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      Progressive Reduction of Relative Height in Childhood Predicts Adult Stature below Target Height in Boys with Constitutional Delay of Growth and Puberty

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          Abstract

          Background/Aims: In some adolescents with constitutional delay of growth and puberty (CDGP), the reduction in relative height (height SDs) starts already in childhood, before puberty. Some subjects with CDGP do not reach their target height (TH). We investigated whether early height SD reduction or testosterone treatment in low doses (1–2 mg/kg/month) influence final height (FH). Methods: The growth of 70 adult men with a history of CDGP was investigated. 31 subjects (13 treated with testosterone) had progressive height SD reduction between 3 and 9 years, and in 39 (17 treated with testosterone) no such reduction was seen. Results: In untreated subjects without early height SD reduction, FH was closer to TH than in those with such reduction (FH – TH 0.05 ± 0.94 vs. –0.63 ± 0.50 SD, p = 0.009). FH – TH did not differ between the testosterone-treated and untreated subjects in the group with early height SD reduction (FH – TH –0.36 ± 0.48 vs. –0.63 ± 0.50 SD, p = 0.15), nor in the group without such reduction (FH – TH –0.08 ± 0.70 vs. 0.05 ± 0.94 SD, p = 0.64). Conclusion: Subjects with early height SD reduction do not attain FH consistent with their genetic height potential, whereas those without such reduction do. Treatment with low doses of testosterone does not adversely affect FH.

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          Most cited references24

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          The adolescent growth spurt of boys and girls of the Harpenden growth study.

          Logistic curves have been fitted to the growth during puberty of the 55 boys and 35 girls of the Harpenden Growth Study who were measured every three months during puberty and thereafter until growth ceased. Very good fits were obtained for stature, sitting height, subischial leg length, biacromial and bi-iliac diameters from approximately six months after the beginning of the adolescent spurt. This beginning, called "take-off", was determined graphically as the point of minimum velocity. The total height gained from take-off point to cessation of growth averaged 28 cm in boys and 25 cm in girls with standard deviations of about 4 cm. The adult sex difference in height was due much more to the later take-off in boys than to a greater male adolescent spurt. A sex difference in the spurt occurred in sitting height but not in leg length. Mean-constant curves for the four measurements are presented. In each measurement size at take-off and total adolescent gain were nearly independent, the average correlation coefficient being --0-2. The correlations between adolescent gains in different measurements averaged only 0-47, and between peak velocities of different measurements only 0-27. This implies considerable shape change at adolescence. In contrast the average correlation between ages at which the peak velocities were reached was 0-87. Ages at take-off, at peak velocity, and at menarche were independent of mature size, though correlated with percentage of adult size reached at the ages in question, a measure of somatic maturity. Relationships with the development of breasts, pubic hair and genitalia were examined; ages at take-off and at peak velocity correlated to the extent of 0-6 to 0-8 with ages of B2 and PH2 but both these parameters and also peak velocities were uncorrelated with the rapidity with which sex characters developed.
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            Clinical longitudinal standards for height and height velocity for North American children

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              Bias, precision and heritability of self-reported and clinically measured height in Australian twins.

              Many studies of quantitative and disease traits in human genetics rely upon self-reported measures. Such measures are based on questionnaires or interviews and are often cheaper and more readily available than alternatives. However, the precision and potential bias cannot usually be assessed. Here we report a detailed quantitative genetic analysis of stature. We characterise the degree of measurement error by utilising a large sample of Australian twin pairs (857 MZ, 815 DZ) with both clinical and self-reported measures of height. Self-report height measurements are shown to be more variable than clinical measures. This has led to lowered estimates of heritability in many previous studies of stature. In our twin sample the heritability estimate for clinical height exceeded 90%. Repeated measures analysis shows that 2-3 times as many self-report measures are required to recover heritability estimates similar to those obtained from clinical measures. Bivariate genetic repeated measures analysis of self-report and clinical height measures showed an additive genetic correlation >0.98. We show that the accuracy of self-report height is upwardly biased in older individuals and in individuals of short stature. By comparing clinical and self-report measures we also showed that there was a genetic component to females systematically reporting their height incorrectly; this phenomenon appeared to not be present in males. The results from the measurement error analysis were subsequently used to assess the effects of error on the power to detect linkage in a genome scan. Moderate reduction in error (through the use of accurate clinical or multiple self-report measures) increased the effective sample size by 22%; elimination of measurement error led to increases in effective sample size of 41%.
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                Author and article information

                Journal
                HRE
                Horm Res Paediatr
                10.1159/issn.1663-2818
                Hormone Research in Paediatrics
                S. Karger AG
                1663-2818
                1663-2826
                2007
                July 2007
                22 March 2007
                : 68
                : 2
                : 99-104
                Affiliations
                aHospital for Children and Adolescents, Helsinki University Hospital, Helsinki, and bDepartment of Paediatrics, Kuopio University Hospital, Kuopio, Finland
                Article
                101011 Horm Res 2007;68:99–104
                10.1159/000101011
                17377395
                59222afc-e87e-4b59-9aba-807552619d10
                © 2007 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 23 November 2006
                : 02 August 2007
                Page count
                Figures: 2, Tables: 2, References: 35, Pages: 6
                Categories
                Original Paper

                Endocrinology & Diabetes,Neurology,Nutrition & Dietetics,Sexual medicine,Internal medicine,Pharmacology & Pharmaceutical medicine
                Final adult height,Target height,Constitutional delay of growth and puberty,Childhood growth pattern

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