Gonadotropin Suppression for 7 Years after a Single Histrelin Implant for Precocious Puberty

Gonadotropin releasing hormone analogs (GnRHas) are an effective treatment to address the compromise in height potential seen in patients with central precocious puberty. There is no evidence in the literature of a single GnRHa used for longer than 2 years before being removed or replaced. We describe a patient who was on continuous gonadotropin suppression for 7 years and despite this, achieved a height potential within one standard deviation of mid-parental height. A boy aged 10 years and 3 months presented to endocrine clinic with signs of precocious puberty and advanced bone age. Initial labs showed random LH 9.4 mIU/mL, FSH 16.3 mIU/mL, DHEAS 127 mcg/dl, and testosterone 628 ng/dL. He was initially started on Lupron injections before transitioning to a Histrelin implant. Follow-up laboratory results 5 months post-suppression showed pre-pubertal random LH 0.2 mIU/mL, FSH 0.1 mIU/mL, and testosterone 5 ng/dL. The patient was lost to follow-up and returned 5 years later presenting with gynecomastia and delayed bone age. He had continuous gonadotropin suppression with random LH 0.10 mIU/mL, FSH 0.16 mIU/mL, and testosterone 8 ng/dL. The Histrelin implant was removed and 4 months after removal labs showed random pubertal hormone levels with LH 5.6 mIU/mL, FSH 4.3 mIU/mL, and testosterone 506 ng/dl. The patient’s mid-parental height was 175.3 cm and the patient’s near final height was 170.6 cm which is within one standard deviation of his genetic potential. Further studies are needed to explore continuous gonadotropin hormone suppression with a single Histrelin implant beyond 2 years.

Vietnamese migrants are as tall as they want to be

Background Members of the same social group tent to have the same body height. Migrants tend to adjust in height to their host communities. Objectives Social-Economic-Political-Emotional (SEPE) factors influence growth. We hypothesized that Vietnamese young adult migrants in Germany (1) are taller than their parents, (2) are as tall as their German peers, and (3) are as tall as predicted by height expectation at age 13 years. Sample and Methods The study was conducted in 30 male and 54 female Vietnamese migrants (mean age 26.23 years. SD=4.96) in Germany in 2020. Information on age, sex, body height, school and education, job, height and ethnicity of best friend, migration history and cultural identification, parental height and education, and recalled information on their personal height expectations at age 13 years were obtained by questionnaire. The data were analyzed by St. Nicolas House Analysis (SNHA) and multiple regression. Results Vietnamese young adults are taller than their parents (females 3.85cm, males 7.44cm), but do not fully attain height of their German peers. The body height is positively associated with the height of best friend (p < 0.001), the height expectation at age 13 year (p < 0.001), and father height (p=0.001). Conclusion Body height of Vietnamese migrants in Germany reflects competitive growth and strategic growth adjustments. The magnitude of this intergenerational trend supports the concept that human growth depends on Social-Economic-Political-Emotional (SEPE) factors.

Weakening of the cognition and height association from 1957 to 2018: findings from four British birth cohort studies

