Analysis of Bone Age Data From National Cooperative Growth Study Substudy VII

PEDIATRICS ◽  
1999 ◽  
Vol 104 (Supplement_5) ◽  
pp. 1031-1036
Author(s):  
Stephen F. Kemp ◽  
Judy P. Sy
Keyword(s):  
Age Determination ◽  
Bone Age ◽  
Strongly Correlated ◽  
Growth Study ◽  
Gh Therapy ◽  
Pubertal Stage ◽  
Significant Difference ◽  
Clinically Significant ◽  
National Cooperative ◽  
Age Determinations

National Cooperative Growth Study substudy VII was conducted 1) to compare standardized hand–wrist and knee bone age determinations in pubertal children treated with growth hormone (GH); 2) to compare local determinations of bone ages with centrally determined bone ages; 3) to relate the response to GH therapy to the bone age determinations; and 4) to ascertain the predictive value of each type of bone age determination. Eligible subjects were those in the National Cooperative Growth Study who were at Tanner pubertal stage 2 or greater for breasts (girls) or genitals (boys). Radiographs of the hand–wrist were taken annually, and radiographs of the knee were taken at the beginning and the end of the study. Separate bone age determinations were made from these radiographs. A combined hand–wrist and knee bone age determination also was derived. There were 990 patients in the study; in 925 (677 boys), there were both hand–wrist and knee bone age determinations from the baseline pubertal radiographs. There was only one radiographic assessment in 496 patients, two in 205 patients, and three to eight in the remaining patients. The strongest correlation was between the hand–wrist bone age and the hand–wrist plus knee bone age (r = .995). Also strongly correlated were knee with hand–wrist (r = .872) and knee with hand–wrist plus knee (r = .914). For none of these bone age methods was any statistically significant difference found between the methods. The locally determined bone ages correlated strongly with the centrally determined bone ages for knee (r = .850), hand–wrist (r = .928), and hand–wrist plus knee (r = .930); however, the locally determined knee and hand–wrist values were less (by ∼0.3 year) than the centrally determined values. These differences, however, do not appear to be clinically significant.

Adult Height in Children With Growth Hormone Deficiency Who Are Treated With Biosynthetic Growth Hormone: The National Cooperative Growth Study Experience

PEDIATRICS ◽  
1998 ◽  
Vol 102 (Supplement_3) ◽  
pp. 512-516
Author(s):  
Gilbert P. August ◽  
Joanne R. Julius ◽  
Sandra L. Blethen
Keyword(s):  
Growth Hormone ◽  
Adult Height ◽  
Tanner Stage ◽  
Bone Age ◽  
Hormone Deficiency ◽  
Growth Study ◽  
Pubertal Stage ◽  
Group 2 ◽  
National Cooperative ◽  
Group 1

