS than in those with normal height. In adults, six studies demonstrated impaired QoL with SS versus normal height, while two found no association and one reported mixed results. The literature suggests that compared with those with normal height, children and adults with SS of any cause experience poorer QoL and in children it may negatively impact social and cognitive functioning. Further research could extend our understanding of the human and economic burden in this field.

Chemicals in Personal Care Products Tied to Early Puberty in Girls

Precocious puberty is defined as the onset of menarche before 9 years of age, or the appearance of secondary sex characteristics before 8 years of age. It is associated with many psychosocial disturbances and adverse health outcomes such as: cardiovascular disease, shorter adult stature, an increased risk of type 2 diabetes and breast cancer. There is a general tendency to a progressive decrease in age of reaching puberty, specifically the onset of thelarche and menarche, girls being 10 times more affected than boys. This actual tendency can be explained by the increasing prevalence of childhood obesity and also by increasing environmental exposure to endocrine disruptor chemicals in household and personal care products.Phenols, phthalates, parabens and other compounds, such as polybrominated biphenyls and diethylstilbestrol are associated with precocious onset of puberty in girls, in case of in-utero or peripubertal exposure. These chemicals are frequently found in toothpaste, cosmetics, soups, shampoos, perfumes and other personal care products, interfering with sex hormones and puberty timing. This is why pregnant women should be more aware and avoid products based on these chemicals.

Body surface area and glucose tolerance – The smaller the person, the greater the 2-hour plasma glucose

BackgroundThe oral glucose tolerance test (OGTT) is standardized globally with a uniform glucose load of 75 g to all adults irrespective of body size. An inverse association between body height and 2-hour postload plasma glucose (2hPG) has been demonstrated. Our aim was to evaluate the relationship between body surface area (BSA) and plasma glucose values during an OGTT. MethodsAn OGTT was performed on 2659 individuals at increased cardiovascular risk aged between 45 and 70 years of age, who had not previously been diagnosed with diabetes or cardiovascular disease. Their BSA was calculated according to the Mosteller formula. Study subjects were divided into five BSA levels corresponding to 12.5, 25, 25, 25, and 12.5% of the total distribution. FindingsWhen adjusted for age, sex, waist circumference, alcohol intake, current smoking, and leisure-time physical activity, BSA level showed an inverse linear relationship with the 2hPG in all categories of glucose tolerance (p for linearity < 0.001). Moreover, the smaller the adjusted BSA of the study person, the higher the proportion of newly diagnosed type 2 diabetes based on 2hPG in the OGTT. InterpretationBody size has a considerable impact on the findings from a standardized OGTT. Smaller persons are more likely to be diagnosed as glucose intolerant than relatively larger sized individuals. FundingThis work was supported by the State Provincial Office of Western Finland, the Central Satakunta Health Federation of Municipalities, Satakunta Hospital District, and the Hospital District of Southwest Finland. Research in contextEvidence before this study. We searched PubMed using the MeSH terms “glucose tolerance test”, “body surface area”, “body height”, “body size”, “glucose tolerance”, “insulin resistance”, “blood glucose” and “diabetes mellitus” on March 10, 2019 without language restrictions. We also used Cited Reference Search in Web of Science for relevant articles. The oral glucose tolerance test (OGTT) is standardized globally with a uniform glucose load of 75 g to all adults irrespective of body size. An inverse association between body height and 2-hour postload plasma glucose (2hPG) has been demonstrated. Several studies have shown that 2hPG predicts all-cause mortality better than elevated fasting glucose. However, body height or body surface area are not usually adjusted in epidemiological studies. It is well known that short adult stature is a risk factor for cardiovascular and all-cause mortality.Added value of this study. This is the first study to assess the relationship of body surface area and 2hPG in a typical primary care population at increased cardiovascular risk. Body surface area has a considerable impact on the result of a standardized OGTT. Smaller individuals are more likely to be diagnosed as glucose intolerant than relatively larger sized individuals.Implications of all the available evidence. There is a possibility that the diagnosis of type 2 diabetes made by an OGTT is a false positive result in a relatively small individual, and a false negative result in a relatively larger individual. Association of 2hPG concentrations and mortality may be influenced by body size as confounding factor. Given that the OGTT is a time and effort consuming test both for patients and laboratory personnel, validity of the OGTT for different body sizes should be reconsidered.

