Stature Group Research Articles

Investigation of vitamin D deficiency in girls with growth and development variations—a single center study

PurposeTo understand the status of vitamin D deficiency in girls with growth and developmental variations, as well as the impact of COVID−19 on their vitamin D levels, and to provide reference for the prevention and treatment of vitamin D deficiency in children.MethodsA retrospective analysis was conducted on 1,345 instances of girls with growth and developmental variations who visited our pediatric endocrinology department and completed vitamin D detection. A total of 279 girls with complete data were included in this study. Among them, 246 girls were classified into four groups based on different growth and developmental variations: early puberty group, menarche group, obesity group, short stature group, and 33 healthy girls served as the control group. Besides, the girls were divided into pre-epidemic and post-epidemic groups by the occurrence of the COVID-19 epidemic. Vitamin D were measured in all girls. The 25(OH)D <20 ng/ml was used as the standard for vitamin D deficiency.ResultsThe levels of vitamin D in the early puberty group, menarche group, obesity group, short stature group, and control group were as follows: 20.23 ± 5.90 ng/ml, 17.85 ± 5.69 ng/ml, 21.31 ± 8.99 ng/ml, 27.90 ± 12.27 ng/ml, and 29.42 ± 12.65 ng/ml, respectively. The levels of vitamin D in the early puberty group, menarche group, and obesity group were significantly lower than those in the control group (P < 0.05). The individual vitamin D deficiency rates in the aforementioned groups were 52.07%, 73.91%, 59.46%, 30.95%, and 30.30%, respectively. The vitamin D levels in the pre-epidemic and post-epidemic groups were 20.48 ± 6.22 ng/ml and 22.50 ± 9.74 ng/ml, respectively (P > 0.05).ConclusionGirls with early puberty, menarche, and obesity have a certain deficiency of vitamin D levels, and appropriate vitamin D treatment should be provided clinically. Girls with short stature and healthy girls also have certain levels of vitamin D deficiency, and awareness of prevention should be strengthened.

Vitamin K2 Deficiency and its Association with Short Stature in Children: A Cross-Sectional Study

ObjectivesThis study examines the relationship between vitamin K2 (VK2) status and the occurrence of short stature in children. MethodsA cross-sectional analysis was conducted between January 2021 and August 2022, involving 235 children with a clinical diagnosis of short stature at the Second Affiliated Hospital of Wenzhou Medical University (short stature group) and 454 children with average height (±1 SD) from the same period (healthy group). Serum VK2 levels were compared between the two groups. Multivariate logistic regression analysis was used to identify factors associated with short stature, and Spearman correlation analysis was used to examine the relationship between VK2 status and age. ResultsChildren in the short stature group exhibited lower VK2 levels (P = 0.019) and a significantly higher prevalence of VK2 deficiency (P = 0.011) compared to the healthy group. VK2 deficiency was identified as an independent risk factor for short stature (OR = 1.535, 95% CI = 1.061–2.222, P = 0.023) through multivariate logistic regression analysis. Furthermore, an inverse correlation was observed between serum VK2 levels and age in children aged 2 to 15 years (ρ = -0.133, P < 0.001). ConclusionsVK2 deficiency may be associated with an increased risk of short stature in children.

Robust growth hormone responses to GH-releasing peptide 2 in adolescents.

GH-releasing peptide-2 (GHRP2) can be used for provocative growth hormone testing (GHT). Since it acts as a powerful stimulus for GH secretion, cut-off peak GH level in GHRP2 loading test (GHRP2T) is higher than in other GHT. Nevertheless, data on response at adolescents are limited. This report aimed to investigate peak GH levels in GHRP2T in adolescents. Clinical data of adolescents after onset of puberty who underwent GHRP2T at our institution from May 2010 to March 2023 were collected retrospectively. Subjects were classified into three groups according to underlying diseases. A total of 23 patients were included: 12 in organic or genetic GHD (o/gGHD) group, three in idiopathic GHD (iGHD) group, and eight in short stature (SS) group. The median GH peak levels were 3.4 ng/mL in o/gGHD group, 88.9 ng/mL in iGHD group, and 90.1 ng/mL in SS group, indicating a robust response of GH peak levels in iGHD and SS groups. Two patients exceeded the cut-off for GHRP2T but below for other GHT, indicating the current cut-off for GHRP2T may miss some GHD patients. The GH response to GHRP2T in adolescents except the o/gGHD group may be robustly responsive. For the correct diagnosis of GHD, the cut-off peak GH levels in GHRP2T in adolescents may require revisiting.

