Pubertal growth and adult height? Accelerated height growth (height spurt) along with the development of secondary sex characteristics is an important feature of pubertal growth. The process of height gain generally occurs six months to one year after the start of breast development in girls and around the time of voice change in boys, and the process lasts about one year. The average annual growth rate for girls is 8 to 9 cm, and for boys it is 1 to 2 cm more than for girls. After this period, growth decelerates and returns to pre-pubertal speed, i.e., about 4 to 5 cm per year, and then 1 year later decreases sharply to only 1 to 2 cm per year, until the epiphysis is completely closed and stops growing, i.e., reaching the annual height. Deceleration time, girls before and after menarche, boys after the change of voice. Adolescent growth has an important impact on adult height, the main factors are: ① the beginning of youth development (refers to the girl’s breast development, the boy’s scrotum becomes loose, testicular enlargement) height: at this time, short people, regardless of the beginning of late development, early later are shorter. ② the speed of sudden increase in height this speed has individual differences, there can be a difference of 6.4 to 11 cm range. Some children have almost no growth acceleration, and such cases usually have a pathological basis, such as underlying chronic wasting diseases, malnutrition or even endocrine abnormalities, and should be promptly checked for causes to avoid losing the height that should be increased. ③The duration of the growth spurt is slowed down in some children in only half a year, while in others it can last as long as 2 years. ④The years from the beginning of development to the complete fusion of the epiphysis bone growth is the basis for the body to grow taller, bone has a growth zone called epiphysis; bone cells in this zone proliferate actively during childhood to make the bone grow longer. Bone growth is accompanied by the maturation process during development. When the sex hormones secreted by the gonads (ovaries or testes) reach a certain high concentration in late adolescence, bone growth slows down and maturation accelerates until the epiphysis fuses with the backbone, i.e., the bone growth zone closes and growth stops, and no growth-promoting substance can make the bone grow again at this point, which is why adults cannot grow taller. What is the balance between growth and maturation during puberty? The balance between growth and maturation during adolescence is harmonious and allows the child to eventually develop into an adult with adult body and fertility. It is not difficult to understand why the balance between the two is tilted towards the growth end of the spectrum, i.e. growth is faster than maturity, if it is for the benefit of height, so that adult height can increase. As the speed of maturation is related to the number of years of sustainable growth, the slow progress of the epiphysis closing late, its adult height will be higher than the fast progress, combined with the aforementioned growth law is also a matter of course. Unfortunately, early adolescents often have a tendency to close their epiphyses prematurely, resulting in a short adult stature due to the “momentum” of maturation. Conversely, there are cases where youthful development is late or slow, but their growth rate is not as fast as desired, and their adult height is often not satisfactory. What is the role of bone age in determining adult height? Bone age is an important and quantifiable indicator of the maturity of human development. Bone age reflects the percentage of body growth completed at a certain bone age until the final height of the body, so it can be used to predict the adult height of children and adolescents. The height and bone age measured at the same time (judged by X-ray) can be calculated to estimate adult height, but it is unreliable for younger ages because of the many factors affecting it, but it is more reliable up to puberty. Therefore, if we ask how much can be grown after menstruation, it will be determined by the bone age at this time. In addition, we can use the parents’ height to calculate the child’s genetic height and combine it with the bone age to estimate the child’s growth potential. Precocious puberty treatment and adult height? Precocious puberty refers to the onset of paraphilia before the age of 8 for girls and 9 for boys, with the main consequence being short stature in adulthood. In general, the development starts before the age of 6 years or is close to 8 years, but the momentum of maturation is too strong and the adult height is easily impaired. Precocious puberty does not always require treatment, but when the goal is to improve adult height, the following cases require treatment: ① bone age is 2 years or more above age; ② bone age exceeds height age; ③ endocrine hormone tests have high sex hormone levels; ④ short before development and no significant height gain during development. Specialists need to treat each child differently, and those with excessive maturation are the focus of timely treatment. At present, it is common to use drugs that inhibit gonadotropin secretion in order to suppress gonadal suspension and reduce the production of sex hormones to the pre-growth level, thus slowing down and relieving the harm of accelerated bone age, thus prolonging the growth time and improving adult height. When the drug is discontinued, the gonadal inhibition is lifted, the gonads resume development, and the child completes his or her puberty in due time.