Objective. To determine whether the height gain during puberty in children with growth hormone deficiency (GHD) who are treated with biosynthetic growth hormone (GH) is similar to that in otherwise healthy children with delayed bone ages and whether the height standard deviation score (SDS), which began to increase before puberty, continues to increase during puberty. Methods. The inclusion criteria included a diagnosis of idiopathic GHD, prepubertal on enrollment in the National Cooperative Growth Study, and spontaneous onset of puberty, as defined by Tanner stage 2 breast development in girls and a testicular volume of at least 3 mL in boys. Near-adult height was judged to have been attained in the subjects who had reached a chronologic age of at least 18 years (females) or 20 years (males) or had reached at least pubertal stage 4 and a chronologic age of at least 14 years (females) or 16 years (males). These subjects constituted group 1. Group 2 was a subgroup of these subjects who met a more stringent criterion for near-adult height; in addition to meeting the above criteria, they had to have attained a bone age of at least 14 years (females) or 16 years (males). Results. Group 1 consisted of 480 males and 194 females. Group 2 consisted of 153 males and 105 females. In the subjects in group 1, the Tanner pubertal stage 2 was 14.1 ± 1.5 years in males and 12.6 ± 1.6 years in females; the bone age at this stage was 11.9 ± 1.5 years in males and 10.6 ± 1.5 years in females; and the height SDS was −2.1 ± 0.9 in males and −2.4 ± 0.9 in females. The total height gained during puberty was 22.4 ± 7.9 cm in males and 17.4 ± 6.3 cm in females; the percentage of adult height gained during puberty was 13.3% ± 4.6% in males and 11.3% ± 4.0% in females; the near-adult height SDS was −1.3 ± 1.0 in males and −1.6 ± 0.9 in females; and the target adult height SDS was −0.4 ± 0.8 in males and −0.5 ± 0.7 in females. The growth characteristics in the subjects in group 2 were of similar magnitude. In both groups, there was a significant negative correlation between age at the onset of Tanner stage 2 and both the total height gained during puberty and the percentage of adult height gained. Conclusions. The growth characteristics of these subjects were similar to those reported in normal children and in previous reports of the pubertal growth in smaller populations of children with GHD. The height SDS increased in these subjects during puberty, but the target adult height SDS was not attained. This is a strong argument for early diagnosis and treatment in children with GHD to optimize prepubertal growth.

The alteration of IGF-1 levels and relationship between IGF-1 levels and growth velocity during GnRH analogue therapy

2020 ◽  
Vol 33 (1) ◽  
pp. 113-120
Author(s):  
Nursel Muratoglu Sahin ◽  
Havva Nur Peltek Kendirci ◽  
Semra Çetinkaya ◽  
Şenay Savaş Erdeve ◽  
Zehra Aycan
Keyword(s):  
Growth Velocity ◽  
Standard Deviation Score ◽  
Central Precocious Puberty ◽  
Bone Age ◽  
Chronological Age ◽  
Gnrh Analogue ◽  
Pubertal Stage ◽  
Ovarian Volume ◽  
Significant Difference ◽  
High Level

AbstractBackgroundSome studies have examined the effect of gonadal suppression on insulin-like growth factor-1 (IGF-1) levels and the growth velocity (GV) with conflicting results.MethodsForty-four girls treated with gonadotropin-releasing hormone analogue (GnRHa) for central precocious puberty (CPP) were included in the study. IGF-1 levels were examined at the beginning and after 12 months of treatment.ResultsIGF-1 and IGF-1 standard deviation score (SDS) according to chronological age (CA-IGF-1 SDS) at diagnosis were positively correlated with chronological age (CA), anthropometric measurements, stage of puberty, bone age (BA), BA-CA, follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol, uterus length, endometrium thickness and ovarian volume (OV) at diagnosis (p < 0.05). There was no significant difference in IGF-1 levels after treatment. However, there was a negative correlation between ΔIGF-1 SDS and IGF-1 level, CA-IGF-1 SDS and BA-IGF-1 SDS at diagnosis (p < 0.05). There was no correlation between GV and IGF-1, ΔIGF-1. GV was negatively correlated with basal LH level at diagnosis (p = 0.008, r = −0.397). Peak LH levels of the patients who had GV-SDS < 0 were more suppressive than those of the patients who had GV-SDS > 0 after 12 months of treatment.ConclusionsIt was determined that the IGF-1 level and CA-IGF-1 SDS at baseline were correlated with more advanced pubertal stage prior to treatment. Initiation of treatment with a relatively high level of IGF-1 increased the risk of a decrease in the IGF-1 level. Likewise, the initiation of treatment with a relatively high LH level may increase the risk of low GV, but low GV was not related to the IGF-1 level. Increased sex steroid suppression may increase the risk of low GV.

scholarly journals Growth Hormone Therapy Benefits Pituitary Stalk Interruption Syndrome Patients with Short Stature: A Retrospective Study of 75 Han Chinese