Additive association of blood pressure and short stature with stroke incidence in 450,000 Japanese adults: the Shizuoka study.

Short stature was suggested to be a risk factor for cardiovascular events. Because short stature increases central blood pressure, this study aimed to investigate a longitudinal association between short stature, blood pressure, and incidence of cardiovascular disease by the analysis of insurance-based real-world dataset. We analyzed data from 463,844 adults aged 40 or older with a mean age of 66.7 enrolled in National Health Insurance, excluding individuals who experienced a stroke or myocardial infarction, or required long-term care. Data from annual health checkups were used to obtain baseline clinical information. Comorbidities and incidences of stroke and myocardial infarction were obtained from the insurance data. During a 5.5-year follow-up period, we observed 11,027 cases of stroke. Adults of a short stature exhibited a higher incidence rate in both men (≤155 cm: 99.7, >175 cm: 24.4) and women (≤140 cm: 85.9, >160 cm: 13.7). Although those in the short stature group had higher blood pressure, and often took antihypertensive drugs, the inverse association between height and stroke incidence was independent of these factors (hazard ratio for 5 cm shorter in height; men: 1.06 [1.03-1.09], women: 1.11 [1.06-1.13]). Short stature and blood pressure showed additive association with stoke incidence (log-rank p < 0.001). No significant association was observed with myocardial infarction (men: 1.01 [0.95-1.06], women: 1.06 [0.98-1.14]). In a longitudinal analysis of a large general Japanese population, short stature was linked to an increased risk of stroke in both genders in any blood pressure range.

Exome Sequencing Identifies Multiple Genetic Diagnoses in Children with Syndromic Growth Disorders

To evaluate the presence of multiple genetic diagnoses in syndromic growth disorders. We carried out a cross-sectional study to evaluate 115 patients with syndromic tall (n=24) or short stature (n=91) of unknown cause from a tertiary referral center for growth disorders. Exome sequencing was performed to assess germline single nucleotide, InDel, and copy number variants. All variants were classified according to ACMG/AMP guidelines. The main outcome measured was the frequency of multiple genetic diagnoses in a cohort of children with syndromic growth disorders. The total diagnostic yield of the cohort was 54.8% (63/115). Six patients had multiple genetic diagnoses (tall stature group=2; short stature group=4). The proportion of multiple diagnoses within total cases was 5.2% (6/115), and within solved cases was 9.5% (6/63). No characteristics were significantly more frequent when compared with patients with single or multiple genetic findings. Among patients with multiple diagnoses, 3 had syndromes with overlapping clinical features, and the others had syndromes with distinct phenotypes. Recognition of multiple genetic diagnoses as a possibility in complex cases of syndromic growth disorders opens a new perspective on treatment and genetic counseling for affected patients, defying the medical common sense of trying to fit all findings into one diagnosis.

Do neonatal birth weight thresholds for labor dystocia outcomes differ between short and normal stature women?

To determine if there is a correlation between maternal short stature and neonatal birth weight among women with adverse outcomes related to labor dystocia. The medical records of singleton deliveries with adverse obstetric outcomes related to labor dystocia during 2014-2020, in a single tertiary center, were reviewed. Outcomes included at least one of the following: cesarean delivery (CD) due to cephalopelvic disproportion (CPD), prolonged second stage, shoulder dystocia, third- or fourth-degree perineal tear. Maternal short stature was defined as height below the 10th centile (short stature group) and normal stature was defined as maternal height between the 10th and 90th centiles (normal stature group). Maternal and neonatal characteristics were compared between the groups. A total of 3295 women were included, among them, 307 in the short stature group (9.3%, height 1.52 ± 0.02 m) and 2988 in the normal stature group (90.7%, height 1.63 ± 0.04 m). Evaluating the entire cohort revealed similar neonatal birth weights comparing the short and normal stature groups. A subgroup analysis of women after CD due to CPD (n = 296) revealed lower neonatal birth weights in the short stature group (n = 31) compared with the normal stature group (n = 265) (3215 ± 411 vs 3484 ± 427 g, P = 0.001, respectively). Multivariable linear regression was performed for women who underwent CD due to CPD. After adjusting for obesity and diabetes mellitus, short stature and nulliparity were found to be independently associated with decreased neonatal birth weight (266 g less for short stature, P = 0.001, and 294 g less for nulliparity, P = 0.001). Among women with short stature, CD due to CPD occurs at lower neonatal birth weights.

