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Nationwide age references for sitting height, leg length, and sitting height/height ratio, and their diagnostic value for disproportionate growth disorders

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Author: Fredriks, A.M. · Buuren, S. van · Heel, W.J.M. van · Dijkman-Neerincx, R.H.M. · Verloove-Vanhorick, S.P. · Wit, J.M.
Type:article
Date:2005
Institution: TNO Kwaliteit van Leven
Source:Archives of Disease in Childhood, 8, 90, 807-812
Identifier: 238630
doi: doi:10.1136/adc.2004.050799
Keywords: Health · Jeugd en Gezondheid · Diagnostic procedure · Growth disorder · Hypochondroplasia · Leg length · Major clinical study · Marfan syndrome · Newborn · Nomogram · Reference value · Sitting · Adolescent · Adult · Age Factors · Anthropometry · Body Height · Bone Diseases · Child · Child, Preschool · Cross-Sectional Studies · Crown-Rump Length · Female · Humans · Infant · Infant, Newborn · Leg · Male · Marfan Syndrome · Netherlands · Posture · Reference Values · Regression Analysis

Abstract

Aims: To obtain age references for sitting height (SH), leg length (LL), and SH/H ratio in the Netherlands; to evaluate how SH standard deviation score (SDS), LL SDS, SH/H SDS, and SH/LL SDS are related to height SDS; and to study the usefulness of height corrected SH/H cut-off lines to detect Marfan syndrome and hypochondroplasia. Methods: Cross-sectional data on height and sitting height were collected from 14 500 children of Dutch origin in the age range 0-21 years. Reference SD charts were constructed by the LMS method. Correlations were analysed in three age groups. SH/H data from patients with Marfan syndrome and genetically confirmed hypochondroplasia were compared with height corrected SH/H references. Results: A positive association was observed between H SDS, SH SDS, and LL SDS in all age groups. There was a negative correlation between SH/H SDS and height SDS. In short children with a height SDS <-2 SDS, a cut-off limit of +2.5 SD leads to a more acceptable percentage of false positive results. In exceptionally tall children, a cut-off limit of -2.2 SDS can be used. Alternatively, a nomogram of SH/H SDS versus H SDS can be helpful. The sensitivity of the height corrected cut-off lines for hypochondroplasia was 80% and for Marfan syndrome only 30%. Conclusions: In exceptionally short or tall children, the dependency of the SH/H ratio (SDS) on height SDS has to be taken into consideration in the evaluation of body proportions. The sensitivity of the cut-off lines for hypochondroplasia is fair.