Contribution of growth phases to adult size

Based on the data of the First Zurich Longitudinal Growth Study we investigate how interindividual differences in adult size arise in the variables leg height, sitting height and standing height, arm length, bi-iliac width and bihumeral width. Specifically, we are also interested in the question of whether across sexes and variables the same growth phases and the same parameters are predictive for achieving a certain adult size. A rather complex pattern emerges, demonstrating that regulation of growth is not the same for boys and girls and moreover is not the same for the six anthropometric variables studied. Prepubertal growth is characterized by its intensity (average velocity) and by its duration. Whereas duration has by itself no appreciable influence on adult size, prepubertal intensity determines adult size to a high degree across all variables and both sexes. The intensity of prepubertal growth determines adult size to a larger degree for boys than for girls. For a given size at the end of the prepubertal period, a small duration enhances the chance of obtaining a large adult size. Compared with prepubertal growth, the amount of variance of adult size explained is small for pubertal parameters, and--with respect to linear measures--significant for girls only. A small duration of prepubertal growth is in the following mainly compensated by a stronger pubertal spurt (PS), to a varying degree across variables. The overall picture which emerges indicates that sitting height--and to a lesser extent bihumeral width--develop in a more irregular fashion than the variables bi-iliac width and leg height.     

Growth processes leading to a large or small adult size

BACKGROUND: The way in which a large size in anthropometric variables is achieved is a longstanding problem, since the pubertal spurt shows statistically and clinically little association with adult size (mostly studied for height). By analysing longitudinal growth of groups of subjects with a large or a small adult size separately for height, leg and sitting height, and bihumeral and biiliac width, we studied this problem in some detail. Of interest are growth patterns specific for these variables and for boys or girls. METHODS: The data consist of 120 boys and 112 girls followed longitudinally from 4 weeks until adulthood. Statistically, structural average velocity curves were computed for each variable and each subgroup separately for comparison. This velocity curve represents the average intensity and the average tempo of growth. Since the area under the velocity curve is adult size, differences in the growth process can be visualized. RESULTS: Both sexes show similar patterns in reaching a small or large adult size. The different variables, however, show marked differences. Only for legs is the pubertal spurt delayed for the large groups (with additional gains in prepubertal years). For sitting height and biiliac width, a slightly elevated velocity all along development (after 2 years) leads to a larger size and for bihumeral width the size of the pubertal peak is decisive. CONCLUSIONS: The steering of growth to a certain target size is qualitatively similar for boys and girls, but quite different for different anthropometric variables. This leads to questions about endocrinological control for various parts of the body and differential bone growth in development.     

An analysis of variance of the pubertal and midgrowth spurts for length and width.

Using data from the first Zurich Longitudinal Growth Study characteristics of the growth of six variables--bihumeral width, biiliac width, standing height, sitting height, leg height and arm length--are studied. The main interest is in differences between boys and girls, and across variables and in particular in whether there are sex differences that are specific for some variables. For each child and variable, individual velocity and acceleration curves are estimated using a kernal smoother. From these curves, parameters characterizing the midgrowth spurt (MS) and the pubertal spurt (PS) are estimated: timings, durations and intensities. The level of childhood velocity is used for characterizing early growth. These parameters are analysed using a repeated measures analysis of variance (ANOVA) to assess the statistical significance of differences between boys and girls and across variables. This necessitates some kind of standardization and two types of standardization are used here. The MS shows negligible or small differences between boys and girls, and the same is true for velocity in childhood. Differences across variables during the MS are much more pronounced: with respect to intensity, bihumeral width has an MS about six times more intense than height. The PS is later for boys (as is well known), and there are significant differences across variables: bihumeral width and sitting height are late while legs are early. With the exception of biiliac width, the duration of the PS (which has been subdivided into three phases-early, middle and late) is slightly longer for boys for all variables: boys have a longer starting phase, the middle phase is about equal in length for both boys and girls, and girls have a slightly longer late phase. Leg height and height experience a PS of short duration while bihumeral and biiliac width experience a long one and these differences are highly statistically significant. For all variables, with the exception of biiliac width, boys have a more intense PS (in terms of maximal acceleration), even having adjusted for their larger adult size. Differences in intensity are also marked across variables, bihumeral width and sitting height having the highest intensity and legs the lowest. Differences between sexes and across variables are much smaller for the stopping intensity, characterized by maximal deceleration.     

