Short stature

Short stature refers to a height of a human being which is below expected. Shortness is a vague term without a precise definition and with significant relativity to context. Because of the lack of preciseness, there is often disagreement about the degree of shortness that should be called short.

The American Association of Clinical Endocrinologists defines "short stature" as height more than 2 standard deviations below the mean for age and gender, which corresponds to the shortest 2.3% of individuals.

Causes
Shortness in children and young adults nearly always results from below-average growth in childhood, while shortness in older adults usually results from loss of height due to kyphosis of the spine or collapsed vertebrae from osteoporosis.

From a medical perspective, severe shortness can be a variation of normal, resulting from the interplay of multiple familial genes. It can also be due to one or more of many abnormal conditions, such as chronic (prolonged) hormone deficiency, malnutrition, disease of a major organ system, mistreatment, treatment with certain drugs, chromosomal deletions, inherited diseases, birth defect syndromes, bone structures fusing earlier than intended or many other causes.

HGH deficiency may occur at any time during infancy or childhood, with the most obvious sign being a noticeable slowing of growth. The deficiency may be genetic.

Increasing final height in children with short stature may be beneficial and could enhance HRQoL outcomes barring troublesome side effects and excessive cost of treatments.

Cultural issues
From a social perspective shortness can be a problem independently of the cause. In many societies there are advantages associated with taller stature and disadvantages associated with shorter stature, and vice versa.

Pharmaceutical companies Genentech and Eli Lilly, makers of human growth hormone, have worked to medicalize short stature by convincing the public that short stature is a disease rather than a natural variation in human height. Limiting sales of the hormone to children diagnosed with growth hormone deficiency, rather than being short for any reason, limited their sales market. Expanding it to all children whose height was below the third percentile would create 90,000 new customers and US $10 billion in revenue. In the early 1990s, they paid two US charities, the Human Growth Foundation and the MAGIC Foundation, to measure the height of thousands of children in schools and public places, and to send letters urging medical consultations for children whose height was deemed low. Parents and schools were not told that the charities were being paid by the drug companies to do this.

Paired with a campaign to advertise the hormone to physicians, the campaign was successful, and tens of thousands of children began receiving HGH. About half of them do not have growth hormone deficiency, and consequently benefited very little, if at all, from the hormone injections. Criticism of the universal screening program eventually resulted in its end.