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      Total Pubertal Growth and Markers of Puberty Onset in Adolescents with GHD: Comparison between Mathematical Growth Analysis and Pubertal Staging Methods

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          Two methods of determining puberty onset (Preece- Baines model 1 (PB1) and Tanner staging) were used to calculate total pubertal growth (TPG) in adolescents with growth hormone deficiency (GHD). Patients and Methods: 34 patients (11 girls) met the following inclusion criteria: isolated GHD, >2 years growth hormone therapy prior to puberty onset, regular weight-adjusted GH dosage, known final height (age >21 years or height velocity <0.5 cm/year), no induction of puberty. PB1 was used to define age and height at onset of the pubertal growth spurt (‘take-off’). Results: The results (mean ± SD) were as follows: in girls, mean age at take-off was 9.8 years; 2.0 ± 1.1 years before breast stage B2. In boys, mean age at take-off was 11.3 years; 1.4 ± 0.8 years before testes volume >3 ml. Height at take-off was lower than at Tanner stage 2 by 12.4 ± 7.6 cm in girls and 7.7 ± 5.3 cm in boys. TPG was thus markedly greater (p < 0.001) using the PB1 method, as compared with Tanner stage2. Peak height velocity was normal. Final height was –0.5 ± 0.7 SDS in females and –0.4 ± 0.9 SDS in males. Conclusions: The method of measuring TPG from take-off is more objective, and has potentially greater implications for GH therapeutics than the Tanner stage method. In our study, 40% of TPG occurred before ‘breast stage B2’ was attained in GHD girls; whereas 23% of TPG occurred before ‘testes >3 ml’ in GHD boys.

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          Most cited references 18

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          Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II.

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            On the modelling of human growth.

             J Karlberg (1987)
            A new approach to modelling human linear growth from birth to maturity is presented. The model splits growth into three additive and partly superimposed components, appropriately named infancy, childhood and puberty; we refer to it as the ICP-model for obvious reasons. A key feature of this model, compared with others, is that the components correspond with known features of the endocrinological regulation of growth and can be considered in isolation from one another.
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              A Biologically-Oriented Mathematical Model (ICP) for Human Growth

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                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                April 2005
                06 April 2005
                : 63
                : 2
                : 95-101
                aUniversity Children’s Hospital, Tübingen, Germany and bLaboratorium Antropogenetica, Vrije Universiteit Brussel (VUB), Brussels, Belgium
                84156 Horm Res 2005;63:95–101
                © 2005 S. Karger AG, Basel

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                Figures: 1, Tables: 3, References: 32, Pages: 7
                Original Paper


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