Background: On average taller individuals have been repeatedly found to have higher scores on cognitive assessments, yet it is unclear whether the magnitude of this association has systematically changed across time. Recent studies have found that this association can be explained by genetic factors, yet this does not preclude the influence of environmental or social factors that affect the genome. We tested whether the association between cognition and height has weakened across time. Methods: We used four British birth cohorts (born 1946c, 1958c, 1970c, and 2001) with comparable data available at 10/11 and 14/17 years (N = 41,418). Height was measured at each age, and cognition via verbal reasoning (10/11 years) and vocabulary/comprehension scales (14/16 years) and via mathematical tests at both ages. We constructed age-adjusted height and cognition measures and converted cognition measures to ridit scores to aid interpretation. We then used linear and quantile regression to investigate whether cross-sectional associations between cognition and height differed in each cohort, sequentially adjusting for sex, childhood socioeconomic position, and maternal and paternal height. Results: Taller participants had higher mean cognitive assessment scores in childhood and adolescence, yet the associations were weaker in later (1970c and 2001c) cohorts. After adjustment for sex the mean difference in height comparing the highest with lowest verbal cognition scores at 10/11 years was 0.57 SD (95% CI = 0.44, 0.7) in the 1946c, 0.59 SD (0.52, 0.65) in the 1958c, 0.47 SD (0.41, 0.53) in the 1970c, 0.30 SD (0.23, 0.37) in the 2001c. This pattern of change in association was observed across all specifications (ages 10/11 and 14/16 years, and for each cognition measure used), and was robust to adjustment for social class and parental height, and modelling of plausible missing-not-at-random scenarios. Quantile regression suggested that these average differences were driven by differences in the lower centiles of height. This pattern was most evident in older cohorts. For example, in 1958c, the difference in height was 0.73 SD (0.64, 0.82) at the 10th centile, yet 0.46 SD (0.34, 0.57) at the 90th centile. Conclusion: Associations between height and cognitive assessment scores in childhood-adolescence weakened by at least half from 1957 to 2018. These results support the notion that environmental and social change can markedly weaken associations between cognition and other traits.

Association of Parental Height With Offspring Stunting in 14 Low- and Middle-Income Countries

Background: Maternal height has been confirmed to be associated with offspring stunting in low- and middle-income countries (LMICs), but only limited studies have examined the paternal-offspring association, and few studies have examined the joint effect of maternal and paternal height on stunting.Objective: To investigate the association between parental height and stunting of children aged under five in LMICs.Methods: We obtained data from the Demographic and Health Surveys (DHS) conducted in 14 LMICs from 2006 to 2016. The association between maternal and paternal height and height-for-age z score (HAZ) of children aged under five was analyzed using a linear regression model in consideration of complex survey design, and regression coefficients (β) with 95% confidence intervals (CIs) were reported. Then, the association between maternal and paternal height quintile and child stunting was analyzed using a modified Poisson regression approach with robust error variance in consideration of complex survey design with adjustment for covariates. The effect estimates were expressed as relative risks (RRs) with 95% CIs.Results: A total of 50,372 singleton children were included and the weighted prevalence of stunting was 34.5%. Both maternal height and paternal height were associated with child HAZ (β = 0.047; 95% CI, 0.043, 0.050; and β = 0.022; 95% CI, 0.018, 0.025, respectively). Compared with those born to the tallest mothers and fathers, children from the shortest mothers and the shortest fathers had higher risks of stunting (adjusted RR = 1.89; 95% CI, 1.78, 2.01; adjusted RR = 1.56; 95% CI, 1.47, 1.65, respectively). The mother-offspring associations are substantively larger than the father-offspring associations for each corresponding height quintile. Children from the shortest parents had the highest risk of stunting compared with children from the tallest parents (adjusted RR = 3.23; 95% CI, 2.83, 3.68).Conclusions: Offspring born to short parents are at increased risk of stunting in LMICs, and this intergenerational effect is partly driven by maternal intrauterine influence. This suggests the importance of improving the nutritional status of children and adults in LMICs, especially female caregivers.

Effects of parental stature on child stunting in India

Adult heights in India are short. Child stunting remains high though the prevalence fell from 48% to 38% in the decade prior to 2016. This study assesses the links between parental height and child stunting using nationally representative data on 28,975 under-five-year-old children from the 2015–16 National Family Health Survey. Parental heights are represented as quintiles. Logistic regression was applied to estimate the effect of parental heights after adjustment for household wealth, parental schooling, place of residence and other covariates. The unadjusted estimates showed the effect on stunting to be similar for maternal height, wealth and education. In the multivariate analysis maternal height emerged as the strongest predictor of stunting, with adjusted odds of 2.85 for the shortest compared with the tallest quintile. The two other strong predictors of stunting were paternal height and wealth, with adjusted odds of close to 2.0 for the lowest quintile relative to the highest quintiles. In comparison, associations between stunting and other factors were minor, with the partial exception of mother’s education. The findings underscore the key role of intergenerational influences on stunting. Maternal height has a stronger association with childhood stunting than paternal height and socioeconomic influences such as education and household wealth. The influence of paternal height is also strong, equal in magnitude to household wealth. Health workers need to be alerted to the special needs of short women.

