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      Boys with a Simple Delayed Puberty Reach Their Target Height

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          Introduction: Final height in boys with delayed puberty is thought to be below target height. This conclusion, however, is based on studies that included patients with genetic short stature. We therefore studied final height in a group of 33 untreated boys with delayed puberty with a target height >–1.5 SDS. Methods: Standing height, sitting height, weight and arm span width were measured in each patient. Final height was predicted by the method of Greulich and Pyle using the tables of Bailey and Pinneau for retarded boys at their bone age (PAH1) and the tables of Bailey and Pinneau for average boys plus six months (PAH2). Results: Mean final height (175.8 ± 6.5 cm) was appropriate for the mean target height (174.7 ± 4.5 cm). The prediction method of Bailey and Pinneau overestimated the final height by 1.4 cm and the modified prediction method slightly underestimated the final height (–0.15 cm). Conclusion: Boys with untreated delayed puberty reach a final height appropriate for their target height. Final height was best predicted by the method of Bailey and Pinneau using the tables for average boys at their bone age plus six months.

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          Most cited references 20

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          Bmi in childhood and its association with height gain, timing of puberty, and final height.

          No large population-based study has addressed the question of how overnutrition is related to subsequent height gain in childhood, timing of puberty, and final height. The present data represent a large Swedish population-based longitudinal growth study. Height gain in childhood, timing of reaching peak height velocity and height gain during adolescence, and final height were regarded as the short-term, interim, and long-term outcomes of childhood nutritional status, i.e. body mass index (BMI) change between 2 and 8 y. Midparental height was adjusted as the genetic influence on linear growth of the child. Childhood BMI gain was related to an increased height gain during the same period, i.e. an increase of 1 BMI unit was associated with an increase in height of 0.23 cm in boys and 0.29 cm in girls. A higher BMI gain in childhood was related to an earlier onset of puberty; the impact on the timing of puberty was 0.6 y in boys and 0.7 y in girls. Each increased unit of BMI gain in childhood also reduced the height gain in adolescence, 0.88 cm for boys and 0.51 cm for girls. No direct correlation was shown between childhood BMI gain and final height. We conclude that overnutrition between 2 and 8 y of age will not be beneficial from a final height point of view, as the temporary increase in height gain in childhood will be compensated by an earlier pubertal maturity and a subnormal height gain in adolescence.
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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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              Final height in boys with untreated constitutional delay in growth and puberty.

              To determine the natural history and psychological impact of the growth pattern in boys with constitutional delay in growth and puberty (CDGP), 43 boys presenting with short stature due to CDGP were followed up to final height. At presentation mean (SD) chronological age was 14.0 (1.9) years, bone age delay 2.7 (1.0) years, standing height standard deviation score (SDS) -3.4 (0.6), and predicted adult height SDS -1.3 (0.7). Final adult height SDS was -1.6 (0.9), measured at 21.2 (2.6) years. There was no significant difference between final height and predicted adult height, but there was a significant difference between final height and measured mid-parental height. Psychological questionnaires showed no significant difference in self esteem, marital, or employment state between the CDGP group and a control group. There was no correlation between self esteem and final height, but 25 felt their growth delay had affected their success either at school, work, or socially and 20 would rather have had treatment to advance their growth spurt. This study supports the more frequent use of active medical treatment to advance growth in boys with CDGP, and shows that although boys with CDGP reach their predicted heights, this is short for their families.

                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                October 2008
                05 September 2008
                : 70
                : 4
                : 209-214
                Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium
                137663 Horm Res 2008;70:209–214
                © 2008 S. Karger AG, Basel

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                Page count
                Figures: 4, Tables: 5, References: 31, Pages: 6
                Original Paper


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