Evaluation of the Effects of Malnutrition Detected in Children and Adolescents on the Adult Final Height

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ayca Torel Ergur ◽  
◽  
Ozutok HEC ◽  
Keyword(s):  
Children And Adolescents ◽  
Adult Height ◽  
Final Height ◽  
Bone Age ◽  
Nutritional Deficiency ◽  
Anthropometric Measurement ◽  
Target Height ◽  
Chronic Malnutrition ◽  
Moderate Malnutrition ◽  
Actual Height

Aim: It is known that chronic malnutrition observed in the early childhood creates many negative results in adult life. Studies examining the effects of nutritional deficiency experienced at older ages and in adolescence are quite limited. In other words, the long-term consequences of nutritional defect in acute/ chronic moderate or mild malnutrition patients still remains important as an issue to be investigated. For this purpose; In this study, it was aimed to determine the final adult height (predicted adult height) of children and adolescents with different age distribution and who were diagnosed with malnutrition as a result of nutritional-endocrinological anthropometric evaluations, and to compare these data with their genetic potential. Material and Methods: The study included 21 cases diagnosed with malnutrition in the pediatric endocrinology department. After the detailed history of the cases, anthropometric measurements and physical examination, biochemistry, hormonal and micronutritional status, celiac antibody levels were evaluated. In the anthropometric evaluation of all cases, body weight, height, height deviation, bone age, target height, target height deviation parameters were used. Patients’ pubertal development was determined according to Tanner-Marshall staging. In the determination of the nutritional status of the patients, data including Weight for Age (WA), Height for Age (HA) and Weight for Height (WH) were used as a nutritional anthropometric measurement using the Gomez-Waterlow classification. In addition, the predicted adult height was calculated with special formulas based on skeletal ages in all cases. Predicted adult height data were obtained using Bayley N Pinneau tables. Results: Of the 21 cases with an average age of 9.81±4.34 years, 12 were prepubertal and 9 were pubertal. Acute episode over chronic malnutrition was found in 19 cases, chronic in 2 cases and acute malnutrition in one case. Considering the severity of malnutrition; WA parameter was determined as severe malnutrition in 1 case, mild-moderate malnutrition in 20 cases, HA parameter was determined as normal in 12 cases, mild-moderate malnutrition in 9 cases, WH parameter was determined as normal in 3 cases, mild-moderate malnutrition in 18 cases. While the predicted adult height of all cases was 164.89±7.96 cm, the target height average of these cases was 166.5±8.09 cm. It was observed that the predicted adult height compared to the target height was the lowest in the chronic group. In seven cases with bone age below 6 years of age, the actual height deviations were distinctly behind the target height deviation. All of these cases were compatible with chronic malnutrition. Conclusion: These results are valuable in terms of showing that malnutrition experienced in any period of growth may negatively affect the predicted adult height. On the other hand, this research; It emphasizes the importance of nutritional anthropometry in all cases with or without short stature. In addition, in another study we conducted in 11 adolescents, it was found that nutritional defect negatively affected growth by decreasing IGF1/IGFBP3 levels, and growth factors increased and growth was supported in the cases that were nutritionally supported. In this study, if the nutritional deficiency is not replaced in patients with malnutrition, it suggests that even if the actual height is not affected, there will be retardation in the final height of the patients.

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

2018 ◽  
Vol 7 (3) ◽  
pp. 456-459 ◽  
Author(s):  
Farzaneh Rohani ◽  
Mohammad Reza Alai ◽  
Sedighe Moradi ◽  
Davoud Amirkashani
Keyword(s):  
General Population ◽  
Adult Height ◽  
Final Height ◽  
Bone Age ◽  
Target Height ◽  
Pubertal Stage ◽  
X Ray ◽  
Constitutional Delay ◽  
Parental Height ◽  
The Mean

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.

scholarly journals Final Height in Pubertal Short Stature Boys Treated with GH Combination with Letrozole: A retrospective study

