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Utah Growth Study: growth standards and the prevalence of growth hormone deficiency
R Lindsay1, M Feldkamp, D Harris
1Department of Pediatrics, University of Utah Medical Center, Salt Lake City.
Insights
This study assessed growth in American children, finding current growth charts remain valid. It also revealed that while most slow-growing children lack endocrine disorders, many cases of growth hormone deficiency (GHD) and Turner syndrome go unrecognized.
Area of Science:
- Pediatrics
- Endocrinology
- Growth and Development
Background:
- Established growth charts are crucial for monitoring child development.
- Growth hormone deficiency (GHD) is a significant endocrine disorder affecting children's growth.
- Accurate prevalence data for GHD in American children is essential for timely diagnosis and treatment.
Purpose of the Study:
- To assess the validity of existing height and growth velocity curves for contemporary American children.
- To determine the prevalence of growth hormone deficiency (GHD) in a large cohort of American elementary-school children.
- To identify unrecognized cases of GHD and other endocrine disorders, including Turner syndrome.
Main Methods:
- Serial height and growth velocity measurements were collected from over 114,000 elementary-school children over two years.
- Children with short stature (< 3rd percentile) and poor growth rates (< 5 cm/yr) were further evaluated.
- Growth hormone deficiency (GHD) was diagnosed based on peak levels (< 10 ng/dl) from two provocative tests.
Main Results:
- Generated height and growth velocity curves closely matched existing charts, confirming their continued validity.
- Among children with short stature and poor growth, 5% had an endocrine disorder; GHD was identified in 16 previously unrecognized children.
- The prevalence of GHD in the US was estimated at a minimum of 1:3480, with boys affected 2.7 times more often than girls. Six cases of Turner syndrome were also identified.
Conclusions:
- Current growth charts remain relevant for assessing child growth in the present day.
- A significant proportion of children with GHD and Turner syndrome may be undiagnosed and untreated.
- Growth hormone deficiency is more prevalent in boys, highlighting the need for increased awareness and screening.
Abstract:
Serial measurements of elementary-school children were conducted for 2 consecutive years to assess height and growth velocity and to determine the prevalence of growth hormone deficiency (GHD) in American children. Trained volunteers measured 114,881 children the first year; 79,495 growth rates were calculated after the second measurements. The height and growth velocity curves generated were very similar to the currently used charts. We examined 555 children with short stature (< 3rd percentile) and poor growth rates (< 5 cm/yr). Five percent had an endocrine disorder. The presence of GHD (peak level, < 10 ng/dl with two provocative tests) was found in 16 previously unrecognized children; 17 children from this school population were already known to have GHD. Boys outnumbered girls 2.7:1 (p = 0.006). Six girls with Turner syndrome also were identified. We conclude that (1) the growth curves generated in the 1960s and 1970s are valid for children of the 1990s; (2) most children growing < 5 cm/yr (a commonly used threshold rate) will not have an endocrine disorder; (3) many children (48% in this study) with GHD and others with Turner syndrome may currently be unrecognized and untreated; (4) GHD appears to be more common in boys; and (5) the prevalence of GHD in the United States is at least 1:3480.