Final height and predicted height in boys with untreated constitutional growth delay

Abstract

We report on 49 boys with constitutional growth delay (CGD) who were initially seen in our clinic at a mean chronological age of 13.3 years (range, 7.3-16.4) and a bone age of 11.1 years (range, 6.0-13.5). All were below the 5th height percentile for chronological age. A positive family history with delayed growth and puberty in one or both parents could be elicited in 75%. All 49 patients were re-examined at a mean age of 22.9 years (range, 20.4-31.2). Measured final height was 171.3 cm (range, 161.2-181.7), which was slightly, but significantly lower than mean target height of 173.0 cm. Final height expressed as standard deviation score (SDS) of a male adult population standard was -1.0 (range, -2.4 to 5), also significantly lower than initial height SDS related to bone age (SDSBA) of -0.5 (range, -1.6 to 2). If related to target height (Tanner), final height was found to correlate positively with the initial bone age deficit and the initial height SDSBA. Observed final height was also compared with the predicted adult height by the methods of Bayley-Pinneau (BP), Tanner-Whitehouse Mark II (TW II) and Roche-Wainer-Thissen. Regression equations between all three prediction methods and final height showed an excellent correlation (P < 0.0001). However, only by the BP method was predicted height very close to and no different from measured final height (paired t-test). Despite this, final height in 16 of 49 patients (32.6%) differed by more than 5.0 cm from BP predicted height.(ABSTRACT TRUNCATED AT 250 WORDS)

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

“…However, not all boys with CDGP reach their genetic TH [7, 9, 10, 13]. Although in some previous studies FH of CDGP cases was only 0.1–0.2 SDs smaller than their TH [5, 8], several other studies have reported FH from 0.8 to 1.5 SDs below TH [7, 8,10,11,12,13].…”

“…Subjects with CDGP have previously been shown to achieve FH that is normal or lower-range normal compared with the general population, with values ranging from –1.9 to –0.6 SDs [5,6,7,8,9,10, 12]. However, not all boys with CDGP reach their genetic TH [7, 9, 10, 13].…”

“…Although the correlation between these and measured heights has shown to be relatively high (0.75–0.97) [9,23,24,25], the self-reported heights of parents and older individuals, as well as of those with short stature, may be upwardly biased [10, 26, 27]. We believe that in our study, the possibility of misreported heights is similar in both groups of subjects, as well as in parents.…”

“…At least in a subgroup of CDGP subjects, the reduction in height SDs starts already early in childhood, well before puberty [4, 5]. Although boys with CDGP may be short during pubertal years, many will achieve a final adult height (FH) that is normal compared with the general population [5,6,7,8,9]. However, some subjects with CDGP have been shown to attain a FH that is significantly (>0.8 SDs) below their genetic target height (TH) [7,10,11,12,13].…”

Boys with a Simple Delayed Puberty Reach Their Target Height

“…There is still no consensus on the issue whether boys with a delayed puberty reach a final height appropriate for their target height [1, 2,7,8,9,10,11,12,13]. Most authors found that boys with pubertal delay reach a final height appropriate for their parental centiles, while others claim final height was significantly below target height [6,7,8,9,10,11,12,13].…”