Conduite à tenir devant un enfant de grande taille

The diagnostic approach to tall stature in children is based on collecting birth data (macrosomia), sizes and family puberty, a family history of constitutional or pathological tall stature, search for a delay of development, dysmorphia, disproportion, analysis of the growth velocity (normal or accelerated), general and pubertal assessment, and bone age. When there is psychomotor retardation, a family history of pathological tall stature, or a disproportion in the clinical examination, the genetic causes of tall stature will be mentioned. The most frequent causes are Marfan syndrome and similar, Sotos syndrome, Beckwith–Wiedemann syndrome, Klinefelter syndrome, and MEN2B. These different genetic syndromes with tall stature justify a consultation with the geneticist. When the speed of growth is accelerated, first of all, it evokes puberty and early pseudopuberty, obesity and acromegaly. Finally, when the speed of growth is regular, and the parents are of tall stature, it evokes constitutional tall stature: this is the most frequent diagnosis to retain after having rejected pathological tall statures.     

Body height estimation based on tibia length in different stature groups

Long bone length is one of the best-known indicators of human stature. Although the long bone length/height ratio differs in tall and short individuals, no detailed study has investigated whether specific formulae should be used to calculate height in different stature groups. This study proposes a new height estimation method. Body height and tibia length were measured in 121 male subjects aged 18.0-34.3 years. Three subgroups were established according to body height (short, medium, or tall), using the 15th and 85th percentiles as cutoff levels. The general formula and a group-specific regression formula were used to estimate height in each subgroup. A control group with the same properties as the study group was analyzed in the same manner. Particularly with "short" and "tall" subjects, the difference between true height and the height predicted by the group-specific formulae was smaller than the difference observed when the general formula was used. These discrepancies were statistically significant. When estimating height based on tibia length, the individual's general stature category should be taken into consideration, and group-specific formulae should be used for short and tall subjects.     

Differential contribution of stature phenotypes to assortative mating in parents of Philadelphia Black and White school children

Assortative mating for stature, weight, and the ponderal and Quetelet's indices is considered in a large sample of Philadelphia Blacks and Whites. The husband-wife correlation for stature is positive and significant in Whites (r = 0.34, d.f. = 382), but negligible in Blacks (r = 0.06, d.f. = 420). Correlations for weight and the body indices are positive and significant in both samples, those for body indices showing some dependency on the husband-wife correlations for stature and weight. When couples are grouped into statural mating combinations on the basis of short (S), medium (M) and tall (T), White spouses' statures show an approximately linear relationship to one another. The distribution of Black spouses' statures, however, is not completely independent, even though the husband-wife correlation is close to zero. There are elements of both positive and negative assortative mating among Blacks, resulting in an excess of certain mating types over that expected on the basis of chance. These mating types are usually those in which the husband is shorter than the wife, except at the heterogeneous extremes of the bivariate array.     

Proportionality of the long bones and their relation to stature among Mesoamericans

A total of 235 (176 ♂ and 59 ♀) cadavers were measured. Of these blood samples of 132 (103 ♂ and 29 ♀) are drawn. Only those cadavers of which the long bones could be measured afterwards were used in the investigation, and of these only those whose blood was of group O and Rh +. A sample of 98 (69 ♂ and 29 ♀) was thus arrived at and divided morphoscopically into seven categories going from “pure” Indian to “pure” white. With electronic computers, means and standard deviations were calculated for all six unpaired long bones and for stature, as well as the coefficient of multiple correlation among the seven variables, for both males and females. As categories leading from “pure” white towards the other extreme were withdrawn, the sample size was reduced but the coefficient of multiple correlation increased from 0.71 to 0.90 in males, and from 0.74 to 0.94 in females, indicating that a more homogeneous population was being dealt with. Mean stature for this population was 161.50 cm and 149.80 cm for males and females, after 2.5 cm are deducted from cadaveral measurements. As the sample is morphoscopically and serologically as close as one could get to pre-hispanic conditions and as the statures arrived at are representative of what is known, tables were drawn giving the corresponding values of statures of males and females going from 180 cm to 130 cm at steps of 0.5 cm. It is submitted that until a larger sample is obtained, the newly drawn tables and formulae are more appropriate to calculate stature from long bones of American pre-hispanic populations than any other hitherto used.     