2021 ◽  
Author(s):  
Yaping Ma ◽  
Ruofan Jia ◽  
Bingyang Xia ◽  
Bin Tang ◽  
Zhuangjian Xu
Keyword(s):  
Retrospective Study ◽  
Short Stature ◽  
Adult Height ◽  
Final Height ◽  
Standard Deviation Score ◽  
Bone Age ◽  
Growth Potential ◽  
Target Height ◽  
Final Adult Height ◽  
Epiphyseal Fusion

Abstract BackgroundThe growth potential of pubertal short stature boys is limited by the effect of estrogen on epiphyseal fusion. This study aims to identify the efficacy and safety of growth hormone (GH) combination with letrozole on final adult height (FAH) in pubertal short stature boys. MethodsThis is a retrospective study. Among pubertal short stature boys who treated with GH and letrozole were be followed up in our hospital, 20 cases reached FAH. ResultsBaseline chronological age were 12.12±1.14yr, bone age were 13.00±0.93yr. The treatment duration was 1.94±0.67yr. The height standard deviation score for bone age was increased from -1.46±0.51 to -0.12±0.57 (p<0.000). The predicted FAH before treatment, predicted FAH after treatment, FAH, and genetic target height were 161.02 ±4.12 cm, 172.11±4.20 cm, 172.67±2.72cm and 167.67±3.56 cm, respectively. There was significant differences between predicted FAH before treatment and after treatment (p<0.000), as well as predicted FAH before treatment and genetic target height (p<0.000).The predicted FAH after treatment was higher than that of genetic target height (p<0.001), as well as FAH and genetic target height (p<0.000). ConclusionsThe GH combination with letrozole can enhance the FAH in pubertal short stature boys. No significant side effects were observed.

Height Increment and Laboratory Profile of Boys Treated With Aromatase Inhibitors With or Without Growth Hormone

2017 ◽  
Vol 49 (10) ◽  
pp. 778-785 ◽  
Author(s):  
Ludmila Pedrosa ◽  
Joice de Oliveira ◽  
Paula Thomé ◽  
Cristiane Kochi ◽  
Durval Damiani ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Aromatase Inhibitors ◽  
Adult Height ◽  
Final Height ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Bone Age ◽  
Height Loss ◽  
Retrospective Data Analysis ◽  
Height Gain

AbstractAromatase inhibitors (AIs) have been used to recover height loss due to their capacity to delay growth plate closure. Long-term studies describing final heights are needed to determine the efficacy and safety profiles of these drugs for the treatment of impaired growth. This study aims to identify the therapeutic efficiency of AIs in improve growth and to describe potential adverse effects during treatment. Retrospective data analysis of 96 adolescents, among which 22 patients already attained near-final height, were followed at outpatient clinics of two referral centers. Patients were all in puberty and present idiopathic decrease in predicted adult height. Patients were treated with Anastrozole (ANZ: 1 mg/day) or Letrozole (LTZ: 2.5 mg/day) with/without recombinant human growth hormone (0.05 mg/kg/day) for 1.0 to 3.5 years (2.1±1.2 years). Height gain, body mass index, lipid, liver enzyme, gonadotropins and testosterone levels were described before and at the end of treatment. Predicted adult height (PAH) and NF height were compared with the TH. The height SDS (adjusted to bone age) significantly increased (p<0.05) in all groups [0.8±0.7 (ANZ), 0.7±0.7 (ANZ+GH), 0.3±0.5 (LTZ), and 1.2±0.8 (LTZ+GH)]; the latter group exhibited the highest increment of PAH and growth recovery to the TH (p<0.004). No significant side effects were observed. AI treatment, especially when used in association with GH was able to improve growth and the attainment of familial target height.