Growth of early and late maturers

BACKGROUND: This is a study on the growth of subgroups of normal children, maturing early or late, in the variables height, leg and sitting height, arm length, biiliac and bihumeral width. While a longer growth period affects adult height only marginally, less is known about the other variables. It is also of interest to see in what way a shorter growth period is compensated by a higher velocity. METHODS: Out of 120 boys and 112 girls followed from 4 weeks until adulthood, subgroups of 40 boys and 37 girls were formed with respect to the average timing (across variables) of the pubertal spurt as an indicator of maturity. RESULTS: Only leg height shows a smaller adult size for early maturers. The shorter growth period is compensated by a higher prepubertal velocity and a higher level in pubertal years. The pubertal peak is a little larger for early maturing boys but not for girls. CONCLUSIONS: There is an inherent pacemaker for growth that leads to the same adult size for a shorter growth period via a higher basic intensity. Legs are an exception since late maturers have, on average, longer legs as adults.     

Sex dimorphism in growth

While there is agreement that sex differences in height are small up to the onset of the pubertal spurt in girls, there has been some debate about the question of which, and to what extent, various growth phases contribute to the average adult sex difference of about 13cm. There has been no consistent agreement between authors as to what extent this difference is due to the late onset of the pubertal spurt (PS) for boys and to what extent it is due to their more intense PS. In this paper, we investigate this question for the variables height, sitting and leg height, arm length, bihumeral and biiliac width. Biiliac width is a special case since both sexes have roughly the same adult size, but girls still have a shorter growing period. The gains for boys, when compared to girls, show a very different pattern across variables: for the legs, the additional growth due to the later spurt is responsible for most of the adult sex difference (64%). On the other hand, for bihumeral width and sitting height, the more intense PS contributes almost 50% to the adult sex difference. An analysis across variables indicates that increments from 1.5 to 6 years largely compensate for deviations in infant morphology from adult morphology.     

Sex dimorphism in growth

While there is agreement that sex differences in height are small up to the onset of the pubertal spurt in girls, there has been some debate about the question of which, and to what extent, various growth phases contribute to the average adult sex difference of about 13 cm. There has been no consistent agreement between authors as to what extent this difference is due to the late onset of the pubertal spurt (PS) for boys and to what extent it is due to their more intense PS. In this paper, we investigate this question for the variables height, sitting and leg height, arm length, bihumeral and biiliac width. Biiliac width is a special case since both sexes have roughly the same adult size, but girls still have a shorter growing period. The gains for boys, when compared to girls, show a very different pattern across variables: for the legs, the additional growth due to the later spurt is responsible for most of the adult sex difference (64%). On the other hand, for bihumeral width and sitting height, the more intense PS contributes almost 50% to the adult sex difference. An analysis across variables indicates that increments from 1.5 to 6 years largely compensate for deviations in infant morphology from adult morphology.     

Statistical characterization of the pubertal growth spurt.

BACKGROUND: This is a methodical investigation into the problem of estimating parameters for the pubertal spurt (PS). The variability involved in determining the timing, intensity and duration of the PS for height, leg height and biiliac width is estimated via a realistic simulation. Further, a decomposition of adolescent growth into a component due to the pubertal peak and one due to ongoing prepubertal velocity is evaluated. METHODS: Data for 120 boys and 112 girls are available from 4 weeks to adulthood. The curve-fitting method is kernel estimation for distance, velocity and acceleration. RESULTS: The age of peak velocity and the age of stopping of the PS are well determined. In contrast, the age of onset of the PS is less well determined. Intensity is less variable for the parameter peak velocity than for maximal acceleration. It is feasible to decompose adolescent growth into a component due to the pubertal peak and one due to ongoing prepubertal growth. CONCLUSIONS: Nonparametric curve-fitting methods which do not rely on a parametric growth model can be successfully used to extract individual characteristics of the PS.     

