A CLINICAL ACCOUNT OF SHORT STATURE IN PAKISTANI CHILDREN AND ADOLESCENTS PRESENTED AT AN ENDOCRINE CENTER IN KARACHI.

Background: Short stature in children is a multifactorial condition influenced by genetic, hormonal, nutritional, and environmental factors. Differentiating between normal growth variants and pathological causes is essential for timely intervention. In resource-limited settings, such as Pakistan, understanding local patterns of short stature helps guide cost-effective diagnostic strategies and avoid unnecessary therapies. This study investigates the causes and contributing factors of short stature among pediatric patients evaluated at a tertiary endocrine care center in Karachi. Objective: To evaluate various etiologies of short stature in children and adolescents presenting at a tertiary care endocrine center. Methods: A retrospective cohort study was conducted at the Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi. Medical records from the past five years were reviewed. Children aged 2 to 20 years with complaints of short stature were included. Data collected included age, gender, weight, height, BMI, mid-parental height, birth and feeding history, developmental milestones, and history of chronic illness. Investigations included IGF-1 levels, bone age assessment, thyroid function, vitamin D levels, and anti-tissue transglutaminase antibodies. Data were recorded using a standardized proforma and analyzed using SPSS version 26. Results: Among 120 participants (56 males, 64 females), the mean age was 13.23 ± 3.18 years. Mean weight was 38.2 ± 13.85 kg, height 136.38 ± 16.19 cm, and BMI 20.12 ± 4.63 kg/m². Mid-parental height averaged 160.2 ± 8.46 cm. IGF-1 levels were 279.38 ± 69.81 ng/mL and bone age was significantly lower in males than females (12.39 ± 3.25 vs. 13.58 ± 3.20 years, p = 0.047). Normal growth variation was identified in 33.3% of cases, followed by constitutional growth delay (22.5%) and idiopathic short stature (18.3%). Significant positive correlations with height SD were found for IGF-1 (p = 0.045), hemoglobin (p = 0.007), and birth weight (p = 0.002). Conclusion: Normal growth variation was the most prevalent cause of short stature, followed by constitutional growth delay and idiopathic short stature. These findings highlight the importance of differentiating physiological growth patterns from pathological conditions to avoid overtreatment.