Can you predict your child’s height?

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In a first, Pune-based researchers have established the normal pattern of bone age advancement in children that can now help doctors predict how tall they can grow.

In a new study published in the Journal of Paediatric Endocrinology and Metabolism, doctors from the Hirabai Cowasji Jehangir Medical Research Institute (HCJMRI), have shown how bone density and age analysis can plot future growth of the child. “For instance, if a 10-year-old child wants to know how tall he or she is going to be, it is now possible to perform accurate bone age analysis. Using complex computerised models and algorithms, it is possible to predict the final height with a fair accuracy,” says Dr Vaman Khadilkar, senior paediatric endocrinologist and lead researcher of the study.

Skeletal maturity or bone age assessment has been a part of medical investigations in children with a suspected hormonal disorder. It is also a powerful tool to predict the final adult height that will be achieved by a normal child. “This is particularly important in children who are opting for careers that require a certain adult height, for example military service, police service, the entertainment and modelling industry. The success or failure of a child to get to these specific career goals depends on the final height they are likely to achieve as adults,” says Dr Khadilkar, who has also been the convener, Growth Charts Committee of the Indian Academy of Paediatrics.

Bone age assessment is a method of assessing skeletal maturity or skeletal age of a child. The chronological age of a child, as counted in months and years, is not always the same as the skeletal age and differs slightly in normal children and those with a medical condition. In normal children, the difference between bone age and chronological age is usually two years during childhood and puberty, says Dr Anuradha Khadilkar, Deputy Director of HCJMRI.

Bone age assessment can be done from a simple wrist and X-ray of the left hand. No special equipment is needed although the hand should be positioned in a certain way. Once the X-ray is done, the bone age is ascertained using the Tanner – Whitehouse or Greulich Pyle method or Gilsanz and Ratib methods. This is followed by a computerised assessment of the final height the child can grow to, using complex prediction equations.

All these methods have primarily been developed using Caucasian population and Dr Khadilkar is trying to develop an India-specific module. The study included 804 pre-school/school-going children. Anthropometric measurements and pubertal assessments were performed using standard protocols and were converted to age and sex standardized scores using Indian references while the bone age was estimated by Tanner-Whitehouse method that was considered statistically significant. “There are no Indian studies comparing bone age with chronological age using the Tanner-Whitehouse method which is more applicable to Asians,” Dr Khadilkar adds.

Study researchers observed that the highest increase in bone age in both girls and boys was during puberty. “We found that height age and bone age were tightly correlated with chronological age. The difference between height age, weight age, chronological age and bone age was within a one-year range. The increase in BMI was associated with an increase in bone and height age. During pubertal years, the height age showed a greater increase in comparison with the chronological and bone age in boys. In girls, the bone age increased more as compared to the height age,” explains Dr Khadilkar.

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