growth & puberty - kenyapaediatric.org · outline •growth •factors influencing growth...
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Outline
•Growth • Factors influencing growth • Determinants of growth in different stages
•Puberty: • Triggers of puberty • Tanner Staging
GROWTH
Growth:
• An increase in body size both weight and height over a period of time.
• A sensitive indicator of health and well-being.
Factors involved in Growth
4
Main Factors Involved in Phases of Normal Growth
Growth hormone
Thyroid hormone
Sex steroids
Growth hormone
Nutrition
Rapid
deceleration
Slow
deceleration
Rapid
acceleration
then
deceleration
Infancy Childhood Puberty Phase:
Pattern:
Major
factor(s):
Clark PA, et al. Endocrinol Metab Clin North Am. 1996;25:665. Karlberg J, et al. Acta Paediatr Scand. 987;76:478,337(suppl):12. Kuczmarski RJ, et al. Adv Data. 2000;314:1.
5
Female vs. Male Pubertal Growth Spurt
Girls Boys
Peak
11.5 yr
Peak
13.5 yr
• Female vs. male – starts, peaks, ends ~1.5 – 2 yr earlier
– peak velocity ~ 1–2 cm lower
Start
9.5 yr
End
14.5 yr
Start
11.0 yr
End
16.5 yr
PUBERTY
Developmental stage characterized by: • Maturation of gametogenesis • Secretion of gonadal hormones • Development of secondary sexual characteristics and
reproductive organs
Average age of Puberty Onset
Average Age of Puberty Onset: Girls 8.0 - 13.0 years Boys 9.0 - 14.0 years
What triggers puberty?
Source: http://flipper.diff.org/app/pathways/info/3997
Males Testicular Enlargement
Females Breast development
Tanner staging: Breast Development
Engebretsen L et al. Br J Sports Med 2010;44:476-484 Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
Tanner staging: Testicular Development
Engebretsen L et al. Br J Sports Med 2010;44:476-484 Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.
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