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Are constitutional delay of growth and familial short stature different conditions?
Insights
Short stature in children may not fit distinct categories of constitutional delay of growth (CDG) or familial short stature (FSS). This study found that short children did not clearly separate into these two groups based on skeletal age. Further research is needed to understand their growth patterns.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Short stature in children, defined as 2-4 standard deviations below the mean height for age, is often attributed to constitutional delay of growth (CDG) or familial short stature (FSS).
- Distinguishing between these two common diagnoses is crucial for appropriate clinical management and understanding growth patterns.
Purpose of the Study:
- To investigate whether a cohort of 167 children with short stature could be distinctly classified into either CDG or FSS based on clinical and radiographic assessments.
- To analyze the relationship between skeletal age, growth rate, and midparental height in children with short stature.
Main Methods:
- Retrospective analysis of 167 pediatric patients referred for short stature.
- Patients were categorized into subgroups based on skeletal age (SA) relative to chronological age (CA), specifically SA < -2 SD and SA > -2 SD below the mean.
- Comparison of growth rates and midparental heights between the defined subgroups.
Main Results:
- No significant differences in growth rates or midparental heights were observed between subgroups defined by skeletal age delay.
- Height age was significantly more delayed in the subgroup with a greater delay in skeletal age.
- The overall midparental height of the studied population was below the mean for normal American children.
Conclusions:
- The findings suggest that the studied cohort of short children does not clearly segregate into two distinct populations representing CDG and FSS.
- The data indicate a potential continuum of growth patterns or significantly overlapping characteristics between CDG and FSS in this population.
- Further investigation is required to elucidate the precise relationship and differentiation between constitutional delay of growth and familial short stature.
Abstract:
Children between 2 and 4 standard deviations below the mean height for age with no specific cause to account for their short stature are usually considered to represent either constitutional delay of growth (CDG) or familial short stature (FSS). This study was undertaken to determine whether 167 patients who were referred to our clinic for short stature could be divided into two distinct populations that fit the criteria of CDG and FSS. When the patients were artificially divided into 2 subgroups based on skeletal age greater or less than 2 standard deviations below the mean, no significant difference in growth rates or midparental heights could be found between them. Height ages were significantly more delayed in the group with greater skeletal age delay. Midparental height of our total population of short children was less than the mean midparental height of normal American children. It was concluded that our patients did not distribute into these two clear-cut entities. Whether they represented one continuum or two largely overlapping populations could not be decided on the basis of our data.