Short-term and long-term variability of standard deviation scores for size in children

PRIMARY OBJECTIVE: To quantify long-term and short-term variability in the standard deviation scores (SDS's) for six skeletal size variables and body mass index (BMI) in children and to compare average values of these quantities for boys with those of girls and to make comparisons across variables. METHODS AND PROCEDURES: The analysis is based on measurements made regularly for 120 boys and 112 girls from 1 month until 20 years for seven variables (standing height, sitting height, leg height, arm length, biiliac width, bihumeral width and BMI) as part of the first Zurich longitudinal growth study. Variation in these scores due to variablity in the timing of the pubertal spurt (PS) is separated out by rescaling the age axis on an individual basis and comparing children with the same developmental age rather than the same chronological age. For a given child, the relationship between the value of its SDS and age is modelled as the sum of an arbitrary (child dependent) smooth function plus an error term. The long-term variability for that child is defined to be the mean square of the departures of this smooth function from its mean level while the short-term variability is defined to be the variance of the error term. MAIN OUTCOMES AND RESULTS: Girls' SDS scores have significantly more long-term variability than those of boys, while there is no significant difference between the sexes for short-term variability. Bihumeral width, BMI and sitting height have significantly more long-term variation than the other variables. Bihumeral width and BMI have the largest short-term variability and standing height has the smallest. Correlations between long-term variability and adult size and timing and intensity of the PS were small. CONCLUSIONS: A useful way of assessing long-term and short-term variability of SDS's, which is widely applicable has been described and applied to data relating to the growth of children. The results of this analysis are intriguing. Why is the underlying growth process of girls more variable than that of boys? Differences across skeletal parameters are also interesting and deserve further consideration.     

Analysis of the adolescent growth spurt using smoothing spline functions

Height growth velocity curves between 4·5 and 17·75 years were estimated, using smoothing spline functions, for 112 boys and 110 girls from the Zurich Longitudinal Study (1955–1976). Parameters characterizing the growth process, such as peak height velocity and age at peak height velocity, were calculated directly from the estimated curves.

The variability of parameters describing the adolescent growth spurt is large, both between and within sexes. Peak height, defined as increase of height velocity during the growth spurt, and age at peak height velocity both characterize the sex difference in growth in a highly significant manner. Peak height of at least 4 cm/year is found in 70% of the boys, but in only 11% of the girls. The age at peak height velocity averages 12·2 years in girls and 13·9 years in boys and has a wide range of 5·7 years and 3·8 years respectively.

The sex difference in adult height of 12·6 cm is composed of the following 4 factors: +1·6 cm caused by more prepubertal growth in boys, +6·4 cm by the boys' delay in spurt, +6·0 cm by the more extensive spurt in boys and ?1·4 cm by more post-spurt growth in girls.

Correlations between parameters indicate that the adult height depends neither on the duration of growth, nor on the duration and height of the peak. Minimal pre-spurt height velocity and peak height velocity, but not peak height, are age- and height-dependent.

Partial correlations given adult height reveal two compensating mechanisms between growth in the prepubertal and in the pubertal period. Small prepubertal height and low height velocity with respect to adult height are followed by a late adolescent spurt and vice versa. Small height at the onset of the spurt with respect to adult height is followed by a longer lasting, but not higher spurt and vice versa.     

Growth processes leading to a large or small adult size

Background: The way in which a large size in anthropometric variables is achieved is a longstanding problem, since the pubertal spurt shows statistically and clinically little association with adult size (mostly studied for height). By analysing longitudinal growth of groups of subjects with a large or a small adult size separately for height, leg and sitting height, and bihumeral and biiliac width, we studied this problem in some detail. Of interest are growth patterns specific for these variables and for boys or girls.

Methods: The data consist of 120 boys and 112 girls followed longitudinally from 4 weeks until adulthood. Statistically, structural average velocity curves were computed for each variable and each subgroup separately for comparison. This velocity curve represents the average intensity and the average tempo of growth. Since the area under the velocity curve is adult size, differences in the growth process can be visualized.

Results: Both sexes show similar patterns in reaching a small or large adult size. The different variables, however, show marked differences. Only for legs is the pubertal spurt delayed for the large groups (with additional gains in prepubertal years). For sitting height and biiliac width, a slightly elevated velocity all along development (after 2 years) leads to a larger size and for bihumeral width the size of the pubertal peak is decisive.

Conclusions: The steering of growth to a certain target size is qualitatively similar for boys and girls, but quite different for different anthropometric variables. This leads to questions about endocrinological control for various parts of the body and differential bone growth in development.