Longitudinal Associations between Intake of Fruit and Vegetables and Height Attainment from Preschool to School Entry

To examine associations between fruit and vegetable intake in young childhood and height attainment during preschool and at school entry. Data for this study was based on “The Healthy Start” primary intervention study, which included 635 obesity-prone children, (58% boys), from the greater Copenhagen area, with a mean (SD) age of 4.0 (1.1) years (age range 2–6 years) at baseline. In the current study, 553 children (57% boys) were included with information on dietary intake at baseline and height measured at baseline (preschool age), and 511 children (56.8% boys) with the height measured at school entry (~6 years old). Height was measured by trained health professionals during the intervention and by school nurses at school entry. Information on intakes of fruit and vegetables, separately and combined, was gathered with four-day dietary records reported by parents. Participants were grouped into tertiles for their intakes at baseline. Compared to boys with low consumption, those with a moderate and high intakes of fruit and vegetables (F&V) had a greater attained height at preschool of 1.3 cm (95% confidence interval (CI): 0.3; 2.3) and at school entry of 2.4 cm (95% CI: 0.8; 3.9) and 1.8 cm (95% CI: 0.2; 3.4), respectively, also after adjustment for differences in age, body mass index (BMI), and total energy intake. Additional adjustment for mid-parental height and parents’ education did not alter the significant associations between moderate consumption of F&V and attained height at preschool and school entry. There was no association among girls. Our results showed that a moderate consumption of F&V was directly associated with higher attainment in height at preschool and school entry in boys. From a public health perspective, it should be prioritized to continue developing intervention programs to improve fruit and vegetable intake.

Polygenic Scores and Parental Predictors: An Adult Height Study Based on the United Kingdom Biobank and the Framingham Heart Study

Human height is a polygenic trait, influenced by a large number of genomic loci. In the pre-genomic era, height prediction was based largely on parental height. More recent predictions of human height have made great strides by integrating genotypic data from large biobanks with improved statistical techniques. Nevertheless, recent studies have not leveraged parental height, an added feature that we hypothesized would offer complementary predictive value. In this study, we assessed the predictive power of polygenic risk scores (PRS) combined with the traditional parental height predictors. Our study analyzed genotypic data and parental height from 1,071 trios from the United Kingdom Biobank and 444 trios from the Framingham Heart Study. We explored a series of statistical models to fully evaluate the performance of several PRS constructed together with parental information and proposed a model we call PRS++ that includes gender, parental height, and PRSs of parents and proband. Our estimate of height with an R2 of ∼0.82 is, to our knowledge, the most accurate estimate yet achieved for predicting human adult height. Without parental information, the R2 from the best PRS-driven model is ∼0.73. In summary, using adult height prediction as an example, we demonstrated that traditional predictors still play important roles and merit integration into the current trends of intensive PRS approaches.

Identification and characterization of factors associated with short stature and pre-shortness in Chinese preschool-aged children