Quadriceps Angle Measurement in Adolescents With Short Stature: Exploring the Relationship Between Postural Alignment and Lower Limb Mechanics.

Background The quadriceps angle (Q angle) is measured as an angle formed by two lines that extend from the anterior superior iliac spine to the midpoint of the patella and from the midpoint of the patella to the tibial tuberosity. The average Q angle value for children aged between seven to 12 years was 13.1˚±3.5˚in boys and 13.7˚±4.9˚ in girls, whereas 8˚-15˚ in men and 12˚-19˚ in women. Abnormal variation in Q angle is associated with patellofemoral pain syndrome, lateral patellar malposition, dislocation, chondromalacia patella, patella alta, genu varum, etc. Methodology The present study explores the status of Q angle values among adolescents with short stature and their comparison with age and gender-matched children between 10 and 15 years of age. Results We found a statistically significant difference between the Q angle value in the control group and the male with short stature group aged 14-15 years, with a mean difference of 3.7˚. However, among females, there was a significant difference between the control group and the short-stature group aged 12-13 and 14-15 years, with a mean difference of 2.8˚ and 2.5˚, respectively. Implications Early detection and timely remedial measures, e.g., quadriceps strengthening exercises, before skeleton maturity can prevent Q angle-related misalignments and abnormalities in the limb.

The problem of a child with short stature in the paediatrician’s and family doctor’s office

Height and weight measurements are an important element of every child’s visit to the paediatrician’s or family doctor’s office. Short stature is defined as a height below the 3rd percentile for age and sex. It is important to identify children in the short stature group (3% of the population) whose short height is not due to familial factors and therefore requires treatment. Correct measurement of the child’s height followed by its plotting onto a sex- and age-appropriate percentile chart is the first step to identify the problem of short stature in a child. This should be followed by determining the target height and growth rate. Therefore, regular updating of child’s medical record book is of key importance. Diagnostic work-up is needed in children with height below the 3rd percentile or with height difference of more than 2 percentile channels compared to the mean parental height, as well as in children with excessively slow growth rate (indicated by progressive decrease of percentile height position).

PSAT108 Impact of recombinant human growth hormone (rhGH) on skeletal muscle strength, power, endurance and agility in prepubertal boys with significant short stature: preliminary results