Early Menarche is a Risk Factor for Short Stature in Young Korean Females: An Epidemiologic Study

Objective:To assess the association between age at menarche and adult height [and body mass index (BMI)] in young Korean females and also to investigate whether early menarche (<12 years) is a risk factor for short stature and obesity in young Korean females.Methods:Data on 1148 females aged 18-30 years and 612 mother (612 pairs of mothers and daughters) from the 6th Korea National Health and Nutrition Examination Survey (2013-2015) were analyzed.Results:Among 1148 females, 256 (22.3%) had early menarche. Their stature was approximately 0.445 cm shorter when menarche had occurred one year earlier. The prevalence of short stature (≤153 cm) and obesity (BMI ≥25) was higher in females with early menarche compared to those with later menarche (short stature: 10.5% vs 6.4%, obesity; 20.7% vs 13.1%, all p<0.001). In multivariate regression, the odds ratio (OR) for short stature was 2.62 [95% confidence interval (CI): 1.26-5.44] after adjusting for current age and mother’s height. OR for obesity was 1.74 (95% CI: 0.98-3.07) after adjusting for age and maternal BMI.Conclusion:Final height in girls is influenced by age of menarche. Early menarche increased the risk for adult short stature in young Korean females.

The Dual Burden of Malnutrition Increases the Risk of Cesarean Delivery: Evidence From India.

Background: Among contemporary human populations, rates of cesarean delivery vary substantially, making it difficult to know if the procedure is inadequately available, or used excessively relative to medical need. A much-cited evolutionary hypothesis attributed birth complications to an “obstetric dilemma,” resulting from antagonistic selective pressures acting on maternal pelvic dimensions and fetal brain growth during hominin evolution. However, the childbirth challenges experienced by living humans may not be representative of those in the past, and may vary in association with trends in ecological conditions. We hypothesized that variability in maternal phenotype (height and nutritional status) may contribute to the risk of cesarean delivery. In many populations, high levels of child stunting contribute to a high frequency of short adult stature, while obesity is also becoming more common. The combination of short maternal stature and maternal overweight or obesity may substantially increase the risk of cesarean delivery.Methods: Using data from two large Indian health surveys from 2005–6 to 2015–2016, we tested associations of maternal somatic phenotype (short stature, overweight) with the risk of cesarean delivery, adjusting for confounding factors such as maternal age, birth order, rural/urban location, wealth and offspring sex.Results: Secular trends in maternal body mass index between surveys were greater than trends in height. Maternal short stature and overweight both increased the risk of cesarean delivery, most strongly when jointly present within individual women. These associations were independent of birth order, wealth, maternal age and rural/urban location. Secular trends in maternal phenotype explained 18% of the increase in cesarean rate over 10 years.Conclusion: Our results highlight how the emerging dual burden of malnutrition (persisting short adult stature which reflects persistent child stunting; increasing overweight in adults) is likely to impact childbirth in low and middle-income countries.

Suplementação de hormônio do crescimento ou zinco no crescimento de crianças não eutróficas: síntese de evidências para tomada de decisão estratégica na gestão em saúde

A baixa estatura infantil está relacionada a fatores como morbidade, mortalidade, baixa estatura na idade adulta, e estado nutricional, podendo ser causada por influências genéticas ou ambientais. Objetivo: Revisar na literatura acerca das técnicas a suplementação do zinco ou a utilização de hormônio GH no crescimento de crianças, comparando suas vantagens e aplicações. Metodologia: Trata-se de uma revisão da literatura com síntese de evidências, com artigos sobre a comparação entre os efeitos do hormônio do crescimento GH e zinco no crescimento de crianças não eutróficas. Síntese de evidências: ao se comparar a capacidade de ambos os métodos de diferenciação o hormônio GH é um tratamento em longo prazo podendo levar à altura adulta dentro do esperado e a suplementação do zinco atua diretamente no hormônio GH já produzido pela criança obtendo resultados diferentes pois depende da resposta de cada organismo.