Ancient-to-modern secular changes in Korean stature

Statural growth in human populations is a sensitive indicator of socio-economic well-being, and improvements in socio-economic status are reflected in secular increases in adult height. In the present study, we investigated the statures of historical Korean societies to show how stature changed over time. Applying Fujii's equation, derived from modern Japanese, to the measurement of femora removed from 15th- to 19th-century Joseon tombs, the average heights of Korean adults during the Joseon dynasty were estimated to be 161.1 ± 5.6 cm and 148.9 ± 4.6 cm for males and females, respectively. Plotting statures for successive historical societies against time revealed that Korean heights remained relatively unchanged through to the end of the 19th century, a pattern that differs from that seen in many Western countries in which stature transiently decreases after the Middle Ages. In contrast, a sharp increase in Korean stature was observed at the beginning of the 20th century, similar to trends seen in other nations (although exact timing varies in different countries). There were no accompanying changes of stature sexual dimorphism. The data reported in this study reflect the unique historical experience of Korea; the relative isolation of Joseon society, the late onset of modernization (at the end of the 19th century), and the later occurrence of industrialization (during the 1960s).     

Genetic analysis of tall stature

Tall stature is less often experienced as an important problem than short stature. However, a correct diagnosis may be of eminent importance, especially when interventions are planned, or to know the natural history. Overgrowth can be caused by endocrine disorders and skeletal dysplasias, but also by several genetic syndromes. Despite a systematic diagnostic approach, there will be patients with tall stature who do not fit a known diagnosis. In this group of patients possibilities of genetic analysis do exist, but are not common practice. The FMR1 gene should be analyzed in patients with tall stature and mental retardation, and in these patients the NSD1 gene can be considered whenever some features of Sotos syndrome do exist. In tall patients without mental retardation and some features of Sotos or Beckwith-Wiedemann syndrome it may still be useful to look for mutations in the NSD1 gene, but also for changes in the 11p15 region. The various possibilities are discussed and placed in a flowchart.     

Secular trend for stature in adult male Yucatec Maya to 1968

Statures for 64 adult male Yucatec Maya (18+ years old, sons of campesinos) were measured in 1968 and compared with mean statures presented in results for previous studies. There were no significant changes in mean stature since 1895. If the sample is divided into 5-year age groups, no secular trend is evident. Using osteological information from as early as the Late Preclassic, stature of adult Maya males has decreased 119 mm in a little more than 20 centuries (?0.06 cm/decade). Comparing the results with measurements from other Mesoamerican groups, only one – the Otomí – show evidence of significant secular change. It is possible that modern economic development schemes in Mesoamerica are too recent or ineffective to have had an effect on stature.     

Menstruation and marital sex

This paper explores differences in sexual behavior between menstrual and nonmenstrual days, using daily report data from 85 husbands and wives for about 100 days each. Most of the men were in graduate school and the wives had a mean education of 16 years. All couples practiced contraception, but not a hormonal or rhythm method. Husband's desire for intercourse was reduced by 6%, the wife's by 19%. A sexual frustration index is arrived at by taking the % of nonintercourse days on which the respondents nevertheless reported wanting intercourse. Husbands showed a frustration index of 22% on nonmenstrual days and 36% on menstrual days. Wives demonstrated a 15% sexual frustration level when not menstruating, 19% during menstruation. The frustration reduction index (arrived at by counting the number of "want intercourse days" on which orgasm occurred without intercourse), was 17% in husbands on menstrual days, 10% on nonmenstrual days; for wives the index was 7% on menstrual days, 6% on nonmenstrual days. The authors conclude that in the highly educated group studied, intercourse and orgasm are reduced during menstruation, in association with impressively less female desire for intercourse during menstruation. The women respond to a resultant potential increase in male sexual frustration by providing the husbands an increase in noncoital orgasm on menstrual days. However, the wives do not experience an increased intercourse frustration level during menstruation and their heterosexual noncoital orgasm rate is relatively stable throughout the cycle. The different patterns of desire levels for husbands and wives may have a biological base, and the different behavior observed represent a sociological compromise.     

