Solving Short: Genes, HGH and Surgery to Change Height

Photo: Solving Short: Genes, HGH and Surgery to Change Height: Bone-Breaking Operation Lengthens Teens Skeleton

Being short certainly kills your chances for a basketball or modeling career, but social research suggests that shorter people also make less money, hold fewer leadership roles and are less sexually active than their taller peers.

For the most part, there is no escaping a short stature: Height is genetically predetermined, though scientists still don't fully understand how our genes control growth.

The most recent research, published Wednesday in the journal Nature, can still identify genes for only 10 percent of the variation in human height.

But for those born vertically challenged, would the world really be a rosier place if viewed from at least average height? Each year, many go under the knife, risking life and limb and tens of thousands of dollars, to find out.

For Kevin Kadakia, 23, now a third year medical student at the University of Miami, 5'2 was as tall as he was naturally going to get. His mother was short, so it didn't come as much of a surprise to him, but when given the opportunity to gain a full four inches through a leg lengthening orthopedic surgery, Kadakia decided to go for it.

"You don't get taken as seriously as someone of average height. It wasn't like I had low self-esteem, it was more of just trying to be normal as opposed to having a disadvantage," he says.

Days after graduating high school, the Oklahoma native flew to Baltimore to be operated on by Dr. Dror Paley, an expert in limb lengthening and reconstruction at St. Mary's Medical Center. The surgery broke the bones in Kadakia's upper and lower legs and implanted a system of bolts and braces that pulls the bones apart over a period of months, during which he couldn't walk and underwent extreme physical therapy.

"You don't realize what you're getting yourself into and the pain you're going to have to endure until you do it, especially as a teenager. But as I reflect back, I would do it again," Kadakia says.

Challenging Nature, Changing Heights

Surgical manipulation of the skeleton is the only way to boost height in adults, but endocrinologists have other ways of addressing height deficiencies in children, notes Dr. Joel Hirschhorn, a lead author on the recent Nature study and a paediatric endocrinologist at Children's Hospital of Boston.

"Most of the time when a child is growing slowly there's a familial tendency, but we don't understand much about what genes are involved," he says. The recent research, which drew on the genomes of more than 180,000 individuals, identified a hundred additional locations where changes in the genetic code could lead to differences in height.

"We're learning about human growth itself. From a better understanding of the biology to better therapy in individuals, that is at minimum a decade long process," he says.

At this point in time, children who are identified as having a growth problem are most often treated with medicines containing human growth hormone.

"It's the major hormone of growth in children," says Dr. Michael Yafi, an endocrinologist at University of Texas Medical School at Houston. "Parents usually have the idea that taller people in society have better chances in life, so they want their kids to be taller."

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