Hintergrund: Die Art, in der anthropometrische Variable die Erwachsenengröße erreichen, ist ein seit langer Zeit bestehendes Problem, da der puberale Spurt statistisch und klinisch nur geringe Assoziationen zur Erwachsenengröße zeigt (am häufigsten untersucht für die Körperhöhe). Wir untersuchten dieses Problem detailliert durch die Analyse des longitudinalen Wachstums von Probandengruppen mit großer oder geringer Erwachsenengröße jeweils für Körperhöhe, Beinlänge, Sitzhöhe sowie Ellbogenbreite und Beckenbreite. Dabei waren die Wachstumsmuster speziell für diese Variablen für Jungen und Mädchen von Interesse. Methodik: Die Daten stammen von 120 Jungen und 112 Mädchen, die von der vierten Lebenswoche bis zum Erwachsenenalter longitudinal untersucht wurden. Statistisch wurden die strukturellen mittleren Kurven der Wachstumsgeschwindigkeit für jede Variable und zum Vergleich getrennt für jede Untergruppe berechnet. Diese Geschwindigkeitskurven stellen die mittlere Intensität und das mittlere Tempo des Wachstums dar. Da die Fläche unter der Geschwindigkeitskurve die adulte Größe darstellt, können auf diese Weise Unterschiede im Wachstumsprozess verdeutlicht werden. Ergebnisse: Beide Geschlechter zeigen ähnliche Muster hinsichtlich des Erreichens einer geringen oder großen Erwachsenengröße. Die einzelnen Variablen weisen jedoch erhebliche Unterschiede auf. Nur bei der Beinlänge ist der puberale Wachstumsspurt in der Gruppe mit großer Endgröße verzögert (mit einem zusätzlichen Zuwachs in den präpuberalen Jahren). Bei der Sitzhöhe und der Beckenbreite führt eine geringfügig gesteigerte Geschwindigkeit während der gesamten Entwicklung (nach dem zweiten Lebensjahr) zu einer größeren Erwachsenengröße und bei der Ellbogenbreite ist die Höhe des puberalen Wachstumsgipfels ausschlaggebend. Schlussfolgerungen: Die Steuerung des Wachstums hin zu einer bestimmten Zielgröße ist für Jungen und Mädchen qualitativ ähnlich, dagegen ziemlich unterschiedlich für verschiedene anthropometrische Variable. Daraus ergeben sich Fragen bezüglich der endokrinologischen Steuerung des Wachstums verschiedener Körperteile und eines unterschiedlichen Knochenwachstums während der Entwicklung.

Arrière plan: Considérant qu'il y a peu d'association statistique et clinique entre la poussée pubertaire et le format adulte (surtout étudié pour la stature), la façon dont de grandes valeurs des dimensions anthropométriques sont atteintes, demeure un problème irrésolu. C'est à cela que s'attache ce travail, en procédant par l'analyse de la croissance longitudinale d'un groupe de sujets de format corporel adulte soit petit soit grand, pour lesquels sont considérées séparément, les dimensions de la stature, de la jambe, de la taille-assis, de la largeur bihumérale et de la largeur biiliaque. En particulier, s'est-on intéressé aux modalités spécifiques de croissance de ces variables chez les garçons et chez les filles. Méthodes: Les données portent sur 120 garçons et 112 filles suivis longitudinalement de l'âge de quatre semaines jusqu'à l'état adulte. Des courbes statistiques de vélocitéstructurale moyenne ont été établies pour comparaison dans chaque sous-groupe séparément et pour chaque variable. Cette courbe de vélocité représente l'intensité moyenne et le tempo moyen de la croissance. L'aire située au-dessous de la courbe étant la taille adulte, des différences dans le processus de croissance peuvent ainsi être observées. Résultats: Les deux sexes montrent des modalités similaires dans l'atteinte de la taille adulte, qu'elle soit petite ou grande. Les diverses variables montrent cependant des différences marquées. La poussée pubertaire n'est retardée que pour les jambes, dans le groupe de grand format (avec des gains additionnels pendant la période prépubertaire). Pour la taille-assis et la largeur biiliaque, une vélocité modérément élevée pendant l'ensemble du développement (après deux ans) conduit à une taille plus grande; pour la largeur bihumérale, on observe que l'importance du pic pubertaire est décisive. Conclusions: le déroulement de la croissance jusqu'à atteindre une dimension projetée est qualitativement semblable pour les garçons et pour les filles, mais très différent suivant les variables anthropométriques concernées. Ceci conduit à s'interroger sur le contrôle endocrinologique de diverses parties du corps, ainsi que sur la croissance osseuse différentielle pendant le développement.     

Secular change in height,sitting height and leg length in rural Oaxaca,southern Mexico: 1968–2000

Objective: To evaluate secular changes in height, sitting height and estimated leg length between 1968 and 2000 in residents in a rural Zapotec-speaking community in Oaxaca, southern Mexico.