Methods for estimating missing human skeletal element osteometric dimensions employed in the revised fully technique for estimating stature

One of the greatest limitations to the application of the revised Fully anatomical stature estimation method is the inability to measure some of the skeletal elements required in its calculation. These element dimensions cannot be obtained due to taphonomic factors, incomplete excavation, or disease processes, and result in missing data. This study examines methods of imputing these missing dimensions using observable Fully measurements from the skeleton and the accuracy of incorporating these missing element estimations into anatomical stature reconstruction. These are further assessed against stature estimations obtained from mathematical regression formulae for the lower limb bones (femur and tibia). Two thousand seven hundred and seventeen North and South American indigenous skeletons were measured, and subsets of these with observable Fully dimensions were used to simulate missing elements and create estimation methods and equations. Comparisons were made directly between anatomically reconstructed statures and mathematically derived statures, as well as with anatomically derived statures with imputed missing dimensions. These analyses demonstrate that, while mathematical stature estimations are more accurate, anatomical statures incorporating missing dimensions are not appreciably less accurate and are more precise. The anatomical stature estimation method using imputed missing dimensions is supported. Missing element estimation, however, is limited to the vertebral column (only when lumbar vertebrae are present) and to talocalcaneal height (only when femora and tibiae are present). Crania, entire vertebral columns, and femoral or tibial lengths cannot be reliably estimated. Further discussion of the applicability of these methods is discussed.     

Trends in stature in the South Australian Aboriginal Murraylands

Millennial and secular changes in body height of prehistoric and recent Aboriginal South Australians are investigated. Skeletal remains of 55 male and 40 female individuals who were excavated at Roonka on the River Murray were dated from 9800 to 100 years BP. Stature was reconstructed by using humerus, femur, and tibia ratios to stature derived from Abbie's (1975) data on living Aborigines and the Trotter-Gleser method for blacks. The respective averages were 1,652 mm and 1,665 mm for males and 1,527 mm and 1,549 mm for females. In 1996/1997, statures of 27 adult males and 21 adult females were measured in Aboriginal centers of Gerard and Raukkan (Point McLeay) on the Lower River Murray. These people, as far as it can be ascertained, are the descendants of the people from Roonka. Their statures were adjusted for the stature loss with age, so that the data represent young individuals (≤30 years of age). The average male stature was 1,712 mm, and the average female stature was 1,567 mm. Data collected by Wood Jones and Campbell in 1924 for Aboriginal South Australians show that young adult male stature was 1,668 mm (n = 6), and female stature was 1,552 mm (n = 4). Slopes of regressions of individual statures on radiocarbon dates and on dates of birth are not significantly different from zero. The same is true for regressions of individual long bone lengths on radiocarbon dates. It can be concluded that there was little change in stature of Aboriginal South Australians from prehistoric to recent times. Regressions of individual age-corrected heights on birth dates (1860–1980) of Aboriginal men and women measured in 1924 and in 1996 further indicate no significant increase in height in either sex. Am J Phys Anthropol 106:505–514, 1998. © 1998 Wiley-Liss, Inc.     

Femoral lengths and stature in Plio-Pleistocene hominids

This study reports the femoral lengths of 31 Plio-Pleistocene hominids dated between 3.1 and 0.7 million years ago, and uses those lengths to estimate stature by way of the femur-stature ratio reported by Feldesman et al. (Am. J. Phys. Anthropol. 78:219-220, 1989). By this method the average female Australopithecus afarensis is 105 cm and the average male is 151 cm. The respective values are 115 and 138 cm for A. africanus. As defined by Howell (In VJ Maglio and HBS Cooke (eds): The Evolution of African Mammals. Cambridge: Harvard University Press, 1978) and Johanson et al. (Kirtlandia 28:1-14, 1978), Homo habilis is a sexually dimorphic species, with females standing 118 cm and males 157 cm. Such apparently strong dimorphism may be due to the possibility that there are actually two species of nonrobust hominids between 2 and 1.7 m.y.a. The estimate for the female Australopithecus boisei is 124 cm and for the male, 137 cm, but these estimates are especially difficult to be certain of because there are no femora that can be positively identified as male A. boisei. Australopithecus robustus is estimated to be 110 cm (female) and 132 cm (male). African Homo erectus stood 160 cm (female) and 180 cm (male). From these estimates several generalizations are apparent. First, there is apparently strong sexual dimorphism in stature in A. afarensis and H. habilis, but less in the other species. Second, the "robust" australopithecines were relatively small statured. Third, it is apparently not true that humans have been getting progressively taller throughout their evolutionary history. Some individuals were as tall as modern humans 3 m.y.a., by 2 m.y.a. one individual stood about 173 cm, and by 1.7 m.y.a. a stature of 180+ cm was not uncommon.     

