1. Andrada Otvos-Moldovan, Iulia Armean, Elena Tanase, Vlad Frandes University of Medicine and Pharmacy, Targu-Mures Scientific coordinators: Pascanu Ionela, Pop Raluca

2.  Growth charts based on data collected in different populations and time periods are key tools to assess children’s linear growth.  The recommended standard for our country is the Swiss one, developed in 1989, but it may be outdated because of the secular trend in height 2

3.  National growth charts are unavailable in numerous countries, including Romania.  Impaired growth is a major global public health issue, and its correct diagnosis is crucial to prompt timely intervention. 3

4.  1. Primary growth abnormalities: A. Osteochondrodysplasias B. Chromosomal abnormalities C. Intrauterine growth retardation 4

5.  2. Secondary growth disorders: A. Malnutrition B. Chronic disease C. Endocrine disorders such as: a. Hypothyroidism b. Cushing sindrome c. Pseudohypoparathyroidism d. Rickets e. IGF deficiency 5

6.  3. Idiopathic short stature:  Familial  Non-familial 6

7.  to evaluate the different standards used for height measurement of children in Romania 7

8.  cross-sectional study  target population - children 6-14 years of age  randomized sample - 1168 children from 8 schools in Mures County  evaluated from November 2013- January 2014 8

9.  variables: age, sex, height,environment, height standard deviations using WHO and Swiss standards  height was measured with a stadiometer 9

10.  Statistical analysis: GrowthAnalyzer, AnthroPlus, M.O. Excel and GraphPadInStat3.06  each legal representative signed an informed consent to participate  The study was approved by the Ethics Committee UMF Targu Mures 10

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14.  To determine whether the longitudinal growth pattern of a child is normal, height should be compared to an appropriate reference population. [2]  The variation in linear growth charts appeared to be related both to the era of data collection and to true population differences.  Population differences could be related to environmental, socio-economical, genetic factors or differences in the extent of the secular trend. [2] 14

15.  There is an important difference in the incidence of short stature depending on the standards used.  The choice of reference charts substantially affects the clinical decision whether a child is considered short-for-age.  The low rate of agreement between the standards might show a source of error when defining short stature according to a certain standard and underlines the need for national references. 15

16. [1] Mary M. Lee, M.D., Idiopathic Short Stature, N Engl J Med 2006;354:2576-82. [2] Marjolein Bonthuis, Karlijn J. van Stralen, Enrico Verrina, Alberto Edefonti, Elena A. Molchanova, Anita C. S. Hokken-Koelega, Franz Schaefer, Kitty J. Jager, Use of National and International Growth Charts for Studying Height in European Children: Development of Up-To- Date European Height-For-Age Charts, www.plosone.org August 2012 ; 7:1-11 [3] David B. Allen, M.D., and Leona Cuttler, M.D., Short Stature in Childhood — Challenges and Choices, N Engl J Med 2013;368:1220-8. [4] Otilia Marginean, Ioan Simedrea, Dana Bucuras, Ecaterina Pavel, Adrian Craciun, Ioana Maris, Camelia Daescu, The etiologic profile of short stature in the south west of Romania between 2004-2009, www.endocrin abstracts.org 2010 [5] www.who.int/growthref/who2007_height_for_age/en/ 16

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