Abstract Objectives To investigate the impact of rhGH on measures of skeletal muscle strength, power, endurance, agility, and lean body mass accrual in prepubertal boys with significant short stature compared to age-matched healthy controls growing normally. Methods 40 prepubertal boys were recruited, 25 with significant short stature -either isolated GH deficiency or idiopathic (mean (SE) age: 8.9±0.3yrs; HT SDS: -2.3±0.1) and 15 normally growing healthy controls (age: 8.8±0.4yrs; HT SDS: -0.3±0.2). All had testing at baseline including anthropometry, blood, DEXA scan (body composition), and indirect calorimetry (resting energy expenditure (REE)). Protocolized muscle function tests were performed by expert personnel including measures of skeletal muscle strength (isokinetic dynamometry (flexion/extension) upper and lower extremities), power (vertical jump), endurance (modified push-ups), and agility (timed shuttle-runs). Boys with short stature were started on daily rhGH (Norditropin®, 0.3mg/kg/w) and baseline studies repeated identically in all at 6 and 12 months. Mixed effects model ANOVA (and 2 sample t-test) was used to compare main outcomes over time between groups (significance p ≤0.05). Results Baseline N=40, 6 months N=34, 12 months N=27 participants thus far. All grew well and remained prepubertal throughout the study. At baseline, there were measurable differences in fat free mass (FFM) between groups: short stature: 15.9±0.5kg, controls: 20.4±1.1 (p=0.001); both groups gained FFM at 12 months, short stature group gained 27.3% (p&amp;lt;0.001) vs. controls 10.7% (p&amp;lt;0.001) (p&amp;lt;0.001 between groups). Measures of agility and power were comparable at baseline between groups, agility improved by 12 months 5.5% in the rhGH-treated group (p=0.007) vs. 2.7% in controls (p=0.178) (p=0.157 between groups); measures of power improved 9.1% in the rhGH-treated group (p=0.001) vs. 3.8% in controls (p=0.386) at 12 months (p&amp;lt;0.258 between groups). There were significant differences between groups in muscle strength at baseline, lower particularly in elbow flexion (biceps) in the short stature group: 79.7±3.7 Newtons vs. controls: 97.6±5.5 (p=0.008), and knee flexion (hamstrings): 82.6±3.4 Newtons vs. 95.7±3.2 (p=0.013). At 12 months the rhGH-treated group improved biceps strength (25.7%, p&amp;lt;0.001), vs. controls (12.5%, p=0.008) (p=0.019 between groups); whereas hamstrings strength improved comparably at 12 months in the rhGH-treated group (24.1%, p=0.008) vs. controls (28.0%, p=0.01) (p=0.79 between groups). Measures of endurance (modified push-ups) at baseline were 17.5±1.5 reps in the short stature group vs. 24.9±3.3 in controls (p=0.057), improving in the rhGH-treated (63%, p&amp;lt;0.001) vs. controls (43%, p=0.07) at 12 months (p=0.959 between groups). There were no significant differences in REE (kcal/kg/d) between groups during 12 months. Conclusion There are significant differences in FFM and skeletal muscle strength and endurance in prepubertal boys with severe short stature compared to healthy age-matched controls. FFM accrual and isokinetic measures of muscle strength, endurance, agility and power improve after 12 months of rhGH, changes approaching measures of those of healthy controls. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Comparison of Cognitive Function in Children with Stunting and Children with Undernutrition with Normal Stature.

Background Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median. According to the Indonesia Basic National Health Survey 2013, Indonesia's stunting prevalence reached 37.2%. Various studies have shown that impaired cognitive development is found in children with stunting and undernutrition. This study aims to determine cognitive development in stunted and undernutrition with normal stature children using the Bayley Scale of Infant Development III (Bayley-III). Methods A cross-sectional study on 51 children aged one month to 3 years who fulfilled the inclusion criteria and who visited the outpatient clinic of Dr. Cipto Mangunkusumo National General Hospital from June 2017 to January 2018 was performed. Cognitive development was assessed using the Bayley Scale of Infant Development, Third Edition (Bayley-III). Results 26 children with stunting and 25 children with undernutrition with normal stature participated in this study. There was a statistically nonsignificant trend toward lower median score percentiles in the stunted group compared to that in the undernourished with normal stature group in the motor (median (range) 1 (0.1–75) vs. 4 (0–79); p=0.183), cognitive (12.5 (0.1–75) vs. 16 (0.1–99.9); p=0.550), and adaptive behavior (7 (0.1–75) vs. 12 (0.1–58); p=0.657) domains. Conclusions There is a trend toward lower cognitive, motor, and adaptive behavior abilities in stunted children compared to undernourished children with normal stature which needs further study. In addition, children with undernutrition have below-average abilities across all domains even before stunting has occurred.

