Utah Growth Study: Growth standards and the prevalence of growth hormone deficiency,☆☆,,★★

Presented at the annual meeting of the Society for Pediatric Research, Washington, D.C., 1993.
https://doi.org/10.1016/S0022-3476(94)70117-2Get rights and content

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. (J PEDIATR 1994;125:29-35)

Section snippets

METHODS

A prospective prevalence study was designed; this design is particularly useful for studying conditions that may be quantified and yet vary with time.8

Utah is a large state (85,000 square miles) with a population census in 1990 of 1,722,850.9 Seventy-seven percent of the population resides along the Wasatch Front, a narrow corridor 80 miles in length along the Wasatch mountain range in north central Utah. Approximately 11% of the population is composed of minority groups: Hispanic 5%;

RESULTS

A total of 123,948 elementary students, from kindergarten to fifth grade exclusively, were measured in the first year of the survey. We found that a child could be measured and the results recorded in <30 seconds when the process was done properly. Thus a full classroom took <20 minutes and there were few complaints about disruption from teachers or principals. Children absent because of illness represented 4.9% of the school population (Utah State School Board: unpublished data, 1992). In

DISCUSSION

Several growth charts have been constructed from measurements of North American children.1, 2 National Center of Health Statistics data1 provide the most recent and widely used percentile growth charts for height and weight of North American children from 2 to 18 years of age. These data are thought to be representative of childhood growth in the United States. The percentile values for Utah elementary children fit well with the standards for height in North American children.12 The standards

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    From the Division of Pediatric Endocrinology, Department of Pediatrics, University of Utah Medical Center, Salt Lake City

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    Supported by a grant from Genentech, Inc.

    Reprint requests: Rob Lindsay, MD, 508 East South Temple, No. 310, Salt Lake City, UT 84102.

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    0022-3476/94/$3.00 + 0 9/20/54999

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