Materials and methods: Height and sitting height were measured in school children 6–13 years (1968, 1978, 2000), in adolescents 13–17 years (1978, 2002) and adults 19–29 years (1978, 2000). Leg length was estimated as height minus sitting height. The sitting height/height ratio was calculated. Subjects were grouped by sex into four age categories: 6–9, 10–13, 13–17 and 19–29 years for analysis. The Preece–Baines Model I growth curve was fitted to cross-sectional means for 1978 and 2000.

Results: There were no differences between children 6–9 and 10–13 years in 1968 and 1978 with the exception of the sitting height ratio in girls 6–9 years. Children of both sexes 6–13 years and adolescent boys 13–17 years were significantly larger in the three dimensions in 2000 compared to 1978; adolescent girls differed only in height and sitting height. Adult males in 2000 were significantly taller with longer legs than those in 1978, but the samples did not differ in sitting height and the ratio. Adult females in 1978 and 2000 did not differ significantly in the three dimensions. Rates of secular change in height and sitting height between 1978 and 2000 were reasonably similar in the three age groups of male children and adolescents, but the rate for estimated leg length was highest in 10–13-year-old boys. Secular gains were smaller in adult males, but were proportionally greater in estimated leg length. Girls 6–9 and 10–13 years experienced greater secular gains in height, sitting height and estimated leg length than adolescent and young adult females, while secular gains and rates decreased from adolescent girls to young adult women. Ages of peak velocity for height, sitting height and estimated leg length declined in boys, while only ages of peak velocity for height and estimated leg length declined in girls.

Conclusions: There are major secular increases in height, sitting height and estimated leg length of children and adolescents of both sexes since 1978. Secular gains in height are of similar magnitude in boys and girls 6–13 years, but are greater in adolescent and young adult males than females. The secular increase in height of young adults of both sexes is smaller than that among adolescents. Estimated leg length accounts for about 60% of the secular increase in height in children of both sexes. Estimated leg length and sitting height contribute equally to the secular increase in height in adolescent boys, whereas estimated leg length accounts for about 70% of the secular increase in height in young adult males. Sitting height contributes about two-thirds of the secular increase in height in adolescent and young adult females.     

Secular change in height, sitting height and leg length in rural Oaxaca, southern Mexico: 1968-2000

OBJECTIVE: To evaluate secular changes in height, sitting height and estimated leg length between 1968 and 2000 in residents in a rural Zapotec-speaking community in Oaxaca, southern Mexico. MATERIALS AND METHODS: Height and sitting height were measured in school children 6-13 years (1968; 1978, 2000), in adolescents 13-17 years (1978, 2002) and adults 19-29 years (1978, 2000). Leg length was estimated as height minus sitting height. The sitting height/ height ratio was calculated. Subjects were grouped by sex into four age categories: 6-9, 10-13, 13-17 and 19-29 years for analysis. The Preece-Baines Model I growth curve was fitted to cross-sectional means for 1978 and 2000. RESULTS: There were no differences between children 6-9 and 10-13 years in 1968 and 1978 with the exception of the sitting height ratio in girls 6-9 years. Children of both sexes 6-13 years and adolescent boys 13-17 years were significantly larger in the three dimensions in 2000 compared to 1978; adolescent girls differed only in height and sitting height. Adult males in 2000 were significantly taller with longer legs than those in 1978, but the samples did not differ in sitting height and the ratio. Adult females in 1978 and 2000 did not differ significantly in the three dimensions. Rates of secular change in height and sitting height between 1978 and 2000 were reasonably similar in the three age groups of male children and adolescents, but the rate for estimated leg length was highest in 10-13-year-old boys. Secular gains were smaller in adult males, but were proportionally greater in estimated leg length. Girls 6-9 and 10-13 years experienced greater secular gains in height, sitting height and estimated leg length than adolescent and young adult females, while secular gains and rates decreased from adolescent girls to young adult women. Ages of peak velocity for height, sitting height and estimated leg length declined in boys, while only ages of peak velocity for height and estimated leg length declined in girls. CONCLUSIONS: There are major secular increases in height, sitting height and estimated leg length of children and adolescents of both sexes since 1978. Secular gains in height are of similar magnitude in boys and girls 6-13 years, but are greater in adolescent and young adult males than females. The secular increase in height of young adults of both sexes is smaller than that among adolescents. Estimated leg length accounts for about 60% of the secular increase in height in children of both sexes. Estimated leg length and sitting height contribute equally to the secular increase in height in adolescent boys, whereas estimated leg length accounts for about 70% of the secular increase in height in young adult males. Sitting height contributes about two-thirds of the secular increase in height in adolescent and young adult females.     

