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Sitting Height to Standing Height Ratio Reference Charts for Children in the United States

Colin Patrick Hawkes1, Sogol Mostoufi-Moab1, Shana E McCormack1

  • 1Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, PA; Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, PA.

The Journal of Pediatrics
|June 25, 2020
PubMed

Insights

Reference charts for sitting height to standing height ratio (SitHt/Ht) were created for US children. Non-Hispanic Black children showed lower SitHt/Ht, necessitating ancestry-specific charts for skeletal dysplasia screening.

Area of Science:

  • Pediatric endocrinology and growth studies.
  • Anthropometry and human growth assessment.
  • Public health and population studies.

Background:

  • The sitting height to standing height ratio (SitHt/Ht) is crucial for assessing skeletal proportions.
  • Accurate interpretation of SitHt/Ht requires age-, sex-, and population-specific reference data.
  • Previous studies highlight the need for refined reference charts for diverse pediatric populations.

Purpose of the Study:

  • To develop reference charts for the sitting height to standing height ratio (SitHt/Ht) in US children.
  • To analyze the developmental trajectory of SitHt/Ht throughout puberty.
  • To identify potential ethnic variations in SitHt/Ht for improved clinical interpretation.

Main Methods:

  • Cross-sectional analysis of data from the National Health and Nutrition Examination Survey III (1988-1994).
  • Inclusion of 9569 children aged 2-18 years across Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Mexican American groups.
  • Statistical comparisons (ANOVA) to assess ethnic differences and pubertal stage effects on SitHt/Ht.

Main Results:

  • Significant differences in SitHt/Ht were observed among ethnic groups; NHB children exhibited lower ratios than NHW and Mexican American children (P < .001).
  • SitHt/Ht demonstrated a distinct pattern during puberty, decreasing from prepuberty to early puberty and increasing in late puberty for both sexes.
  • Sex-specific percentile charts for SitHt/Ht versus age were generated, stratified by ancestry.

Conclusions:

  • Age-, sex-, and ancestry-specific reference charts are essential for accurate SitHt/Ht interpretation in clinical settings, particularly for detecting skeletal dysplasias.
  • The lower SitHt/Ht in NHB children necessitates the use of standardized, ancestry-specific charts for screening.
  • The study provides validated reference charts to aid in the early detection of disproportionate short stature.
Abstract

Keywords:
disproportionhypochondroplasiashort staturesitting heightskeletal dysplasia

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