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      Evaluation of near final height in boys with constitutional delay in growth and puberty

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          Abstract

          Background

          This study was conducted to find out whether boys with constitutional delay in growth and puberty (CDGP) could attain their target height and predicted adult height (PAH) in adulthood or not.

          Methods

          After measuring the height, weight, pubertal stage, parental height and bone age data of the patients at their first presentation were extracted from the files and their height and weight were measured at the end of the study, wrist X-Ray was performed in order to determine the bone age. PAH was calculated using Bayley–Pinneau method and target height was estimated by mid parental height. Final or near final heights of the patients were measured and compared with the target height and PAH.

          Results

          The mean age at presentation and the end of study was 15.2 ± 0.95, 20 ± 0.75 years respectively. Mean of bone age at the beginning of study was 12.97 ± 1 years and at the end of study were 17.6 ± 0.58 years. Mean of delayed bone age was 2.2 ± 0.82 years. Mean of the primary measured heights was 150.16 ± 7 cm (138–160 cm). Mean of final or near final heights was 165.7 ± 2.89 cm (161–170.5 cm). Final or near final heights in our subjects were smaller than either their PAH (165.7 ± 2.89 vs 170.7 ± 5.17) ( P value <0.005) or target height (165.7 ± 2.89 vs 171.8 ± 4.65) ( P value <0.0001).

          Conclusion

          Most patients with CDGP do not reach their target height or predicted adult height; they are usually shorter than their parents and general population. Such patients need to be followed up until they reach their final height and, in some cases, adjunctive medical treatment might be indicated.

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          Most cited references14

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          Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards.

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            Standards for children's height at ages 2-9 years allowing for heights of parents.

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              Treatment with the aromatase inhibitor letrozole during adolescence increases near-final height in boys with constitutional delay of puberty.

              We investigated whether inhibition of oestrogen biosynthesis with the aromatase inhibitor, letrozole, during adolescence improves near-final height in boys with constitutional delay of puberty. Seventeen boys with constitutional delay of puberty were randomized to receive testosterone (T) enanthate (1 mg/kg i.m.) every 4 weeks for 6 months in combination with placebo (Pl, n = 8), or the aromatase inhibitor letrozole (Lz, 2.5 mg/day orally) (n = 9), for 12 months. After treatment, patients were followed up until near-final height. Height discrepancy was calculated as near-final height minus mid-parental target height. The primary end point was the difference in near-final height between the groups treated either with T + Pl or T + Lz. Secondarily, height discrepancy and gain in height standard deviation score (SDS) were analysed in both groups. Boys treated with T + Lz reached a higher mean near-final height than did boys on T + Pl (175.8 vs. 169.1 cm, respectively, P = 0.04). In T + Lz-treated boys, mean near-final height did not differ from their mid-parental target height (175.8 vs. 177.1 cm, P = 0.38), whereas in T + Pl-treated boys, mean near-final height was lower than mid-parental target height (169.1 vs. 173.9 cm, P = 0.007). T + Lz-treated boys had a greater increment in height SDS over the pretreatment height SDS than T + Pl-treated boys (+1.4 SDS vs.+0.8 SDS, P = 0.03). Our findings indicate that in adolescent boys an increase in adult height can be attained by use of aromatase inhibitors.
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                Author and article information

                Journal
                Endocr Connect
                Endocr Connect
                EC
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                2049-3614
                March 2018
                19 February 2018
                : 7
                : 3
                : 456-459
                Affiliations
                [1 ]Pediatric Growth and Development Research Center Iran University of Medical Sciences, Tehran, Iran
                [2 ]Department of Pediatric Endocrinology and Metabolic Diseases Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [3 ]Endocrine Research Center Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
                [4 ]Department of Pediatrics Endocrinology and Metabolism Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran
                Author notes
                Correspondence should be addressed to F Rohani: rohani.f@ 123456iums.ac.ir
                Article
                EC180043
                10.1530/EC-18-0043
                5854851
                29459422
                57cb330e-6672-4aa6-bee9-8b07eb601d5e
                © 2018 The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License..

                History
                : 29 January 2018
                : 19 February 2018
                Categories
                Research

                near final height,boys,constitutional delay,growth,puberty
                near final height, boys, constitutional delay, growth, puberty

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