Major correlates of male height: A study of 105 countries

The purpose of this study is to explore the main correlates of male height in 105 countries in Europe & overseas, Asia, North Africa and Oceania. Actual data on male height are compared with the average consumption of 28 protein sources (FAOSTAT, 1993–2009) and seven socioeconomic indicators (according to the World Bank, the CIA World Factbook and the United Nations). This comparison identified three fundamental types of diets based on rice, wheat and milk, respectively. The consumption of rice dominates in tropical Asia, where it is accompanied by very low total protein and energy intake, and one of the shortest statures in the world (∼162–168 cm). Wheat prevails in Muslim countries in North Africa and the Near East, which is where we also observe the highest plant protein consumption in the world and moderately tall statures that do not exceed 174 cm. In taller nations, the intake of protein and energy no longer fundamentally rises, but the consumption of plant proteins markedly decreases at the expense of animal proteins, especially those from dairy. Their highest consumption rates can be found in Northern and Central Europe, with the global peak of male height in the Netherlands (184 cm). In general, when only the complete data from 72 countries were considered, the consumption of protein from the five most correlated foods (r = 0.85) and the human development index (r = 0.84) are most strongly associated with tall statures. A notable finding is the low consumption of the most correlated proteins in Muslim oil superpowers and highly developed countries of East Asia, which could explain their lagging behind Europe in terms of physical stature.     

现代中国人身高的变异

本文依据16个省汉族和23个少数民族身高平均值,运用方差分析法分析和讨论了当代中国人身高的地理变化,男女两性身高的群体变化趋势。     

Polygyny, reproductive success and child health in rural Ethiopia: why marry a married man?

This study examines the reproductive success of men and women in rural Ethiopia as a function of their marital status, specifically by comparing polygamously and monogamously married individuals. In line with predictions from evolutionary theory, polygamy is beneficial to male reproductive success (i.e. producing larger numbers of surviving offspring). The success of polygamously married females depends on wife rank: the first wives of polygamous husbands do better than monogamously married women and much better than second or third wives. These effects are mirrored in child nutritional status: the children of second and third wives have lower weight for height. Due to potential, largely unmeasurable differences in marriageability (quality) between individuals, it was not possible to support a model of either resource-holding polygyny combined with female choice or female coercion into unwanted marriages. First wives of polygamously married men marry at a younger age and attract a higher brideprice, suggesting that both the males and females in the marriage are likely to be of higher quality (due to wealth, family status or some other factor such as beauty). Unions that end up monogamous are likely to be between slightly lower quality individuals; and second and third wives, who marry at the oldest ages and attract the lowest brideprice, may be 'making the best of a bad job'. The relatively long gap between first and second marriages may mean that first wives of highly marriageable males can enjoy considerable reproductive success before their husbands marry again.     

Intelligence and educational level in adult males at the extremes of stature

Stature and intellectual ability are commonly found to correlate positively (r approximately 0.2). In this study we have assessed whether this relationship holds true at the extremes of stature in adults. From a representative study population of 76,111 young Danish men, we defined an extremely short group as those below the 2d percentile (less than or equal to 163 cm) and an extremely tall group as those above the 98th percentile (greater than or equal to 191 cm). The short group had intelligence test scores and educational levels lying at approximately two-thirds of a standard deviation below the overall means. The tall group had means lying approximately one-half standard deviation above the overall means. These deviations are to a large degree in agreement with the observed overall correlations of height with intelligence test scores (r = 0.244) and with educational level (r = 0.264). Both groups, however, appear to score somewhat below the levels expected from a purely linear relationship. For the short group there appear to be local factors that are particularly detrimental to intellectual ability. For the tall group corresponding local factors are relatively independent of intellectual ability.     