Clinical and Genetic Profile of Children With Short Stature Presenting to a Genetic Clinic in Northern India

To define the spectrum of genetic disorders in patients with short stature visiting the genetic out-patientdepartmentin a tertiary care hospital. A chart review was done for 455 individuals (10 months-16 yrs) with short stature, who were evaluated at the genetic clinic from 1 January, 2017 upto 31 October, 2018. 226 patients who needed detailed evaluation, the spectrum of genetic diagnosis is presented. Proportionate short stature was identified in 63% individuals (n=142) of which 93 (65%) were recognizable syndromes such as Turner syndrome, and William syndrome, and RASopathies. In clinically undefined syndromes (39, 27%), a diagnosis could be made by karyotype (n=3/10), chromosomal microarray (6/12) and exome sequencing (1/6). In the 84 children in the disproportionate short stature group (37%), lysosomal storage disorders (LSDs) (45%, n=38) were identified by enzyme analysis in 86.8% and skeletal dysplasias (44%, n=37) identified by skeletal survey in 89% cases. In undefined syndromic short stature, chromosomal microarray may be the first investigation of choice if phenotyping is not suggestive of a specific genetic syndrome. Exome sequencing can be useful in identifying newer genes among idiopathic and familial short stature cohorts.

Altered DNA methylation at age-associated CpG sites in children with growth disorders: impact on age estimation?

Age estimation based on DNA methylation (DNAm) can be applied to children, adolescents and adults, but many CG dinucleotides (CpGs) exhibit different kinetics of age-associated DNAm across these age ranges. Furthermore, it is still unclear how growth disorders impact epigenetic age predictions, and this may be particularly relevant for a forensic application. In this study, we analyzed buccal mucosa samples from 95 healthy children and 104 children with different growth disorders. DNAm was analysed by pyrosequencing for 22 CpGs in the genes PDE4C, ELOVL2, RPA2, EDARADD and DDO. The relationship between DNAm and age in healthy children was tested by Spearman’s rank correlation. Differences in DNAm between the groups “healthy children” and the (sub-)groups of children with growth disorders were tested by ANCOVA. Models for age estimation were trained (1) based on the data from 11 CpGs with a close correlation between DNAm and age (R ≥ 0.75) and (2) on five CpGs that also did not present significant differences in DNAm between healthy and diseased children. Statistical analysis revealed significant differences between the healthy group and the group with growth disorders (11 CpGs), the subgroup with a short stature (12 CpGs) and the non-short stature subgroup (three CpGs). The results are in line with the assumption of an epigenetic regulation of height-influencing genes. Age predictors trained on 11 CpGs with high correlations between DNAm and age revealed higher mean absolute errors (MAEs) in the group of growth disorders (mean MAE 2.21 years versus MAE 1.79 in the healthy group) as well as in the short stature (sub-)groups; furthermore, there was a clear tendency for overestimation of ages in all growth disorder groups (mean age deviations: total growth disorder group 1.85 years, short stature group 1.99 years). Age estimates on samples from children with growth disorders were more precise when using a model containing only the five CpGs that did not present significant differences in DNAm between healthy and diseased children (mean age deviations: total growth disorder group 1.45 years, short stature group 1.66 years). The results suggest that CpGs in genes involved in processes relevant for growth and development should be avoided in age prediction models for children since they may be sensitive for alterations in the DNAm pattern in cases of growth disorders.

Very Short Stature Predicts Morbidity and Mortality After Heart Transplant

<h3>Purpose</h3> Short stature has been linked to increased transplant waitlist times and operative mortality after heart surgery. We aim to describe the relationship between stature and heart transplant outcomes. <h3>Methods</h3> The United Network for Organ Sharing was queried for data on adult heart transplant recipients from 2000 to 2021. Recipients were stratified into five groups by height: very short stature (height ≥2 standard deviations [SD] below the mean), short stature (≥1 and <2 SD below the mean, average stature (within 1 SD of the mean), tall stature (≥1 and <2 SD above the mean), and very tall stature (≥2 SD above the mean). Morbidity was analyzed using Kruskal-Wallis and chi square tests. Mortality was analyzed using Kaplan-Meier estimation, log-rank tests, and Cox regression. <h3>Results</h3> 2,033 (4.3%) heart transplant recipients from 2000 to 2021 had very short stature, 8,551 (18.0%) had short stature, 5,783 (12.2%) had tall stature and 667 (1.4%) had very tall stature. The very short stature group was younger, more commonly female, weighed less, had higher rates of congenital heart disease and restrictive cardiomyopathy, lower rates of pre-transplant mechanical ventilation, and lower serum creatinine than other groups (p<0.05). The very short stature group had increased 30-day mortality (8.1%, p<0.001), rejection rate (31.4%, p<0.001), postoperative stroke rate (3.9%, p=0.015), and median length of stay (16 days, p<0.001). Five-year survival rates ranged from 72.8% to 79.4% with the lowest in very short stature patients (p<0.001; Figure 1). On Cox regression, very short stature and short stature were associated with five-year mortality (HR 1.4, p<0.001 and HR=1.2, p<0.001 respectively), but donor/recipient height mismatch, weight mismatch, and predicted heart mass mismatch were not (HR 1.1, p=0.194; HR=1.0, p=0.709; and HR 1.0, p=0.772 respectively). <h3>Conclusion</h3> Very short stature is associated with increased morbidity and mortality after heart transplant. The mechanism explaining this effect requires further study.