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Cheng-Zhi Wang ◽  
Ling-Ling Guo ◽  
Bai-Yu Han ◽  
An-Ping Wang ◽  
Hong-Yan Liu ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Short Stature ◽  
Final Height ◽  
Bone Age ◽  
Pituitary Stalk ◽  
Gh Therapy ◽  
Gh Treatment ◽  
Significant Difference ◽  
Height Gain ◽  
The Impact

Objective. We aim to investigate the long-term benefits of growth hormone (GH) therapy in short stature adolescents and adults with pituitary stalk interruption syndrome (PSIS), which would be beneficial for future clinical applications.Design and Methods. In this study, initial height, final height, total height gain, and GH treatment history were retrospectively investigated in 75 Chinese PSIS patients. We compared height gain between the GH treated cohort and untreated cohort and explored the impact of different GH therapy duration on height gain.Results. For GH treated patients, their final height (SDS) increased from-1.99±1.91(−6.93~2.80) at bone age (BA) of 11.2 (5.0~17.0) years to-1.47±1.64(−7.82~1.05) at BA of 16.6 (8.0~18.0) years (P=0.016). And GH treated patients had more height gain than the untreated patients (P<0.05). There was a significant difference between the different GH therapy duration groups (P=0.001): GH 0 versus GH 3,P=0.000; GH 1 versus GH 3,P=0.028; GH 2 versus GH 3,P=0.044.Conclusion. Adult Chinese PSIS patients with short stature benefited the most from at least 12 months of GH therapy. Although patient diagnosis age was lagged behind in the developing countries, GH treatment was still effective for them and resulted in a higher final height and more height gain.

Melanocytic Nevi in Children Treated With Growth Hormone

PEDIATRICS ◽  
1999 ◽  
Vol 104 (Supplement_5) ◽  
pp. 1045-1050
Author(s):  
David Wyatt
Keyword(s):  
Growth Hormone ◽  
Skin Cancer ◽  
Turner Syndrome ◽  
Gh Deficiency ◽  
Growth Study ◽  
Gh Therapy ◽  
Melanocytic Nevi ◽  
Duration Of Therapy ◽  
National Cooperative ◽  
Cancer In Children

There is concern that growth hormone (GH) therapy may influence the growth of melanocytic nevi. In a review of the experience of the National Cooperative Growth Study, we found no excess of skin cancer in children who were treated with GH. We also reviewed our experience in 90 children with GH deficiency and 24 with Turner syndrome. We found no difference in the nevi count between control subjects and children with GH deficiency, even after many years of GH therapy. Nor was there any relation between the duration of therapy and the nevi count. Children with Turner syndrome had more nevi, but there was no relation to the duration of GH therapy. These findings and the absence of a greater frequency of skin cancer in acromegaly are reassuring. It is unlikely that GH therapy has a significant influence on nevi count or the risk of skin cancer.

Regular Monitoring of Bone Age Is Useful in Children Treated With Growth Hormone

PEDIATRICS ◽  
1999 ◽  
Vol 104 (Supplement_5) ◽  
pp. 1039-1042
Author(s):  
Francine Ratner Kaufman ◽  
Judy P. Sy
Keyword(s):  
Growth Hormone ◽  
Standard Deviation Score ◽  
Bone Age ◽  
Hormone Deficiency ◽  
First Year ◽  
X Rays ◽  
Growth Study ◽  
Cumulative Change ◽  
National Cooperative

