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Age-based reference ranges for annual height velocity in US children

Andrea Kelly1, Karen K Winer, Heidi Kalkwarf

  • 1Department of Pediatrics (A.K., B.S.Z.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Eunice Kennedy Shriver National Institute of Child Health and Human Development (K.K.W.), Bethesda, Maryland 20892; Department of Pediatrics (H.K.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229; Department of Pediatrics (S.E.O.), Columbia University Medical Center, New York, New York 10032; Department of Medicine (J.L.), Creighton University, Omaha, Nebraska 68102; and Departments of Orthopaedic Surgery and Radiology (V.G.), Children's Hospital Los Angeles, Los Angeles, California 90027.

The Journal of Clinical Endocrinology and Metabolism
|March 8, 2014
PubMed

Insights

New height velocity (HV) reference ranges for US children account for early and late pubertal timing. These data enable more accurate growth assessments for diverse pediatric populations, improving health monitoring.

Area of Science:

  • Pediatric endocrinology
  • Growth and development
  • Biostatistics

Background:

  • Linear growth, assessed by height velocity (HV), is a key health biomarker in children.
  • Existing US reference ranges for HV lack percentiles and Z-scores for early or late maturing children outside peak velocity.
  • This limits accurate growth assessment in diverse pediatric populations.

Purpose of the Study:

  • To establish contemporary, age-specific reference ranges for height velocity (HV) in a US youth cohort.
  • To provide HV percentiles and Z-scores that account for variations in pubertal timing.
  • To improve the clinical assessment of child development and overall health.

Main Methods:

  • Utilized data from the Bone Mineral Density in Childhood Study, a multi-center, multi-ethnic cohort of 1500 children (aged 5-19).
  • Analyzed over 4000 annual HV measurements collected over 7 years.
  • Determined age-specific reference ranges using the LMS method, categorizing pubertal status by clinical assessment.

Main Results:

  • Generated reference ranges (3rd-97th percentiles) for HV across the cohort and for early, average, and late pubertal timing subgroups.
  • Observed earlier pubertal onset and distinct HV patterns in African American girls compared to non-African American girls, which normalized after adjusting for pubertal timing.
  • No significant sex-based differences in HV patterns were noted for males after pubertal timing adjustment.

Conclusions:

  • The new HV reference ranges allow for growth assessment relative to peers, considering individual pubertal timing.
  • These data facilitate the calculation of Z-scores and exact percentiles for HV, valuable for clinical and population studies.
  • Improved HV assessment supports better monitoring of child development and health outcomes.
Abstract

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