Age of pubertal onset affects the intensity and duration of pubertal growth peak but not final height

This paper analyzed the intensity and duration of height growth during puberty in boys and girls in relation to rhythm of maturation. A longitudinal clinical follow‐up between ages of 10 and 20 years, was carried out in a sample of 251 children grouped according to age at pubertal onset: boys (genital stage 2) at the ages of 11 (n = 28), 12 (n = 38), 13 (n = 42), and 14 (n = 27); and girls (breast stage 2) at the ages of 10 (n = 37), 11 (n = 47), 12 (n = 19), and 13 (n = 13). Height was measured annually. Testicular volume and genital development were assessed in boys, and breast development was assessed in girls. There were significant differences (P < 0.001) in height at the age of pubertal onset among maturity groups. Late maturers were taller than early maturers (r = 0.49, P < 0.001 for girls; r = 0.38, P < 0.001 for boys). However, final heights did not differ according to age of onset in either sex. In boys, later onset of puberty was associated with a smaller pubertal height gain (r = ?0.60, P < 0.001) and a shorter period of pubertal growth (r = ?0.61, P < 0.001). Equally in girls, earlier onset of puberty was associated with a greater pubertal height gain (r = ?0.68, P < 0.001) and a longer period of pubertal growth (r = ?0.59, P < 0.001). In conclusion, age of pubertal onset does not affect final height attained in both sexes, since there is an inverse compensatory phenomenon in both sexes between height at pubertal onset and the intensity and duration of pubertal growth. Am. J. Hum. Biol. 13:409–416, 2001. © 2001 Wiley‐Liss, Inc.     

A morphological study of the human prepubertal and pubertal larynx

Measurements were made from ten Caucasian male and ten Caucasian female cadaveric larynges ranging in age from 9 to 18 years. The sample was divided into prepubertal and pubertal groups of each sex, respectively. Each specimen was dissected and measured according to a specified protocol so that data on linear and angular dimensions of the laryngeal cartilages and the weight of each cartilage were obtained. Results from this study highlighted differences in the developmental morphology of the circumpubertal larynx. With few exceptions, pubertal laryngeal measurements were significantly larger than prepubertal counterparts in both sexes. No clear sexual dimorphism was found between male and female prepubertal larynges though measurements of the prepubertal female larynx were closer to adult counterparts in size and weight than were those in the male. Thus the female larynx requires less growth per unit time to reach maturity than the male. By puberty, clear sexual dimorphism was evident in the larynx. Linear and weight measurements of the pubertal male larynx were significantly larger than in the female. Though the angle of the thyroid laminae was not significantly different in pubertal male and female cartilages, the thyroid eminence was clearly more prominent in the male. The vocal folds in both sexes reached essentially their adult length by puberty; however, the absolute length of the male vocal folds had increased by over two times that of the female.     

Growth in some physical dimensions in relation to adolescent growth spurt among rural Indian children

Measurements other than weight and height are rarely used in adolescent growth assessment. It is necessary to examine changes in other physical dimensions especially in relation to spurt in height as stature growth has a significance in the assessment of adolescent growth. The present study, therefore, reports data on four such measurements viz. foot length, sitting height, leg length and shoulder width along with height in a semilongitudinal growth study carried out over a 3 year period, on rural Indian boys (n =587) and girls (n = 433), to examine the occurrence of their maximum increments in relation to spurt in height. Our analysis shows that the sequence of spurt in these physical dimensions is the same in the case of boys and girls, viz. spurt in foot length and leg length occurs before age at peak height velocity (14.3 yr boys, 12.1 yr girls) while that for sitting height and shoulder width occurs after attaining the peak height velocity. While foot length is the first one to reach peak (14 yr-boys, 11 yr-girls), shoulder width is the last one (16 yr boys, 14 yr girls) in this sequence. Thus the duration between the first spurt and the last spurt was observed to be larger in case of girls (3 yr) as compared to boys (2 yr) and apart from biological differences it could be partly due to the differential treatment received by rural girls. Sitting heights and leg lengths of rural children were significantly ( p &lt; 0.01) lower compared to Indian well-off and British children suggest that undernutrition prevailing in rural community affects all components of linear growth.     

