Short stature
Encyclopedia
Short stature refers to a height of a human being which is below expected. Shortness is a vague term without a precise definition and with significant relativity to context. Because of the lack of preciseness, there is often disagreement about the degree of shortness that should be called short.
The American Association of Clinical Endocrinologists defines "short stature" as height more than 2 standard deviation
s below the mean for age and gender, which corresponds to the shortest 2.3% of individuals.
in childhood, while shortness in older adults usually results from loss of height due to kyphosis
of the spine
or collapsed vertebrae from osteoporosis
.
From a medical perspective, severe shortness can be a variation
of normal, resulting from the interplay of multiple familial genes. It can also be due to one or more of many abnormal conditions, such as chronic (prolonged) hormone
deficiency, malnutrition
, disease of a major organ system, mistreatment, treatment with certain drugs, chromosomal
deletions, inherited diseases, birth defect syndrome
s, bone structures fusing earlier than intended or many other causes.
HGH deficiency may occur at any time during infancy or childhood, with the most obvious sign being a noticeable slowing of growth. The deficiency may be genetic.
Increasing final height in children with short stature may be beneficial and could enhance HRQoL outcomes barring troublesome side effects and excessive cost of treatments.
Pharmaceutical companies Genentech
and Eli Lilly
, makers of human growth hormone, have worked to 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. Expanding it to all children whose height was below the third percentile would create 90,000 new customers and US $10 billion in revenue. In the early 1990s, they paid two US charities, the Human Growth Foundation and the MAGIC Foundation
, to measure the height of thousands of 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.
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 growth hormone deficiency
, and consequently benefited very little, if at all, from the hormone injections. Criticism of the universal screening program eventually resulted in its end.
The American Association of Clinical Endocrinologists defines "short stature" as height more than 2 standard deviation
Standard deviation
Standard deviation is a widely used measure of variability or diversity used in statistics and probability theory. It shows how much variation or "dispersion" there is from the average...
s below the mean for age and gender, which corresponds to the shortest 2.3% of individuals.
Causes
Shortness in children and young adults nearly always results from below-average growthHuman development (biology)
Human development is the process of growing to maturity. In biological terms, this entails growth from a one-celled zygote to an adult human being.- Biological development:...
in childhood, while shortness in older adults usually results from loss of height due to kyphosis
Kyphosis
Kyphosis , also called roundback or Kelso's hunchback, is a condition of over-curvature of the thoracic vertebrae...
of the spine
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
or collapsed vertebrae from osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
.
From a medical perspective, severe shortness can be a variation
Human variability
Human variability, or human variation, is the range of possible values for any measurable characteristic, physical or mental, of human beings. Differences can be trivial or important, transient or permanent, voluntary or involuntary, congenital or acquired, genetic or environmental...
of normal, resulting from the interplay of multiple familial genes. It can also be due to one or more of many abnormal conditions, such as chronic (prolonged) hormone
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...
deficiency, malnutrition
Malnutrition
Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....
, disease of a major organ system, mistreatment, treatment with certain drugs, chromosomal
Chromosome
A chromosome is an organized structure of DNA and protein found in cells. It is a single piece of coiled DNA containing many genes, regulatory elements and other nucleotide sequences. Chromosomes also contain DNA-bound proteins, which serve to package the DNA and control its functions.Chromosomes...
deletions, inherited diseases, birth defect syndrome
Syndrome
In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...
s, bone structures fusing earlier than intended or many other causes.
HGH deficiency may occur at any time during infancy or childhood, with the most obvious sign being a noticeable slowing of growth. The deficiency may be genetic.
Increasing final height in children with short stature may be beneficial and could enhance HRQoL outcomes barring troublesome side effects and excessive cost of treatments.
Cultural issues
From a social perspective shortness can be a problem independently of the cause. In many societies there are advantages associated with taller stature and disadvantages associated with shorter stature, and vice versa.Pharmaceutical companies Genentech
Genentech
Genentech Inc., or Genetic Engineering Technology, Inc., is a biotechnology corporation, founded in 1976 by venture capitalist Robert A. Swanson and biochemist Dr. Herbert Boyer. Trailing the founding of Cetus by five years, it was an important step in the evolution of the biotechnology industry...
and Eli Lilly
Eli Lilly
Eli Lilly was the founder of Eli Lilly and Company.Eli Lilly may also refer to:* Eli Lilly and Company, a global pharmaceutical company...
, makers of human growth hormone, have worked to medicalize short stature by convincing the public that short stature is a disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
rather than a natural variation in human height. Limiting sales of the hormone to children diagnosed with growth hormone deficiency
Growth hormone deficiency
Growth hormone deficiency is a medical condition in which the body does not produce enough growth hormone . Growth hormone, also called somatotropin, is a polypeptide hormone which stimulates growth and cell reproduction...
, rather than being short for any reason, limited their sales market. Expanding it to all children whose height was below the third percentile would create 90,000 new customers and US $10 billion in revenue. In the early 1990s, they paid two US charities, the Human Growth Foundation and the MAGIC Foundation
MAGIC Foundation
The MAGIC foundation for children's growth is an American non-profit organization which helps families of children diagnosed with a wide variety of different growth impacting medical conditions through education, networking, physician referrals and numerous other services. It was founded in 1989....
, to measure the height of thousands of 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.
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 growth hormone deficiency
Growth hormone deficiency
Growth hormone deficiency is a medical condition in which the body does not produce enough growth hormone . Growth hormone, also called somatotropin, is a polypeptide hormone which stimulates growth and cell reproduction...
, and consequently benefited very little, if at all, from the hormone injections. Criticism of the universal screening program eventually resulted in its end.
See also
- List of shortest people
- PygmyPygmyPygmy is a term used for various ethnic groups worldwide whose average height is unusually short; anthropologists define pygmy as any group whose adult men grow to less than 150 cm in average height. A member of a slightly taller group is termed "pygmoid." The best known pygmies are the Aka,...
- National Organization of Short Statured AdultsNational Organization of Short Statured AdultsThe National Organization of Short Statured Adults is an American non-profit advocacy group for adults of short stature. The organization defines "short stature" to be men 5'7" or below and women 5'2" or below in height. The group advocates on behalf of short people and hopes to foster greater...
- DwarfismDwarfismDwarfism is short stature resulting from a medical condition. It is sometimes defined as an adult height of less than 4 feet 10 inches , although this definition is problematic because short stature in itself is not a disorder....
- Idiopathic short statureIdiopathic short statureIdiopathic short stature refers to extreme short stature that does not have a diagnostic explanation after an ordinary growth evaluation...
- Growth hormone deficiencyGrowth hormone deficiencyGrowth hormone deficiency is a medical condition in which the body does not produce enough growth hormone . Growth hormone, also called somatotropin, is a polypeptide hormone which stimulates growth and cell reproduction...
- Psychosocial short stature
- Turner's Syndrome
- Primordial dwarfismPrimordial DwarfismPrimordial dwarfism is a form of dwarfism that results in a smaller body size in all stages of life beginning from before birth. More specifically, primordial dwarfism is a diagnostic category including specific types of profoundly proportionate dwarfism, in which individuals are extremely small...