Aromatase excess syndrome in a Chinese boy due to a novel duplication at 15q21.2

2019 ◽  
Vol 32 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Xinrui Tan ◽  
Xiaochuan Wu ◽  
Jie Chen ◽  
Yan Wu ◽  
Shijun Li ◽  
...  
Keyword(s):  
Adult Height ◽  
Linear Growth ◽  
De Novo ◽  
Final Height ◽  
Clinical Manifestations ◽  
Bone Age ◽  
Autosomal Dominant Disorder ◽  
Case Presentation ◽  
Growth Promoting ◽  
Pubertal Gynecomastia

Abstract Background Aromatase excess syndrome (AEXS) is a rare autosomal dominant disorder caused by CYP19A1 overexpression. Clinical manifestations of AEXS include pre- or peri-pubertal gynecomastia, advanced bone age and compromised adult height. Case presentation Here we report an 8-year-old boy diagnosed with AEXS by chromosomal array that revealed a 1.1 Mb novel de novo duplication at 15q21.2, with a predicted final height of 157.4 cm. We prescribed letrozole and growth hormone (GH) to maximize his linear growth. Without further bone age advancement, his height increased from 137.7 cm to 144 cm after an 8-month treatment period. Conclusions We identified a novel duplication at 15q21.2 in AEXS, and found that aromatase inhibitor (AI) plus GH might provide a better growth-promoting approach for AEXS patients.

scholarly journals Increased Final Height in Precocious Puberty after Long-Term Treatment with LHRH Agonists: The National Institutes of Health Experience

2001 ◽  
Vol 86 (10) ◽  
pp. 4711-4716 ◽  
Author(s):  
Karen Oerter Klein ◽  
Kevin M. Barnes ◽  
Janet V. Jones ◽  
Penelope P. Feuillan ◽  
Gordon B. Cutler Jr.
Keyword(s):  
Precocious Puberty ◽  
Adult Height ◽  
Final Height ◽  
Bone Age ◽  
Chronological Age ◽  
Lhrh Agonist ◽  
Duration Of Treatment ◽  
Long Term Treatment ◽  
Predicted Height

We report 98 children who have reached final adult height in a long-term trial of LHRH agonist treatment. These children were 5.3± 2.1 yr old at the start of treatment and were treated with either deslorelin (4 μg/kg·d sc) or histrelin (4–10 μg/kg·d) for an average of 6.1 ± 2.5 yr. Final height averaged 159.8 ± 7.6 cm in the 80 girls, which was significantly greater than pretreatment predicted height (149.3 ± 9.6 cm) but still significantly less than midparental height (MPH) (163.7 ± 5.6). Final height averaged 171.1 ± 8.7 cm in the 18 boys, which was significantly greater than pretreatment predicted height (156.1 ± 14.2 cm) but still significantly less than MPH (178.3 ± 5.2 cm). However, the average adult height of the 54 children who had less than a 2-yr delay in the onset of treatment was not significantly different from their MPH, and 21 children exceeded MPH. Final height sd score correlated positively with duration of treatment (P &lt; 0.01), midparental height (P &lt; 0.001), predicted height at the start of treatment (P &lt; 0.001), and growth velocity during the last year of treatment (P &lt; 0.001) and correlated inversely with delay in the onset of treatment (P &lt; 0.001), age at the start of treatment (P &lt; 0.001), bone age at the start of treatment (P &lt; 0.001), bone age at the end of treatment (P &lt; 0.001), breast stage at the start of treatment (P = 0.02), and bone age minus chronological age at the start of treatment (P = 0.001). We conclude that LHRH agonist treatment improves the final height for children with rapidly progressing precocious puberty treated before the age of 8 yr for girls or 9 yr for boys. Less delay in the onset of treatment, longer duration of treatment, and lower chronological and bone age at the onset of treatment all lead to greater final height. All children with onset of pubertal symptoms before age 8 in girls and age 9 in boys should be evaluated for possible treatment. Treatment is appropriate in children with rapidly progressing puberty, accelerated bone maturation, and compromise of adult height prediction, regardless of bone age or chronological age at time of evaluation. However, once treatment is considered appropriate, it should be initiated quickly, because longer delays lead to shorter final height. In addition, the longer the treatment is continued, the greater is the final height outcome.