Growth of early and late maturers

Background: This is a study on the growth of subgroups of normal children, maturing early or late, in the variables height, leg and sitting height, arm length, biiliac and bihumeral width. While a longer growth period affects adult height only marginally, less is known about the other variables. It is also of interest to see in what way a shorter growth period is compensated by a higher velocity.

Methods: Out of 120 boys and 112 girls followed from 4 weeks until adulthood, subgroups of 40 boys and 37 girls were formed with respect to the average timing (across variables) of the pubertal spurt as an indicator of maturity.

Results: Only leg height shows a smaller adult size for early maturers. The shorter growth period is compensated by a higher prepubertal velocity and a higher level in pubertal years. The pubertal peak is a little larger for early maturing boys but not for girls.

Conclusions: There is an inherent pacemaker for growth that leads to the same adult size for a shorter growth period via a higher basic intensity. Legs are an exception since late maturers have, on average, longer legs as adults.

Hintergrund: Es handelt sich um eine Studie über das Wachstum von Untergruppen früh- oder spätreifender normaler Kinder bezüglich der Variablen Körperlänge, Beinlänge und Sitzhöhe, Armlänge, Beckenbreite und Ellbogenbreite. Während eine längere Wachstumperiode die Erwachsenenkörperhöhe nur unbedeutend beeinflusst, ist über die anderen Variablen wenig bekannt. Es ist daher interessant zu sehen, in welcher Weise eine kürzere Wachstumsperiode durch eine höhere Wachstumsgeschwindigkeit kompensiert wird. Methodik: Aus einer Gruppe von 120 Jungen und 112 Mädchen, die vom Alter von 4 Wochen bis zum Erwachsenenalter untersucht wurden, wurden Untergruppen von 40 Jungen und 37 Mädchen gebildet. Dies erfolgte mit Bezug auf den durchschnittlichen Zeitpunkt (ermittelt aus allen Variablen) des puberalen Spurts als Reifungsindikator. Ergebnisse: Nur die Beinlänge zeigt eine geringere Erwachsenengröße bei den Probanden mit früher Reife. Die kürzere Wachstumsperiode wird durch eine höhere präpuberale Geschwindigkeit und ein höheres Niveau in den Pubertätsjahren kompensiert. Der puberale Gipfel ist etwas größer bei den Jungen mit früher Reife, nicht dagegen bei den Mädchen. Schlussfolgerungen: Es gibt einen inhärenten Schrittmacher für das Wachstum, welcher bei einer kürzeren Wachstumsperiode über eine höhere Basisintensität zur gleichen Erwachsenengröße führt. Die Beinlänge bildet eine Ausnahme, da die spät Reifenden im Durchschnitt als Erwachsene längere Beine haben.

Arrière plan: il s'agit d'une étude sur la croissance de la la stature, hauteur de la jambe et de la taille-assis, de la longueur du bras et des largeurs bihumérale et biiliaque, chez des sous-groupes d'enfants normaux àmaturation lente ou rapide. Alors qu'on sait qu'une plus longue période de croissance n'affecte la stature adulte que de façon marginale, peu de choses sont connues quant aux autres variables. Il est également intéressant de voir dans quelle mesure une période de croissance plus courte est compensée par une vélocité plus grande. Méthode: à partir d'échantillons de 120 garçons et 112 filles suivis de l'âge de quatre semaines jusqu'à l'état adulte, on a formédes sous-groupes de 40 garçons et de 37 filles, selon la chronologie moyenne (calculée sur l'ensemble des variables) de la poussée pubertaire, considérée comme un indicateur de maturité. Résultats: seule la hauteur de la jambe exprime une plus petite taille adulte chez les enfants à maturation rapide. La période de croissance plus courte est compensée par une vélocité prépubertaire plus élevée et un plus haut niveau pendant la puberté. Le pic pubertaire est un peu plus marqué pour les garçons à maturation précoce, mais non pour les filles. Conclusions: il existe un régulateur inhérent au processus de croissance, qui conduit à une dimension adulte identique lorsque se raccourcit la période de croissance, via une intensité de base plus grande. Les jambes en sont une exception, car les enfants à maturation tardive ont en moyenne de plus longues jambes à l'état adulte.     

