Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

Table 2

Advantages and disadvantages of Indian growth reference charts.

Advantages

Disadvantages

Growth reference monitoring data is helpful in diagnosing overweight, undernutrition, obesity as per existing growth pattern of the children; India growth charts are contemporary and are true presentation of current growth pattern; Cut-offs for body mass index (BMI) have been kept lowered by Indian charts (23 Kg/m^2 and 27 Kg/m^2) as suggested by the World Health Organization (25 Kg/m^2 and 30 Kg/m^2); —

All children grow at different pace; variations in growth occur among children due to difference in ethnicity, nutrition intake, and environment. Thus, there are chances that some children may remain undiagnosed; With time, the children growth pattern changes. Thus, the reference data needs to be updated regularly; The limitation of the Indian Academy of Pediatrics (IAP) revised growth chart for the age group 5–18 yr is that the study designs and measurement scales in the nine studies included are different. However, methodology of these studies was carefully assessed to reduce the risk of errors while performing data analysis; The growth reference for children under the age 5 adopted by the IAP was developed based on the data collected between years 1989–1991. As the reference data needs to be updated regularly, the use of these growth references is not recommended now

V. Khadilkar et al. [31–33].