Novel aggrecan variant, p. Gln2364Pro, causes severe familial nonsyndromic adult short stature and poor growth hormone response in Chinese children

BackgroundMutations in the aggrecan (ACAN) gene can cause short stature (with heterogeneous clinical phenotypes), impaired bone maturation, and large variations in response to growth hormone (GH) treatment. For such cases, long-term longitudinal therapy data from China are still scarce. We report that a previously unknown ACAN gene variant reduces adult height and we analyze the GH response in children from an affected large Chinese family.MethodsTwo children initially diagnosed with idiopathic short stature (ISS) and a third mildly short child from a large Chinese family presented with poor GH response. Genetic etiology was identified by whole exome sequencing and confirmed via Sanger sequencing. Adult heights were analyzed, and the responses to GH treatment of the proband and two affected relatives are summarized and compared to other cases reported in the literature.ResultsA novel ACAN gene variant c.7465 T > C (p. Gln2364Pro), predicted to be disease causing, was discovered in the children, without evident syndromic short stature; mild bone abnormity was present in these children, including cervical-vertebral clefts and apophyses in the upper and lower thoracic vertebrae. Among the variant carriers, the average adult male and female heights were reduced by − 5.2 and − 3.9 standard deviation scores (SDS), respectively. After GH treatment of the three children, first-year heights increased from 0.23 to 0.33 SDS (cases in the literature: − 0.5 to 0.8 SDS), and the average yearly height improvement was 0.0 to 0.26 SDS (cases in the literature: − 0.5 to 0.9 SDS).ConclusionsWe report a novel pathogenic ACAN variant in a large Chinese family which can cause severe adult nonsyndromic short stature without evident family history of bone disease. The evaluated cases and the reports from the literature reveal a general trend of gradually diminishing yearly height growth (measured in SDS) over the course of GH treatment in variant-carrying children, highlighting the need to develop novel management regimens.

Relationship Between Dyslipidemia and Short Stature in Adults; from the Korean NHANES Survey

Relationship Between Dyslipidemia and Short Stature in Adults; from the Korean NHANES Survey

Effect of maternal height on caesarean section and neonatal mortality rates in sub-Saharan Africa: An analysis of 34 national datasets.

