A Prospective Study of Etiology of Short Stature in 426 Short Children and Adolescents

BACKGROUND—Short stature is defined as subnormal height relative to other children of the same sex and age, taking family into consideration. This prospective study was designed in order to determine the etiologies of short stature with especial concern on the prevalence of growth hormone deficiency, and to compare the results with world-wide studies.MATERIALS AND METHODS—We studied 426 subjects (272 boys and 154 girls) aged 4-18 years (mean, 10.8 ± 4.8) with short stature. The decision to investigate the growth hormone axis was made with the knowledge that other explanations for growth failure have been excluded by documention of a normal full blood count, ESR, renal function, and measurement of serum thyroxine concentration. In some female subjects, a karyotype was performed to exclude Turner’s syndrome. Bone age was determined in all subjects.RESULTS—Normal variants of growth including constitutional growth delay and familial short stature were identified as the most common causes of growth failure in this study. The results obtained in this study were in agreement with world-wide reports. Growth problems were more common in boys than in girls (1.8: 1). Among the short subjects, 23.4% had classic growth hormone deficiency (GHD). Boys outnumbered girls 2:1 (p < 0.05).CONCLUSION—We conclude that (1) most children with short stature will not have an endocrine disorder, but in endocrine referral centers, the frequency of GHD is higher than in general clinics and (2) GHD appears to be more common in boys.