乙肝病毒家庭内传播情况调查

乙型肝炎病毒感染是全球性的健康问题,其传播途径各个国家及地区存在差异.通过对543位慢性HBV感染者的调查分析,家庭中女性慢性HBV感染者其子女在无任何免疫预防干预下感染后慢性化的几率76.0%;男性慢性HBV感染者其子女感染HBV后慢性化的几率达22.5%;夫妻之间HBV感染的结局是以形成保护性抗体为主,调查的543对夫妻中,夫妻双方均为HBsAg阳性的有50对,达9.2%;HBV在夫妻之间的传播的特点是丈夫感染HBV后更容易慢性化:妻子为慢性HBV感染者,其丈夫被感染后慢性化的几率为13.8%(27/196);而丈夫为慢性HBV感染者的家庭中,其妻子被感染后慢性化的几率为7.1%(23/322),差异具有统计学意义(χ2=6.146,P=0.013);除母婴传播外,乙肝病毒在夫妻、父亲和子女、孩子之间以及其他家庭接触性传播也很重要.     

Why household inefficiency? An experimental approach to assess spousal resource distribution preferences in a subsistence population undergoing socioeconomic change

Two disparate views of the sexual division of labour have dominated the representation of intra-household resource allocations. These joint and separate interests views differ in their interpretation of the relative roles of men and women, and make different predictions about the extent to which marriage promotes economic efficiency (i.e. maximized household production). Using an experimental “distribution task” stipulating a trade-off between household efficiency and spousal equality in allocating surpluses of meat and money, we examine factors influencing spousal distribution preferences among Tsimane forager-horticulturalists of Bolivia (n = 53 couples). Our primary goal is to understand whether and how access to perfectly fungible and liquid resources – which increases with greater participation in market economies – shifts intra-household distribution preferences. We hypothesize that greater fungibility of money compared to meat results in greater squandering of money for individual fitness gain at a cost to the family. Money therefore requires costly strategies to insure against a partner's claims for consumption. Whereas nearly all Tsimane spouses prefer efficient meat distributions, we find a substantially reduced efficiency preference for money compared to meat controlling for potential confounders (adjusted OR = 0.087, 95% CI: 0.02–0.38). Reported marital conflict over paternal disinvestment is associated with a nearly 13-fold increase in odds of revealing a selfish money distribution preference. Selfish husbands are significantly more likely than other husbands to be paired with selfish wives. Lastly, Tsimane husbands and wives are more likely than Western Europeans to prefer an efficient money distribution, but Tsimane wives are more likely than Western European wives to exhibit a selfish preference. In sum, preferences for the distribution of household production surplus support joint and separate interests views of marriage; a hybrid approach best explains how ecological-, family-, and individual-level factors influence spousal preferences through their effects on perceptions of marginal gains within and outside the household.     

Application of Body Mass Index According to Height-Age in Short and Tall Children

Background

In children with either delayed or accelerated growth, expressing the body mass index (BMI) to chronological age might lead to invalid body composition estimates. Reference to height-age has been suggested for such populations; however its validity has not been demonstrated.

Methods

Anthropometric data of healthy children were obtained from the German KiGGS survey. We selected three samples with different height distributions representing short stature (mean height SDS: -1.6), normal stature (height SDS: 0), and tall stature (height SDS: +1.6), and compared BMI-for-age and BMI-for-height-age between these samples across the paediatric age range. Differences between samples were tested using Kruskal-Wallis one-way analysis of variance and permutation tests.

Results

At a given age, BMI was distributed towards lower values in short, and towards higher values in tall subjects as compared to a population with average height distribution. Expressing BMI to height-age eliminated these differences in boys with a short stature from 4 years to 14 years of age, in tall boys from 4 to 16 years, in short girls aged 2-10 years or tall girls aged 2-17 years.

Conclusion

From late infancy to adolescent age, BMI distribution co-varies with height distribution and referencing to height-age appears appropriate within this age period. However, caution is needed when data about pubertal status are absent.