Growth Trajectory in Children with Type 1 Diabetes Mellitus: The Impact of Insulin Treatment and Metabolic Control

2018 ◽  
Vol 89 (3) ◽  
pp. 172-177 ◽  
Author(s):  
Carla Bizzarri ◽  
Tiziana Antonia Timpanaro ◽  
Maria Cristina Matteoli ◽  
Ippolita Patrizia Patera ◽  
Marco Cappa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Adult Height ◽  
Insulin Treatment ◽  
Final Height ◽  
Hdl Cholesterol ◽  
Target Height ◽  
Puberty Onset

Background: Linear growth was reported to be negatively affected by type 1 diabetes mellitus (T1DM), in relation to disease duration and poor metabolic control. It is unclear whether a subtle growth failure still persists despite the optimization of therapy. Our aim was to analyse pubertal growth, adult height, and metabolic profile in a cohort of children with T1DM undergoing intensive insulin treatment by multiple daily injections or continuous subcutaneous insulin infusion (CSII). Methods: One-hundred and four children (51 males) with prepubertal onset of T1DM were prospectively followed up to final height attainment. Results: Age at puberty onset was 11.7 ± 1.1 years in males and 10.9 ± 1.3 in females. Age at adult height attainment was 16.4 ± 1.6 years in males and 14.1 ± 1.8 years in females. Pubertal height gain was 24.4 ± 4.9 cm in males and 19.0 ± 3.8 cm in females. HbA1c, HDL cholesterol, and triglyceride levels increased during puberty. HDL cholesterol levels were higher in patients treated with CSII. Height standard deviation score (SDS) at diagnosis (0.52 ± 1.04) was higher than target height SDS (0.01 ± 1.07), but declined afterwards, and both height SDS at puberty onset (0.22 ± 1.1) and adult height SDS (–0.1 ± 1.02) were not significantly different from target height SDS. BMI SDS showed a positive trend from diagnosis to puberty onset and stabilized later (–0.04 ± 1.4 at T1DM onset, 0.55 ± 2.1 at puberty onset, and 0.53 ± 2.1 at adult height attainment). Conclusions: Although subtle abnormalities of growth still persist, the modern advancements of insulin therapy are able to normalize puberty and final height of children with T1DM.

scholarly journals The impact of intensive high performance training on adult height of female artistic gymnasts: a retrospective study

2016 ◽  
Vol 30 (1) ◽  
pp. 87-95
Author(s):  
Raul Alves FERREIRA-FILHO ◽  
Dalmo Roberto Lopes MACHADO ◽  
Renato Francisco Rodrigues MARQUES ◽  
Myrian NUNOMURA
Keyword(s):  
High Performance ◽  
Adult Height ◽  
Final Height ◽  
International Standards ◽  
Target Height ◽  
Performance Training ◽  
Final Adult Height ◽  
Training History ◽  
The Impact ◽  
Age Of Menarche

Abstract The purpose of this study was to identify the potential impact of the high performance training on the anthropometric and maturational characteristics of female artistic gymnasts and to compare the adult target height with international standards of growth. A sample consisted of 23 elite Brazilian female former gymnasts was evaluated. From a historic retrospective, about 29.56 yrs. ago (average of all) they devoted themselves to the training for 9.3 (2.6) years, with a weekly 24.26 (4.2) training hours, and had been retired from competition around at 13.61 (5.12) years old. From the anthropometric data of the gymnasts (while still competing), their parents and their older sister (1) and younger sister (2), the target height was calculated by Tanner method {[(father’s height -13 cm) + mother’s height] ÷ 2}. Additionally, training history, age of menarche occurrence, and growth classifying in accordance with the international standards was recorded, aimed at comparisons. The average stature shown normal adult stature (NCHS), and some cases surpassed the standard 75th, 90th and 95th percentile. They are higher than their mother (p = 0.039), but not their sister 1 (0.952) or sister 2 (p = 0.998), but the age of menarche was significantly later only than their sisters 1 (p = 0.008) and 2 (p = 0.017). According to the Brazilian percentiles reference (IBGE), the final height of the former gymnasts was always higher of the standard, slightly smaller than their sisters 2 (5th and 10th), but was taller than their mothers and sisters 1. In conclusion, there is no evidence of artistic gymnastics high performance training having adverse effects on the final adult height.

