Short stature

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Short stature
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Short stature refers to a

mean for age and sex, which corresponds to the shortest 2.3% of individuals in that population.[1]

In

imperial measure.[2]

Causes

Shortness in children and young adults nearly always results from below-average

growth in childhood, while shortness in older adults usually results from loss of height due to kyphosis of the spine or collapsed vertebrae from osteoporosis. The most common causes of short stature in childhood are constitutional growth delay or familial short stature. [citation needed
]

From a medical perspective, severe shortness can be a

skeletal dysplasias also known as osteochondrodysplasia usually manifest in short-limbed disproportionate short stature.[3][4]

When the cause is unknown, it is called idiopathic short stature.[5] Short stature can also be caused by the bone plates fusing at an earlier age than normal, therefore stunting growth. Normally, the bone age is the same as the biological age but for some people, it is older. For many people with advanced bone ages, they hit a growth spurt early on which propels them to average height but stop growing at an earlier age. However, in some cases, people who are naturally shorter combined with their advanced bone age, end up being even shorter than the height they normally would have been because of their stunted growth.

Some of the reasons growth development may slow include:

  • Genetics. When a child’s parents and grandparents are short, the child may also be short; this is known as familial short stature. Also, the target height is merely an estimate and some children simply don't grow as tall as expected.
  • Genetic conditions. Several genetic syndromes can lead to short stature, including Prader-Willi syndrome, Turner syndrome and Noonan syndrome.
  • Chronic diseases. Growth hormones are produced by the pituitary gland, located in the middle of the brain. Therefore, chronic medical problems that affect the pituitary gland may also affect growth. For example, radiation to the brain can affect pituitary function, so pediatric cancer or its treatment can lead to short stature. Gastrointestinal diseases that impair nutrition, such as inflammatory bowel disease and celiac can affect growth, can also be a cause. Many other conditions can also delay the growth rate, including hypothyroidism, heart disease, kidney disease, immunological disease and several other endocrine disorders.
  • Growth hormone deficiency. Some children simply don't produce enough growth hormones, including those born with a poorly developed pituitary gland.
  • Malnutrition. This is caused by an inadequate food supply, an eating disorder, or an underlying condition or treatment that affects appetite, lack of nourishment is a common cause of growth delay.
  • Psychosocial stress. Exposure to violence because of war or famine or just being in a home environment that’s not very nurturing, children can also experience a psychosocial stress that keeps them from growing properly,” Dr. Patel says. “That can be reversed just by removing them from the stressful environment.”[6]

Classification

Chronic illnesses, malnutrition, endocrine, metabolic disorders or chromosomal anomalies are characterized by proportionate short stature. On the other hand, most genetic

skeletal dysplasias are known for short stature that may be proportionate or disproportionate. Disproportionate short stature can be further subdivided as specified by the body segments affected by shortening, namely limbs versus trunk:[3][4]

Short-limb short stature can be further subcategorised in accordance with limb segment affected by shortening. These subcategories of limb shortening include, rhizomelic (humerus and femur), mesomelic (radius, ulna, tibia and fibula) and acromelic (hands and feet). Anthropometric measurements provide are very beneficial tools to the diagnostic process of genetic

skeletal dysplasia subtypes.[3]

Treatment

The decision to treat is based on a belief that the child will be disabled by being extremely short as an adult, so that the risks of treatment (including sudden death

symptom of short stature. Although short children commonly report being teased about their height, most adults who are very short are not physically or psychologically disabled by their height.[5] However, there is some evidence to suggest that there is an inverse linear relationship with height and with risk of suicide.[7]

Treatment is expensive and requires many years of injections with human growth hormones. The result depends on the cause, but is typically an increase in final height of about 5 to 10 centimetres (2.0 to 3.9 in) taller than predicted.[5] Thus, treatment takes a child who is expected to be much shorter than a typical adult and produces an adult who is still obviously shorter than average. For example, several years of successful treatment in a girl who is predicted to be 146 centimetres (4 ft 9 in) as an adult may result in her being 151 centimetres (4 ft 11 in) instead. [citation needed]

Increasing final height in children with short stature may be beneficial and could enhance health-related quality of life outcomes, barring troublesome side effects and excessive cost of treatments.[8][dead link]

Cost

The cost of treatment depends on the amount of growth hormone given, which in turn depends on the child's weight and age. One year's worth of drugs normally costs about US$20,000 for a small child and over $50,000 for a teenager.[5] These drugs are normally taken for five or more years.[citation needed]

Cultural, social and economic issues

From a social perspective, shortness can be a problem independent of the cause. In many societies there are advantages associated with taller stature and disadvantages associated with shorter stature, and vice versa.[citation needed]

In popular culture

In

imperial measure.[9]

Short stature as a disease

Pharmaceutical companies

medicalize short stature by convincing the public that short stature is a disease rather than a natural variation in human height. Limiting sales of the hormone to children diagnosed with growth hormone deficiency, rather than being short for any reason, limited their sales market.[10] Expanding it to all children whose height was below the third percentile would create 90,000 new customers and US$10 billion in revenue.[11] In the early 1990s, they paid two US charities, the Human Growth Foundation and the MAGIC Foundation, to measure the height of thousands of American children in schools and public places, and to send letters urging medical consultations for children whose height was deemed low. Parents and schools were not told that the charities were being paid by the drug companies to do this.[10][11]

Paired with a campaign to advertise the hormone to physicians, the campaign was successful, and tens of thousands of children began receiving HGH. About half of them do not have

universal screening program eventually resulted in its end.[11]

Advantage

Short stature decreases the risk of venous insufficiency.[12]

History

During World War I in Britain, the minimum height for soldiers was 5 feet 3 inches (160 cm). Thus thousands of men under this height were denied the opportunity to fight in the war. As a result of pressure to allow them entry, special "Bantam Battalions" were created composed of men who were 4 feet 10 inches (147 cm) to 5 feet 3 inches (160 cm). By the end of the war there were 29 Bantam Battalions of about 1,000 men each. Officers were of normal size.[13]

See also

References

  1. PMID 21274395
    .
  2. ^ "Was Napoleon Short? Origins of the 'Napoleon Complex'". 25 July 2023.
  3. ^
    doi:10.1016/j.ejrnm.2016.10.007
    .
  4. ^
    PMID 25349664
    .
  5. ^
    S2CID 10045158
    .
  6. ^ "Short Stature (Growth Disorders) in Children". Yale Medicine. Retrieved 2022-07-02.
  7. PMID 15994722
    . Retrieved 2014-02-25.
  8. ^ "Was Napoleon Short? Origins of the 'Napoleon Complex'". 25 July 2023.
  9. ^
    ISBN 978-0-7425-5218-0
    .
  10. ^
    ISBN 978-0-7432-3787-1
    .
  11. ^ "Tall height".
  12. ^ Tom de Castella (8 February 2015). "Bantams: The army units for those under 5ft 3in". BBC News Magazine. Retrieved February 9, 2015.

External links

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