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Focus on Boys' Height May Miss Illness in Girls

Doctors see twice as many short-statured boys as girls, study finds

MONDAY, Feb. 7, 2005 (HealthDay News) -- Twice as many boys as girls are referred to doctors for evaluation of short stature or poor growth, even though growth problems may affect girls more, researchers report.

They suspect a cultural gender bias that views short height as more of a problem for boys than girls may be driving the trend.

This gender imbalance may have serious health consequences. For example, underlying diseases that cause growth failure in girls might be overlooked or cause girls to experience delays in diagnosis, the researchers said. Conversely, many short but otherwise healthy boys may be subjected to unnecessary medical evaluations.

The findings are published in the February issue of the Journal of Pediatrics.

"Growth failure is a very sensitive indicator of a child's overall health, and should be evaluated with equal care for both boys and girls. Instead, these referral patterns may result from social pressures implying that short stature is a more significant problem in boys than girls," lead researcher Dr. Adda Grimberg, a pediatric endocrinologist at the Children's Hospital of Philadelphia, said in a prepared statement.

She and her colleagues reviewed the charts of 278 children (182 boys, 96 girls) referred for evaluations of short stature or poor growth. While girls were less likely to be referred than boys, the girls in this study were much shorter than the boys when compared to both the general population and predictions based on their parents' heights.

Overall, 38 percent of the boys were within normal height range, compared with 20 percent of the girls.

The researchers also found that 41 percent of the girls in the study had an underlying disease that made them short, compared with 15 percent of the boys.

Hormone deficiencies, gastrointestinal conditions such as celiac disease or inflammatory bowel diseases, and Turner syndrome (a chromosome abnormality found only in females) are among the diseases that can cause short stature.

"Because our study looked only at referred children, and not at all the children who were not referred, the meaning of this difference in underlying diseases is not clear. It may indicate that diseases are being missed in girls who are not referred, or that the percentage of boys with disease is 'diluted' by the large numbers of healthy boys being referred, or a combination of the two. Either ways, both sexes lose," Grimberg said.

More information

The Nemours Foundation has more about children's growth.

SOURCE: Children's Hospital of Philadelphia news release, Feb. 7, 2005
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