RationaleThe lifecycle perspective reminds us that the roots of adult ill-health may start in-utero or in early childhood. Nutritional and infectious disease insults in early life, the critical first 1000 days, are associated with stunting in childhood, and subsequent short adult stature. There is limited or no opportunity for stunted children above 2 years of age to experience catch-up growth. Some previous research has shown short maternal height to lead to adverse birth outcomes. In this paper, we document the association between maternal height and caesarean section, and between maternal height and neonatal mortality in 34 sub-Saharan African countries. We also explore the appropriate height cut-offs to use. Our paper contributes arguments to support a focus on preventing non-communicable risk factors, namely early childhood under-nutrition, as part of the fight to reduce caesarean section rates and other adverse maternal and newborn health outcomes, particularly neonatal mortality. We focus on the Sub-Saharan Africa region because it carries the highest burden of maternal and neonatal ill-health.MethodsWe used the most recent Demographic and Health Survey for 34 sub-Saharan African countries. The distribution of heights of women who had given birth in the 5 years before the survey was explored. We adopted the following cut-offs: Very Short (<145.0cm), Short (145.0–149.9cm), Short-average (150.0–154.9cm), Average (155.0–159.9cm), Average-tall (160.0–169.9cm) and Tall (≥170.0cm). Multivariate logistic regression was used to assess the contribution of maternal stature to the odds ratio of caesarean section delivery, adjusting for other exposures, such as age at index birth, residence, maternal BMI, maternal education, wealth index quintile, previous caesarean section, multiple birth, birth order and country of survey. We also look at its contribution to neonatal mortality adjusting for age at index birth, residence, maternal BMI, maternal education, wealth index quintile, multiple birth, birth order and country of survey.ResultsThere was a gradual increase in the rate of caesarean section with decreasing maternal height. Compared to women of Average height (155.0–159.9cm), taller women were protected. The adjusted odds ratio (aOR) for Tall women was 0.67 (95% CI:0.52–0.87) and for Average-tall women was 0.78 (95% CI:0.69–0.89). Compared to women of Average height, shorter women were at increased risk. The aOR for Short-average women was 1.19 (95% CI:1.03–1.37), for Short women was 2.06 (95% CI:1.71–2.48), and for Very Short women was 2.50 (95% CI:1.85–3.38). There was evidence that compared to Average height women, Very Short and Short women had increased odds of experiencing a neonatal death aOR = 1.95 (95% CI 1.17–3.25) and aOR = 1.66 (95% CI 1.20–2.28) respectively. When we focused on the period of highest risk, the day of delivery and first postnatal day, these aORs increased to 2.36 (95% CI 1.57–3.55) and 2.34 (95% CI 1.19–4.60) respectively. The aORs for the first week of life (early neonatal mortality) were 1.90 (95% CI 1.07–3.36) and 1.83 (95% CI 1.30–2.59) respectively.ConclusionsShort stature is associated with an increased prevalence of caesarean section and neonatal mortality, particularly on the newborn’s first days. These results are even more striking because we know that caesarean section rates tend to be higher among wealthier and more educated women, who are often taller and that the same patterns may hold for neonatal survival; in such cases, adjusting for wealth, education and urban residence would attenuate these associations. Caesarean sections can be lifesaving operations; however, they cost the health system and families more, and are associated with worse health outcomes. We suggest that our findings be used to argue for policies targeting stunting in infant girls and potential catch-up growth in adolescence and early adulthood, aiming to increase their adult height and thus decrease their subsequent risk of experiencing caesarean section and adverse birth outcomes.

Endocrine and Metabolic Disturbances in Survivors of Hematopoietic Stem Cell Transplantation in Childhood and Adolescence

Background/Aims: The objective was to evaluate endocrine complications in survivors of hematopoietic stem cell transplantation (HSCT) performed during childhood. Methods: Endocrine dysfunction and metabolic syndrome parameters were assessed by chart review of 178 childhood HSCT survivors (median age at evaluation, 15.5 [range: 3.8–29.8] years; median follow-up, 8.5 [range: 2–23.4] years). Results: The following statistically significant associations were identified (p < 0.05 for all): growth hormone deficiency (17.4%) was associated with cranial/craniospinal irradiation, total body irradiation (TBI), allogeneic HSCT, and longer follow-up. Short adult stature (23.3% of patients who had attained adult height) was associated with cranial/craniospinal irradiation and, in females, with younger age at HSCT. Primary gonadal failure was more prevalent in females (52.6 vs. 24.1%), and was associated with TBI in males and with a primary diagnosis of hematological malignancy in females. Hypothyroidism (25.2%) was associated with previous neck/mediastinal irradiation. Metabolic disturbances included obesity (3.9%), type 2 diabetes (2.2%), impaired glucose tolerance (2.8%), and dyslipidemia (18.5%). Dyslipidemia was associated with a primary diagnosis of hematological malignancy, TBI, and a positive family history of dyslipidemia. Endocrine dysfunction was less frequent in patients who had received fludarabine. Conclusions: Patients after HSCT require long-term surveillance for the detection of endocrine and metabolic disorders. Nonmyeloablative conditioning regimens may reduce the incidence of these complications.

