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J Anat. 2018 Feb;232(2):250-262. doi: 10.1111/joa.12748. Epub 2017 Nov 28.

Facial shape manifestations of growth faltering in Tanzanian children.

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Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Aurora, CO, USA.
Weill-Cornell Medicine-Qatar, Doha, Qatar.
Department of Anatomy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Department of Anthropology and Archaeology, University of Calgary, Calgary, AB, Canada.
ENyS. Estudios en Neurociencias y Sistemas Complejos, CONICET-HEC-UNAJ., Av. Calchaquí 5401. CP1882, Buenos Aires, Argentina.
National Institute for Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
Department of Animal Biology, School of Integrative Biology, University of Illinois, Urbana, IL, USA.
Mathematical and Statistical Sciences, University of Colorado, Denver, CO, USA.
Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Anatomy and Cell Biology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada.


Variation in the shape of the human face and in stature is determined by complex interactions between genetic and environmental influences. One such environmental influence is malnourishment, which can result in growth faltering, usually diagnosed by means of comparing an individual's stature with a set of age-appropriate standards. These standards for stature, however, are typically ascertained in groups where people are at low risk for growth faltering. Moreover, genetic differences among populations with respect to stature are well established, further complicating the generalizability of stature-based diagnostic tools. In a large sample of children aged 5-19 years, we obtained high-resolution genomic data, anthropometric measures and 3D facial images from individuals within and around the city of Mwanza, Tanzania. With genome-wide complex trait analysis, we partitioned genetic and environmental variance for growth outcomes and facial shape. We found that children with growth faltering have faces that look like those of older and taller children, in a direction opposite to the expected allometric trajectory, and in ways predicted by the environmental portion of covariance at the community and individual levels. The environmental variance for facial shape varied subtly but significantly among communities, whereas genetic differences were minimal. These results reveal that facial shape preserves information about exposure to undernourishment, with important implications for refining assessments of nutritional status in children and the developmental-genetics of craniofacial variation alike.


childhood growth; complex traits; craniofacial; facial imaging; growth faltering


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