Catch-up growth: possible mechanisms

Abstract

Many systemic diseases impair linear growth. If remission occurs, growth will often accelerate beyond the normal rate for age, a phenomenon termed "catch-up growth." As a result, final height is improved, although this recovery of adult stature is frequently incomplete. Two principal models have been proposed to explain catch-up growth. The first model postulates a central nervous system mechanism that compares actual body size with an age-appropriate set-point and then adjusts growth rate accordingly. However, there is recent evidence that growth inhibition in a single growth plate is followed by local catch-up growth, a finding not readily explained by the neuroendocrine model. Thus, a new model has been proposed that places the mechanism within the growth plate itself. According to this model, growth-inhibiting conditions decrease proliferation of growth plate stem cells, thus conserving their proliferative potential. Additional research is needed to determine whether the mechanisms governing catch-up growth are local, systemic, or both.

The effect of a short-term delay of puberty on trabecular bone mass and structure in female rats: A texture-based and histomorphometric analysis

“…These results and the current study suggest long-term effects from a delay in pubertal onset. However, "catch-up" growth has been reported in other animal models of low bone mass during growth [8,7]. Gafni et al [8] report a complete recovery in BMD, bone volume and trabecular number in rabbits after a 5-week protocol of dexamethasone injections (a protocol resulting in a significant bone mass reduction).…”

“…Specifically, amenorrheic dancers receiving hormone replacement for 2 years had no increase in BMD compared to the placebo or control groups. Therefore, "catch-up" growth may depend on the age of onset and severity of the condition affecting normal growth [7].…”

“…Warren et al [6] found the age of menarche to be more correlated to stress fracture occurrence than bone mineral density (BMD). While increased incidence of stress fractures may increase the risk of osteoporotic fractures later in life, evidence exists for "catchup" growth [7,8]. That is, bone inhibiting and bone enhancing strategies early in life may not have long-term effects on bone strength due to the continued growth occurring in juvenile bone.…”

Delayed pubertal development by hypothalamic suppression causes an increase in periosteal modeling but a reduction in bone strength in growing female rats

“…Yingling et al, 2006 (15) reported a transient decrease in bone strength but a full recovery of bone strength at 6 months of age. However, the mechanism of this recovery remains elusive (16)and data from human studies suggest a sustained bone deficit. Warren et al (2003) (17) treated amenorrheic dancers for 2 years with hormone replacement therapy and found no difference in BMD between treated and placebo groups.…”

Avaliação da estatura final e mineralização óssea de pacientes adultos portadores de síndrome nefrótica idiopática na infância e adolescência

“…Para a avaliação do estado nutricional utilizamos as medidas de peso, da relação peso/estatura e do índice de massa corpórea (IMC) (Zeferino, 2003 (Gafni, 2000). O mecanismo proposto seria a existência de um número máximo de divisões celulares para os condrócitos da placa de crescimento, com diminuição progressiva de sua capacidade de proliferação, a cada nova divisão celular, um processo denominado de envelhecimento.…”