SUN-251 Tanner Stage Adjustment of CDC Height Curves and Potential Clinical Applications

Background: The CDC height charts based upon chronological age (CA-Height) don’t account for the different growth patterns that can be seen in variations of puberty, pubertal disorders or ethnic difference in pubertal timing. Adjustment for differences in timing of puberty between race-ethnicity groups affects estimated prevalence of shortness and tallness. Differences in timing of puberty between race-ethnicity groups affects estimated prevalence of shortness and tallness of attained height that remains uncaptured with CA-Height. Methods: Pooled Tanner staging and anthropometric data for 12,316 children age 8-18 years from three US cross-sectional nationally representative surveys from 1966 through 1994; namely: The National Health Examination Surveys (NHES cycle III); the Hispanic Health and Nutrition Examination Surveys (HHANES 1982-1984) and finally, the 3rd National Health and Nutrition Examination Surveys (NHANES III 1988-1994) was analyzed. Tanner-stage height-for-age (TSA-Height) semi-parametric models were used to develop TSA-Height curves accounted for maturation stage and calendar age. Models had additive splines that enabled age smoothing in the estimation of specialized TSA-Height reference charts. Results: TSA-Height charts as generic race-ethnic neutral and stratified by gender were generated and plotted against the CDC CA-Height curves to account for the differences between these models. We provide clinical examples of the utility of these curves in children with variations in pubertal timing and during treatment for pubertal disorders. We also provide the race-ethnicity specific TSA-Height charts stratified by gender for non-Hispanic White and Black, and for Hispanic American. Conclusions: We have used an expanded set of cross-sectional growth and puberty survey data to model the impact of pubertal timing on attained height. These new specialized TSA-Height charts provide a much-needed tool for clinicians to assess and manage linear growth potential for US children over the course of pubertal progression and could have implications on public health assessment.