Final height of patients treated for isolated GH deficiency: examination of 83 patients

1997 ◽  
pp. 53-60 ◽  
Author(s):  
E Cacciari ◽  
A Cicognani ◽  
P Pirazzoli ◽  
S Zucchini ◽  
S Salardi ◽  
...  
Keyword(s):  
Short Stature ◽  
Gh Deficiency ◽  
Final Height ◽  
Bone Age ◽  
Untreated Group ◽  
Age At Diagnosis ◽  
Chronological Age ◽  
Target Height ◽  
Gh Secretion ◽  
Height Gain

The aim of the present study was to evaluate retrospectively the influence of various auxological and laboratory parameters on final height in a group of GH-deficient children after replacement therapy and to compare their final height with that of a group of short children with normal GH secretion and hence not treated. The final height was evaluated of 83 patients (51 males and 32 females) affected by idiopathic isolated GH deficiency and treated with recombinant human GH (hGH) for 2-7 years. Inclusion criteria at the start of treatment were short stature (mean height for chronological age in standard deviation score (SDS) -2.21) due to idiopathic isolated GH deficiency (GH peak < 8 micrograms/l after two pharmacological tests and/or mean GH concentration < 3.3 micrograms/l during the night) and treatment with recombinant hGH for at least 2 years at a dose of 15-20 U/m2 per week by s.c. injection for 6 or 7 days/ week. Mean chronological age at diagnosis was 12.2 +/- 1.7 years; 35 were prepubertal and 48 pubertal. The final height of 51 untreated short stature (mean height for chronological age in SDS -2.13 at diagnosis) subjects (42 males and 9 females: 29 prepubertal and 22 pubertal at diagnosis with mean chronological age 11.6 +/- 2.4 years) with normal GH secretion was also evaluated. In the treated subjects final height SDS was higher than that of the untreated group (-1.3 vs -1.7 SDS; P = 0.01). Both treated and untreated subjects showed a final height lower than target height, but 39% of the treated subjects vs only 20% of the untreated group (P = 0.035) had a final height greater than target height. In the treated subjects this percentage was higher in the patients improving their height for bone age in the first years of therapy. While treated females showed a positive correlation only between target and final height (P = 0.0001), in treated males final height correlated with the Bayley-Pinneau prediction at diagnosis, height for chronological age and bone age at diagnosis and target height. Patients who started therapy before puberty also showed these correlations with data calculated at the onset of puberty, together with a correlation with chronological age at the onset of puberty. When considering the influence of GH response at tests on final height, the percentage of subjects exceeding target height increased progressively according to the severity of the GH deficiency. There was no difference in height gain between the patients starting therapy before or during puberty. The height gain, however modest, obtained by our treated patients, the number of patients with final height greater than target height and the favourable comparison with the untreated short-stature subjects represent a promising result, which could be improved by personalizing treatment.

scholarly journals Letrozole vs Anastrozole for Height Augmentation in Short Pubertal Males: First Year Data

2014 ◽  
Vol 99 (11) ◽  
pp. 4086-4093 ◽  
Author(s):  
E. Kirk Neely ◽  
Rajiv B. Kumar ◽  
Sydney L. Payne ◽  
Sayali A. Ranadive ◽  
Diane I. Suchet
Keyword(s):  
Adult Height ◽  
Final Height ◽  
Bone Age ◽  
Laboratory Evaluation ◽  
First Year ◽  
Hormonal Manipulation ◽  
Short And Long Term ◽  
Parental Height ◽  
Pubertal Boys