Common Polymorphisms of Growth Hormone: Growth Hormone Receptor Axis in Turkish Children with Short Stature.

Objective: A single-nucleotide polymorphism of the growth hormone 1 gene, GH1IVS4+90A>T (rs2665802), associated with short stature and a polymorphism of the growth hormone receptor gene, exon 3 deleted variant, associated with increased responsiveness to growth hormone have been reported previously. We aimed to investigate the frequency of both polymorphisms and their correlation to height in Turkish short children. Also, we aimed to evaluate the effect of exon 3 deleted variant on response to 1-year growth hormone therapy.Materials and Methods: Children with idiopathic isolated growth hormone deficiency (n = 39) and with idiopathic short stature (n = 10) and 50 control subjects were evaluated for anthropometric parameters, annual growth velocity, and annual height gain. Growth hormone receptor gene polymorphisms were analyzed via multiplex polymerase chain reaction; growth hormone 1 gene polymorphism was analyzed via polymerase chain reaction and single-strand conformation polymorphism techniques.Results: The frequency of genotypes carrying the “A” allele was not significantly higher in the idiopathic isolated growth hormone deficiency group than in the idiopathic short stature and control groups (P = .03 for each). The exon 3 deleted variant genotype was significantly lower in the idiopathic short stature group compared to the control group (P = .01). There was no effect of exon 3 deleted variant, on response to the first-year growth hormone therapy.Conclusion: In Turkish population, no correlation was found between the “A” allele of GH1IVS4+90A>T polymorphism and idiopathic isolated growth hormone deficiency and short stature, and a significant negative correlation was found between exon 3 deleted variant and idiopathic short stature and short stature. Exon 3 deleted variant has no effect on response to growth hormone treatment.

Body composition in preschool children with short stature: a case-control study

BackgroundShort stature is defined as height below 2 standard deviations of the population with the same age, gender. This study is aimed to assess the characteristics of body composition in preschool children with short stature.MethodsAnthropometric measurements and body composition were assessed in 68 preschool children aged 3 to 6 years old with short stature and 68 normal controls matched on age and gender. Height, weight and body composition (total body water, protein, minerals, body fat mass, fat-free mass, soft lean mass, skeletal muscle mass, and bone mineral contents) in the two groups were measured and compared.ResultsThe total body water, protein, minerals, body fat mass, fat-free mass, soft lean mass, skeletal muscle mass, and bone mineral contents were lower in preschool children with short stature than controls (P < 0.05). Body mass index and fat mass index did not differ between groups. Fat-free mass index was significantly lower in short stature group than controls (t = 2.17, P = 0.03). Linear regression analysis showed that there was a positive correlation between height and fat-free mass index [β, 1.99 (0.59, 3.39), P = 0.01], a negative correlation between height and body fat percentage [β, − 0.20 (− 0.38, − 0.01), P = 0.04]. The proportions of fat-free mass in the upper limbs were significantly lower (Right,t = − 2.78,Left t = − 2.76, P < 0.05, respectively) in short stature, although body fat distribution was not.ConclusionsThe fat-free mass such as protein and bone minerals is lower in preschool children with short stature, suggesting the monitoring of fat-free mass for early identification and intervention.