Objective. This study was undertaken to determine whether serial bone age (BA) radiographs were obtained in patients with growth hormone deficiency and to assess whether there were differences in outcome between subjects with and without monitoring of BA radiographs. Research Design and Methods. Data were collected from the National Cooperative Growth Study database on growth hormone-deficient subjects who were treated for at least 3 years. Comparisons were made among three groups of subjects: 1) those with BAs at entry versus those without; 2) those with BA values in the first year of follow-up if an entry radiograph had not been done versus those with no first-year examination; and 3) those with a BA at entry and yearly for 3 years versus those with no radiographs during the same period. Differences in the change in height standard deviation score (SDS); change in height age, age, pubertal progression, number of visits, growth hormone dosage; and number of growth hormone injections per week were compared. Results. Of the 6191 subjects assessed, 93% had at least one BA radiograph obtained; there was a mean of 3.6 ± 2.6 total number of BA radiographs per patient during the 5.2 ± 1.9 years of follow-up. Subjects with BA values at entry were older and had slightly higher cumulative height SDS and height age change compared with those without BA values at entry. Subjects with BA assessment during the first year were older and had shorter growth hormone treatment time and slightly better cumulative change in height SDS and height age than did those without BA in the first year. Comparing those with serial BA determination for the first 3 years of treatment versus those with no BA values, those with BA were older, more pubertal, seen more often, had more growth hormone injections per week of a comparable growth hormone dosage, and had slightly larger cumulative change in height SDS and height age than those without x-rays. Conclusions. These data suggest that National Cooperative Growth Study investigators find it of benefit to obtain baseline and follow-up measurements of BA in most subjects treated with growth hormone. Subjects with BA monitoring do slightly better than do those whose skeletal maturation is not measured. BA assessment should be considered part of the follow-up of patients treated with growth hormone therapy.

scholarly journals A comparison of 3 different methods for assessment of skeletal age when treating leg-length discrepancies: an inter- and intra-observer study

2022 ◽  
Vol 93 ◽  
pp. 222-228
Author(s):  
Anne Berg Breen ◽  
Harald Steen ◽  
Are Pripp ◽  
Ragnhild Gunderson ◽  
Hilde Kristine Sandberg Mentzoni ◽  
...  
Keyword(s):  
Skeletal Maturity ◽  
Intraclass Correlation ◽  
Age Determination ◽  
Bone Age ◽  
Systematic Difference ◽  
Skeletal Age ◽  
Leg Length ◽  
Left Elbow ◽  
Comparison Results ◽  
Significant Difference

Background and purpose — Skeletal maturity is a crucial parameter when calculating remaining growth in children. We compared 3 different methods, 2 manual and 1 automated, in the radiological assessment of bone age with respect to precision and systematic difference. Material and methods — 66 simultaneous examinations of the left hand and left elbow from children treated for leg-length discrepancies were randomly selected for skeletal age assessment. The radiographs were anonymized and assessed twice with at least 3 weeks’ interval according to the Greulich and Pyle (GP) and Sauvegrain (SG) methods by 5 radiologists with different levels of experience. The hand radiographs were also assessed for GP bone age by use of the automated BoneXpert (BX) method for comparison. Results — The inter-observer intraclass correlation coefficient (ICC) was 0.96 for the GP and 0.98 for the SG method. The inter- and intra-observer standard error of the measurement (SEm) was 0.41 and 0.32 years for the GP method and 0.27 and 0.21 years for the SG method with a significant difference (p < 0.001) between the methods and between the experienced and the less experienced radiologists for both methods (p = 0.003 and p < 0.001). In 25% of the assessments the discrepancy between the GP and the SG methodwas > 1 year. There was no systematic difference comparing either manual method with the automatic BX method. Interpretation — With respect to the precision of skeletal age determination, we recommend using the SG method or preferably the automated BX method based on GP assessments in the calculation of remaining growth.

Hearing Aid Gain Usage by Children

1989 ◽  
Vol 20 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Kenneth W. Berger
Keyword(s):  
Hearing Aid ◽  
Appreciable Difference ◽  
Significant Difference ◽  
Clinically Significant

Hearing aid gain usage by two groups of children was examined. No appreciable difference was noted between the groups, nor was there a clinically significant difference between gain usage by these children as compared with a sample of adult hearing aid wearers.

Bone age determination using dual-energy X-ray absorptiometry

2017 ◽  
Author(s):  
Khalaf Alshamrani ◽  
Amaka Offiah ◽  
Elzene kruger
Keyword(s):  
Age Determination ◽  
Bone Age ◽  
Dual Energy ◽  
X Ray
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