Short children born small for gestational age outcomes in the era of growth hormone therapy

Small-for-gestational age (SGA) infants are at risk for short and long term medical and metabolic complications. Most SGA infants (85–90%) demonstrate spontaneous catch-up growth, typically in the first year after birth. Although catch-up growth (CUG) is a desired goal, it is important to note if CUG is too rapid the infants are at increased risk for insulin resistance and type 2 diabetes mellitus as they become adults. On the flip side, infants who do not exhibit CUG are also at increased risk of adverse adult outcomes including those for cardiovascular disease, insulin resistance and type 2 diabetes mellitus, neurodevelopmental and cognitive impairments, in addition to adult short stature. Treatment with growth hormone is safe and effective not only in increasing adult height, but also in improving body composition and decreasing metabolic complications. The aims of this review are to summarize the current knowledge on what constitutes “healthy” catch-up growth in children born SGA as well as provide an update on the role of growth hormone treatment for short children born SGA.

Long-Term Skeletal Disproportion in Childhood-Onset Crohn’s Disease

Background: It is unclear whether Crohn’s disease (CD) is associated with skeletal disproportion in adulthood. Methods: Height (Ht), sitting height (SHt) and leg length were studied in 44 children (male: 22), 23 adults (male: 10) with childhood-onset (CO) CD and 26 adults (male: 9) with adult-onset (AO) CD with a median (range) age of 13.7 (10, 17.3), 21.5 (18, 32) and 31.0 (22, 40) years, respectively. Results: Adults with CO-CD had a median Ht standard deviation score (SDS) of –0.9 (–2.3, 0.0) compared to 0.6 (–0.8, 1.0) in those with AO-CD (p < 0.05). Compared to a normal population, men, but not women, with CO-CD also had lower median SHt SDS at –1.1 (2.5, –0.5) (p < 0.05). The expected positive association that is normally found between leg length and SHt SDS was not evident in the adults with CO-CD. Conclusion: Short stature in adults with CO-CD is more pronounced in men and may be associated with poor spinal growth.

Association between height and periodontitis in Korean adults: Results from KNHANES IV and V.

Evidence shows that a short stature in adulthood is associated with chronic diseases. However, few studies have investigated the association between height and periodontitis. The purpose of this study was to examine the relationship between adult height and periodontitis and to assess the roles of covariates in different birth cohorts of Korea. This was a cross-sectional study using the data from the 4th and 5th Korea National Health and Nutritional Examination Survey. The subjects were grouped into 2 birth cohorts based on their historical and social context: born from 1946 to 1962 and from 1963 to 1978. The dependent variables were periodontitis and severe periodontitis, while the independent variable was the height quartile. Demographic factors (age and gender), socioeconomic position (own education, region and income), health behaviors (frequency of daily tooth brushing and smoking) and medical status (diabetes) were included. Logistic regression analyses estimated the association of adult height with periodontitis after sequential adjustments. The sample size of the final analysis was 18010. The shortest quartile was associated with severe periodontitis (OR=1.55, 95% CI 1.11-2.16) in the 1963-1978 birth cohort. The association remained after full adjustment in the 1963-1978 birth cohort (OR=1.41, 95% CI 1.01-1.97). Our study shows that there is an inverse association between height and severe periodontitis only in the younger Korean birth cohort. Our results support the impact of height, as an early childhood environmental indicator, on severe periodontitis in adulthood.