Effect of growth hormone treatment on the adult height of children with chronic renal failure. German Study Group for Growth Hormone Treatment in Chronic Renal Failure

BACKGROUND: Growth hormone treatment stimulates growth in short children with chronic renal failure. However, the extent to which this therapy increases final adult height is not known. METHODS: We followed 38 initially prepubertal children with chronic renal failure treated with growth hormone for a mean of 5.3 years until they reached their final adult height. The mean (+/-SD) age at the start of treatment was 10.4+/-2.2 years, the mean bone age was 7.1+/-2.3 years, and the mean height was 3.1+/-1.2 SD below normal. Fifty matched children with chronic renal failure who were not treated with growth hormone served as controls. RESULTS: The children treated with growth hormone had sustained catch-up growth, whereas the control children had progressive growth failure. The mean final height of the growth hormone-treated children was 165 cm for boys and 156 cm for girls. The mean final adult height of the growth hormone-treated children was 1.6+/-1.2 SD below normal, which was 1.4 SD above their standardized height at base line (P< 0.001). In contrast, the final height of the untreated children (2.1+/-1.2 SD below normal) was 0.6 SD below their standardized height at base line (P<0.001). Although prepubertal bone maturation was accelerated in growth hormone-treated children, treatment was not associated with a shortening of the pubertal growth spurt. The total height gain was positively associated with the initial target-height deficit and the duration of growth hormone therapy and was negatively associated with the percentage of the observation period spent receiving dialysis treatment. CONCLUSIONS: Long-term growth hormone treatment of children with chronic renal failure induces persistent catch-up growth, and the majority of patients achieve normal adult height.     

Growth in some physical dimensions in relation to adolescent growth spurt among rural Indian children

Measurements other than weight and height are rarely used in adolescent growth assessment. It is necessary to examine changes in other physical dimensions especially in relation to spurt in height as stature growth has a significance in the assessment of adolescent growth. The present study, therefore, reports data on four such measurements viz. foot length, sitting height, leg length and shoulder width along with height in a semilongitudinal growth study carried out over a 3 year period, on rural Indian boys (n = 587) and girls (n = 433), to examine the occurrence of their maximum increments in relation to spurt in height. Our analysis shows that the sequence of spurt in these physical dimensions is the same in the case of boys and girls, viz. spurt in foot length and leg length occurs before age at peak height velocity (14.3 yr--boys, 12.1 yr--girls) while that for sitting height and shoulder width occurs after attaining the peak height velocity. While foot length is the first one to reach peak (14 yr--boys, 11 yr--girls), shoulder width is the last one (16 yr--boys, 14 yr--girls) in this sequence. Thus the duration between the first spurt and the last spurt was observed to be larger in case of girls (3 yr) as compared to boys (2 yr) and apart from biological differences it could be partly due to the differential treatment received by rural girls. Sitting heights and leg lengths of rural children were significantly (p < 0.01) lower compared to Indian well-off and British children suggest that undernutrition prevailing in rural community affects all components of linear growth.     

Ontogeny of gonadotrophin and inhibin secretion in normal girls through puberty based on overnight serial sampling and a comparison with normal boys

We measured luteinizing hormone (LH) and follicle stimulating hormone (FSH) by immunofluorometric assays and alpha-inhibin by radioimmunoassay in serum sampled every 10 min throughout the night (2100-0500 h) from 44 normal girls. Mean overnight LH values rose log- linearly from a mean of 0.2 IU/l in prepubertal girls to 3.0 IU/l in late pubertal girls. Log2 mean overnight FSH rose rapidly through early puberty and then remained constant; mean FSH rose from 1.0 IU/l in prepubertal girls to approximately 2.8 IU/l in Tanner III-V girls. Mean overnight inhibin increased through puberty, rising from 151 ng/l in prepubertal girls to 432 ng/l in fully pubescent girls. Within each of the first three Tanner stages, LH differed approximately 100-fold between the smallest and largest mean concentrations but differed <10- fold within stages IV or V. Such within-pubertal stage variability was less pronounced for FSH, which differed approximately 16-fold among Tanner I subjects and 4-10-fold at later stages, and for inhibin, which varied approximately 4-fold within each Tanner stage. The frequency of LH pulses during overnight sampling increased significantly during puberty, but the frequency of FSH and inhibin pulses remained constant. We compared the results from girls to those from 50 normal boys [Manasco et al. (1995) J. Clin. Endocrinol. Metab., 80, 20462052]. At each pubertal stage, girls had approximately the same mean overnight LH values as boys; girls had higher mean overnight FSH, particularly during Tanner stages II-IV; and boys had mean overnight alpha-inhibin immunoreactivity approximately 1.5 times that of girls at each pubertal stage. Still, hormone concentrations for individuals of both sexes intergraded at each pubertal stage.