Context: Aromatase inhibitors are used off-label to treat short stature in peripubertal boys. Objective: To investigate short- and long-term hormonal and auxologic differences in short pubertal boys treated with letrozole (L) or anastrozole (A). Design: Patients are seen for laboratory evaluation and physical examination every 6 months, bone age yearly, DEXA and spine film every 2 years. They will be followed until they reach their final height. This is a preliminary report after 1 year of treatment. Setting: A single academic children's hospital outpatient clinic. Patients: Boys with age &gt;10 years, bone age ≤14 years, clinical and hormonal evidence of central puberty, and either height &lt; fifth percentile or predicted adult height (PAH) more than 10 cm below mid-parental height (MPH). Intervention: Letrozole (2.5 mg) or anastrozole (1 mg) was administered orally each day. Main Outcome Measures: Hormonal and clinical parameters, growth velocity, and change in bone age and PAH. Results: Thirty-nine boys have completed 1 year of treatment. Baseline means were age 14.1 years, PAH 166 cm, and testosterone 198 ng/dL. At 1 year, letrozole resulted in higher LH (L 6.1 ± 2.5 vs A 3.2 ± 1.7 IU/L) and testosterone (1038 ± 348 vs 536 ± 216 ng/dL) with lower estradiol (2.8 ± 2.8 vs 5.6 ± 2.9 pg/mL) and IGF-1 (237 ± 51 vs 331 ± 79 ng/mL). First year growth velocities were identical (7.2 cm/year), but an increase in PAH was greater in the anastrozole group (4.2 ± 3.5 vs 1.4 ± 4.4 cm, p = 0.03) after 1 year. Conclusions: We present first-year data from a direct comparison of anastrozole and letrozole for height augmentation in short pubertal boys. Letrozole was more potent in hormonal manipulation than anastrozole. First-year growth velocities were comparable, but improvement in PAH was greater in the anastrozole group. It remains to be seen if positive PAH trends will translate to increase in final height in either group.

scholarly journals Analysis of the factors affecting auxological response to GnRH agonist treatment and final height outcome in girls with idiopathic central precocious puberty

1999 ◽  
pp. 140-144 ◽  
Author(s):  
T Arrigo ◽  
M Cisternino ◽  
F Galluzzi ◽  
S Bertelloni ◽  
AM Pasquino ◽  
...  
Keyword(s):  
Gnrh Agonist ◽  
Treatment Duration ◽  
Adult Height ◽  
Final Height ◽  
Central Precocious Puberty ◽  
Bone Age ◽  
Target Range ◽  
Gnrh Agonists ◽  
Entire Treatment Period ◽  
Population Norm

The aim of this retrospective study was to analyze the factors which affected the auxological response to GnRH agonist treatment and the final height (FH) outcome in 71 girls with idiopathic and truly precocious (onset before 8 years) central puberty (CTPP) who had been treated with the same therapy protocol (Decapeptyl Depot, 60 microg/kg i.m. every 28 days) for at least 2 years (since 7.0+/-1. 3 (S.D.) years of age) and followed until puberty was completed and FH was reached. During the entire treatment period we observed: (a) a decrease of height standard deviation scores (SDS) (from 1.5+/-1.7 to 0.9+/-1.3 SDS, P<0.01); (b) a striking deceleration of bone age (BA), revealed by the subnormal DeltaBA:Deltachronological age (CA) ratio (0.2+/-0.1); (c) an increase of predicted adult height (from 155.6+/-7.0 to 160.7+/-6.7 cm, P<0.0005). Treatment interruption was followed by an important catch-down growth, with an FH (158.4+/-5.8 cm) lower (P<0.025) than that predicted at the end of therapy. However, FH fell within the population norm and the target range in respectively 87.3 and 90% of the patients. The tallest FH was recorded in the patients who started therapy at less than 6 years of age and in those who discontinued treatment at a BA of 12.0--12.5 years. At stepwise regression analysis, FH in the whole study population was positively affected by the following independent factors: (a) height at the end of therapy (F=45.45, P<0.0001); (b) pretreatment height (F=13.91, P<0.0005); (c) treatment duration (F=8. 51, P<0.005); (d) target height (TH) (F=7.70, P<0.01). We conclude that: (i) most girls with idiopathic CTPP treated by GnRH agonists may achieve an adult height within the population norm and/or their target range; (ii) the height gain from therapy onset until FH attainment, however, is generally rather limited (on average 2.9 cm) and only few patients are able to reach their target percentile; (iii) the most favorable height prognosis with respect to TH is generally observed in the subjects with the tallest height at the end of treatment and the lowest BA2:CA2 ratio, due to the important deterioration of height prognosis which frequently follows therapy interruption; (iv) FH is also significantly conditioned by both TH and treatment duration; (v) in order to strengthen the weak therapeutic effect of GnRH agonists in CTPP this treatment should be started as early as possible and discontinued at a BA of 12.0--12.5 years.

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