Objectives: We aimed to identify and characterize potential factors, both individually and jointly as a nomogram, associated with short stature and pre-shortness in Chinese preschool-aged children. Methods: A total of 9501 children aged 3-6 years were recruited from 30 kindergartens in Beijing and Tangshan from September to December 2020 using a stratified random sampling method. Effect-size estimates are expressed as odds ratio (OR) and 95% confidence interval (CI). Results: The prevalence of short stature and pre-shortness in preschool-aged children was 3.9% (n=375) and 13.1% (n=1616), respectively. Factors simultaneously associated with the significant risk for short stature, pre-shortness and both included body mass index, parental height, maternal height, birthweight, birth height, latter birth order (≥2) and less parental patience to children. Besides, breastfeeding duration (≥12 months) was exclusively associated with pre-shortness (OR, 95% CI, P: 1.16, 1.01 to 1.33, 0.037), and childhood obesity with both short stature (3.45, 2.62 to 4.54, <0.001) and short stature/pre-shortness (1.37, 1.15 to 1.64, <0.001). Modeling of significant factors in nomograms had descent prediction accuracies, with the C-index of being 77.0%, 70.1% and 71.2% for short stature, pre-shortness and both, respectively (all P<0.001). Conclusions: Our findings indicate the joint contribution of inherited characteristics, nutrition status from uterus to childhood, and family psychological environment to short stature and pre-shortness in Chinese preschool-aged children. Further validation in other independent groups is warranted.

A possible model for estimating birth length of babies from common parental variables using a sample of families in Lagos, Nigeria

Background: Length at birth is important for evaluating childhood growth and development. It is of interest in Pediatrics because of its implications for perinatal and postnatal morbidity and mortality. Predicting birth length will be useful in an- ticipating and managing possible complications associated with pregnancy and birth of babies with abnormal birth length. Objective: The aim was to identify easily accessible parental determinants of baby’s birth length in Lagos, Nigeria, using a sample of patients attending a government hospital. Methods: Parental anthropometrics and other data were obtained from 250 couples by actual measurements, oral interviews and questionnaires. Baby’s birth length was measured immediately after delivery by qualified, a well-trained obstetric nurse, and association between parental and offspring parameters were assessed. Results: Weight gain, maternal weight, parity and mid-parental height were the significant parental explanatory variables of offspring birth length. They were the most suitable variables for a generated model for predicting babies’ birth length from parental variables in the study. Conclusion: A model that might be useful for predicting babies’ birth length from easily accessible parental variables was produced. This model may complement ultrasonographic data for predicting baby’s birth length with a view to achieving better perinatal and postnatal care. Keywords: Parental anthropometrics; birth length; association; model; correlation.

The Correlation of Parents Height Characteristics and Maternal Nutritional Status During Pregnancy Based on Upper Arm Circumference (UAC) and Stunting Incidence of Toddlers Aged 24-59 Months in the Working Area of Berbek Community Health Center Nganjuk Regency

Stunting in Indonesia was the fifth ranks in the world, influenced by many factors, some of which are the height of the parents and the nutritional status of the mother during pregnancy. The purpose of this research was to determine the correlation of parent height characteristics and maternal nutritional status during pregnancy based on Upper Arm Circumference (UAC) with stunting incidence in toddlers aged 24-59 months in the working area of the Berbek Public Health Center Nganjuk Regency. The research design used correlation analytic research design with observational method with case control approach. The independent variables consisted of parental height characteristics and maternal nutritional status during pregnancy based on UAC, and the dependent variable was stunting incidence. The population was 2266 respondents of under-five children aged 24-59 months. The sampling technique used quota sampling consisted 96 respondents. The instrument used height measurement tool, the Mother's Child Health book and the Public Health Center Weigh Activity Report, 2011. This research was conducted from 22 July to 22 August 2019 in three selected villages namely Sumberurip, Sumberwindu and Semare villages. Data analysis used chi-square test α (0.05). The results showed that almost all mothers and fathers had normal height characteristics, almost all respondents had the nutritional status of the mother during normal pregnancy. Analysis of height, circumference of the mother, and nutritional status of the mother during pregnancy based on Upper Arm Circumference (UAC) was obtained ρ value = 0.036; 0,000 and 0,000 <α 0,05. It meant that there was a correlation between parental height characteristics and maternal nutritional status during pregnancy based on Upper Arm Circumference (UAC) with the incidence of stunting in children aged 24-59 months in the Berbek Public Health Center Nganjuk Regency Parental height and nutritional status of the mother during normal pregnancy, it will have the opportunity to have a child with good growth.