The Relationship Between Children's Birth Time and Short Stature.

BackgroundThere are few current reports on the relationship between time of birth and short stature in children. Therefore, we aimed to investigate whether there is an association between time of birth and short stature in children.Materials and MethodsIn this study, basic information was collected from 462 children aged 2–14 years old. We collected data on gender, height, height standard deviation score (SDS), weight, body mass index (BMI), serum 25(OH)D levels, date of birth, and whether the above children were short stature. Demographic description, univariate analysis, multivariate logistic regression analysis, smooth curve fitting, and threshold effects were used to explore possible linear or non-linear relationships between children's birth time and short stature.ResultsThe mean age of the 462 children was 9.76 ± 3.10 years old, and 52.16% were male. A total of 129 (27.92%) children were defined as 25(OH)D insufficiency, including 107 (38.91%) in the short stature group and 22 (11.76%) in the normal stature group. Fully adjusted logistic regression showed that the risk of short stature was reduced by 56.5% in children born in summer compared with spring (P < 0.05) [odds ratio (OR): 0.435, 95% confidence interval (CI): 0.197–0.959]. A non-linear relationship was found between “sequential day of the year” and short stature from the 1st to the 250th day of the year, the risk of short stature in children is reduced by 0.6% for each day that passes (P = 0.002) (OR: 0.994, 95% CI: 0.990–0.998), and from the 250th to the 365th day of the year, the risk of short stature in children was increased by 0.8% for each day that passed (P = 0.008) (OR: 1.008, 95% CI: 1.001–1.025).ConclusionsChildren born in summer have a lower risk of short stature than spring. For children born before the 250th day of the year, “sequential day of the year” was negatively associated with short stature, and for children born after the 250th day, “sequential day of the year” was positively associated with short stature.

Brachydactyly Type A3 Is More Commonly Seen in Children With Short Stature But Does Not Affect Their Height Improvement by Growth Hormone Therapy.

IntroductionTo analyze the prevalence of brachydactyly type A3 (BDA3) in children with short stature and the effect on growth hormone (GH) therapy.MethodsWe analyzed the medical records of pediatric patients from July 2009 to July 2021. We included children with short stature defined as their height standard deviation score (HtSDS) < -2 and normal short height as their HtSDS between -2 and -1. We calculated the prevalence of BDA3 in different groups and compared the differences in children’s characteristics and the therapeutic effect of GH therapy between the BDA3 and no BDA3 groups.ResultsA total of 752 cases were included. The overall prevalence of BDA3 was 23.1%; with a female predominance (30.8% vs. 16.1%, P < 0.01). BDA3 was more prevalent in the short stature group (27.2%) than in the normal short stature group (16.7%) and growth hormone deficiency group (16.5%). Birth length, birth weight, HtSDS, and mid-parental height of children with BDA3 were lower than those without BDA3, but there were no significant differences. In patients with Turner syndrome and idiopathic short stature, the HtSDS of the BDA3 group was significantly lower than that of the no BDA3 group (P < 0.01). During four years of GH therapy, the HtSDS improvement per year in the BDA3 group were 0.79 ± 0.29, 0.50 ± 0.31, 0.20 ± 0.30, and 0.10 ± 0.22, which were not significantly different from those in the no BDA3 group. At the end of treatment, there were no significant differences in the duration of treatment and total HtSDS improvement between these two groups.ConclusionsBDA3 is more commonly seen in children with short stature with a female predominance. BDA3 occurrence is independent of the GH pathway and does not affect the therapeutic effect of GH on short stature children.