GnRH agonist treatment for idiopathic central precocious puberty can improve final adult height in Chinese girls

ObjectTo study the outcomes of GnRHa on final adult height in Chinese idiopathic central precocious puberty (ICPP) girls and the involved factor(s) that can predict height gain.MethodsWe conducted a retrospective analysis on 10 years of data obtained from three clinical hospitals from January 2005 to March 2015, and 101 girls with ICPP, who received GnRHa therapy for more than six months and already reached their adult height were enrolled.ResultsHeight, bone age, midparent height, HtSDS, sexual development, therapy duration and predicted adult height(PAH)at start and end of GnRHa, and the final adult height(FAH) were recorded and calculated. Their PAH significantly increased at end of GnRHa (158.4±6.00cm), compared to that at the start of GnRHa(153.1±5.37cm) (P<0.001), and their final adult height(157.0±4.82) significantly increased compared to PAH at start of GnRHa(P<0.001). There was no difference between PAH at end of GnRHa and FAH(P>0.05). After GnRHa therapy, most of the ICPP girls reached their midparent height compared to that at start of GnRHa(P<0.01). FAH was positively correlated with Ht at start, and end of GnRHa, PAH at start and end of GnRHa, and also with midparent height (R2=0.59, 0.74, 0.68, 0.73 and 0.80, P<0.001). While FAH was not correlated with the duration of treatment and BA at start of GnRHa(R2 = 0.15and 0.1, P>0.05). The percentage of adult short stature decreased and those reached midparent height significantly increased after GnRHa therapy, compared to that at start of GnRHa(60.6% vs.30.4% and 67.85% vs. 94.64%, respectively, P<0.05).ConclusionsGnRHa therapy to ICPP girls can effectively achieve the final adult height. After GnRHa therapy, most of these patients reached their midparent height, while few of these patients had an adult short stature.

Low Habitual Dietary Calcium and Linear Growth from Adolescence to Young Adulthood: results from the China Health and Nutrition Survey

Evidences from clinical trials and meta-analyses of calcium supplementation in linear growth have given conflicting results, and few longitudinal studies have investigated the long-term associations between dietary calcium and linear growth, especially in the population with low-calcium plant-based diets. We investigated the prospective associations of low habitual dietary calcium with adult height and height-for-age z-score (HAZ) from adolescence to adulthood among 2019 adolescents from the China Health and Nutrition Survey (CHNS). The average dietary calcium intakes were 426(standard deviation: 158) mg/d in boys and 355(134) mg/d in girls during adolescence. During a median follow-up of 7.0 (interquartile range: 5.9–9.0) years, boys reached an average of 169.0(6.7) cm and girls reached 158.4(5.8) cm in adulthood. After adjusting for other potential confounders, non-linear regression found that boys with dietary calcium intakes below 327 mg/d had shorter adult stature, and those taking over 566 mg/d had faster height growth whether adjusting for physical exercises level or not. No significant associations were found in girls. Our study suggests that in boys with plant-based diets, higher dietary calcium intake during adolescence is associated with faster height growth, but not with adult height; calcium intake below 300 mg/d may result in shorter adult stature.

The shorter the person, the higher the blood pressure: a birth cohort study.

Short adult stature is known to be associated with increased cardiovascular morbidity and mortality, but the underlying explanatory mechanisms remain largely unknown. The purpose of the current study was to evaluate the relationship between height and blood pressure (BP), a major determinant of cardiovascular disease (CVD). We performed BP measurements including 24-h ambulatory BP measurements in 534 participants (mean age 61 ± 3 years, 51.3% women) from the Helsinki Birth Cohort Study. None of the study participants had medication affecting vasculature or BP. We assessed the influence of height on CVD risk factors with a standardized z-score representing the difference from the mean value for the whole study cohort. Daytime SBP, pulse pressure, and mean arterial pressure showed significant inverse associations with height (adjusted for age, leisure-time physical activity, body fat percentage, and smoking). Height was by itself a strong determinant of pulse pressure independently of BMI. In addition, total cholesterol, triglycerides, and apolipoprotein B concentrations decreased with increasing height. Shorter individuals have higher BP levels than taller individuals. This may at least partly explain the inverse association between height and CVD. In normal weight and slightly overweight individuals, the relationship between BP and height is independent of BMI and adiposity.