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Babies and children grow continuously. This is due to changes in the growth plates in the long bones of their arms and legs. As the growth plates make new bone, the long bones get longer, and the child gets taller.

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Males tend to be taller than females. Adolescent males will typically have a major growth spurt at the onset of puberty, about 2 years after their female counterparts, but they may continue to grow for longer than females.

According to the Centers for Disease Control and Prevention (CDC), in the United States, the average adult male is 5.7 feet (ft), or 175.2 cm, tall, and the average female is 5.3 ft, or 161.2 cm, tall.

As children get older, they need good nutrition and plenty of exercise to help their bodies make the hormones they need to grow. Teenagers will experience a growth spurt during puberty. After that, their bones will stop growing, and they will not get any taller.

Familial tall stature also known as constitutional tall stature is the most common cause of tall stature. The height is consistently above 97th percentile percentile and mid paretal height too is above 90th or 97th percentile. Usually occurs in a female child and the mother often remembers her unusual tall stature during her childhood. The bone as is marginally to moderately advanced so that the final height prediction is not very heigh. Physical examination is normal and lab tests, if obtained, are negative.

The second most common cause of tall stature is nutritional. The height as well as the weight are at higher percentile. Again the bone age is maginally to moderately advanced so that final predicted adult height is not too much.

Hormonal causes of tall stature include hyperthyroidism, precocious puberty and growth hormone excess. Hyperthyroidism is more common in girls and is almost always caused by Grave's disease.The bone age is moderately advanced so that the final adult height is usually compromised.

In cases of precocious puberty, although due to anabolic effects of sex steroids, the child is tall at the onset, the ultimate adult height is compromised due to premature epiphyseal fusion caused by oestrogen. Again, although, delayed puberty may be associated with short stature in childhood, as with constitutional delay, failure to eventually enter puberty and complete sexual maturation may result in sustained growth in adult life, with ultimate tall stature [1].

GH hormone excess causes gigantism in childhhod and acromegaly in adults. Gigantism is characterized by tall stature, broad hands and feet, prognathism, broad root of nose, excessive sweating, hypertension and glucose intolerance. Almost each and every part of the body is affected and large for age. GH levels are consistently high and can exceed 100 ng/ml [2]. Serum IGF-1 and IGFBP-3 are raised and serve as a sensitive screening tool for GH excesses. But the gold standard for making the diagnosis of GH excess is the failure to suppress serum GH levels below 5 ng /dl after 1.75 gm/ kbw glucose challange. This test measures the ability of IGF-1 to suppress GH secretion, because the glucose load results in insulin secretion, leading to suppression of IGFBP-1 which results in an acute increase in serum free IGF-1 level.

Homocystinuria is an autosomal recessive inborn error of aminoacid metabolism due to deficiency of cystathionine synthase. The gene is located on chromosom 21. It is characterized by tall stature, arachnodactyly, mental retardation and various occular manifestations. There is characteristic inferior subluxation of lens. Lab investigation includes positive cyanide nitroprucide test in urine as well as presence of homocystein in the urine. This condition is to be differentiated from Marfan syndrom which is characterized by defective fibrillin gene on chromosom 15,resulting in abnormal synthesis of fibrillin, a glycoprotein that is the major constituent of microfibrills that provide scaffolding network of elastic fibres and have an anchoring function in non- elastic tissues such as aortic adventitia and suspensory ligaments of lens. Unlike homocystinuria there is no mental retadation and the subluxation of lens is upwards.

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Determining how much your child or teen should weigh isn't a simple matter of looking at an insurance height-weight chart. It includes considering the amount of bone, muscle, and fat in their body. The amount of fat is the critical measurement.

A good indicator of how much fat your child or teen carries is the body mass index (BMI). Although it's not a perfect measure, it gives an indirect assessment of how much of your teen's body is composed of fat. BMI is based on weight and height. As a result, it's only a gauge of body fatness. Two people may have the exact same BMI, yet have different amounts of actual body fat.

The formulas below apply to adults only. For children and teens ages 2 to 19 years, the BMI varies by age and sex. An additional step must be done after the BMI has been determined using one of the formulas below. The BMI-for-age percentile is determined by comparing your child or teen's weight to that of other children or teens of the same age and sex.

For example, a person who weighs 165 pounds and is 5 feet 4 inches (64 inches) tall has a BMI of 28. Multiply 165 by 703 for a total of 115,995. Divide that by 64 for a total of 1812. Divide that total by 64 for a BMI of 28.. 041b061a72

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