Vocal Characteristics of Children With Short Stature Before and After Growth Hormone Treatment

To evaluate the vocal characteristics of children with short stature before and 12 months after growth hormone treatment. This analytical, observational cohort study included 23 children (age 5-11 years) diagnosed with short stature. Children in the short stature group (SSG) were matched (1:1) for age and sex with children with normal growth (normal stature group; NSG). Participants in the SSG underwent assessments before and 12 months after growth hormone treatment, while those in the NSG underwent the same assessments at baseline and 12 months. The assessments included evaluation of (A) vocal characteristics (history, vocal self-assessment, auditory-perceptual evaluation, and acoustic analysis), (B) anthropometry, (C) bone age, and (D) measurement of insulin-like growth factor-1 (IGF-1) levels. Children in the SSG had more vocal complaints (P = 0.026) than those in the NSG. The groups were similar in terms of vocal self-assessment and auditory-perceptual evaluation (P = nonsignificant). Results of acoustic analysis were also similar for fundamental frequency (F 0) and perturbation measures (P for both = nonsignificant). F 0 and speech frequency decreased significantly at 12 months in both groups. F1 values were higher at 12 months in the NSG, while F2 values were significantly higher in the baseline evaluation in boys in the SSG. Children in the SSG compared with those in the NSG presented a greater increase in height measurements at 12 months, although the anthropometric means were lower in both evaluations (P < 0.001). Vocal characteristics in children with short stature before and after treatment with growth hormone are comparable to those in children with normal growth.

Growth recovery lines in children: A comparison between psychosocial short stature and other pathological causes of short stature

BackgroundPsychosocial short stature (PSS) is a rare disorder associated with emotional deprivation. Growth recovery lines (GRLs), the radiodense bands in metaphyseal bones, are indicators of stress. ObjectiveTo evaluate the efficacy of using GRLs in the distal radius to identify PSS. Participants and settingThis retrospective cohort study included children 15–138 months of age with short stature whose hands and wrists were radiographed between 2011 and 2020 at Matsuyama Red Cross Hospital in Japan. MethodsPSS was determined if a child with short stature had been reported to be abused or neglected. Other pathological short statures were diagnosed per the established criteria. GRLs, height velocity before and after specific treatment, insulin-like growth factor 1, and the difference between chronological and skeletal age were assessed. ResultsThe PSS and other short stature groups comprised of 7 and 11 children, respectively. The body mass index of the PSS group was smaller than that of other short stature group (−1.15 standard deviation [SD] vs. 0.57 SD, P = 0.003). The PSS group had significantly more GRLs than the other group (5.3 vs. 0.5, P = 0.011). Height velocity before treatment in the PSS group was significantly lower (−5.46 SD vs. −1.86 SD, P = 0.005), with no significant differences in other variables. The specificity for PSS was >90% when children with short stature had at least three GRLs in both distal radii. ConclusionsAbuse or neglect should be considered in children with short stature having multiple GRLs in the distal radius.

The vertical dimension of obesity: adverse pregnancy outcomes in the short obese versus tall obese parturient

The objective of this study was to examine the effect of maternal height on adverse perinatal outcomes in obese parturients. This retrospective study was conducted from January 2015 to December 2015. Patients with BMI ≥ 35.0 kg/m2 before delivery were included and divided into 2 groups based on height. Patients ≤63 inches were in the short stature group and those > 63 inches were in the tall stature group. One hundred and twenty-five patients were in the short stature cohort and 124 in the tall stature cohort. Patients in short cohort had a significantly higher risk of preterm delivery <37 weeks (RR = 4.21 [1.24, 12.88]), spontaneous rupture of membranes (RR 1.47 [1.01–2.16]), and second stage caesarean delivery (CD) (RR 2.64 [1.1–6.39]). After multiple regression analysis, Hispanic race and short stature were independent predictors of preterm birth for obese patients. IMPACT STATEMENT What is already known on this subject? Compared to normal weight individuals, those who are obese have at a higher risk of adverse obstetric and perinatal outcomes including gestational diabetes, hypertension, pre-eclampsia, thromboembolism, macrosomia, higher incidence of caesarean deliveries and perinatal mortality. What do the results of this study add? Our findings show that short stature is an independent predictor for adverse perinatal outcomes in obese women. Specifically, short obese patients had significantly higher risk of preterm delivery before 37 weeks and second stage CD. What are the implications of the findings for clinical practice and/or further research? Our findings highlight the need for formulating a tailored plan for preconception health including pregnancy weight goals in short obese women. Additionally, maternal fat distribution and its effect on pro-inflammatory cytokine profiles is a potential area for future research, as maternal body composition may be a better predictor of perinatal outcome than BMI.