Effect of gonadotropin-releasing hormone analogue treatment in improving final adult height of children with central precocious puberty or early and fast puberty: a Meta analysis / 中国当代儿科杂志

OBJECTIVES@#To systematically evaluate the effect of gonadotropin-releasing hormone analogue (GnRHa) treatment on the final adult height of children over 6 years of age with central precocious puberty (CPP) or early and fast puberty (EFP).@*METHODS@#PubMed, MEDLINE, Embase, Cochrane Library, CNKI, and Wanfang Data were searched for related articles on GnRHa treatment for children with CPP or EFP. Stata 12.0 software was used to perform a Meta analysis of related data.@*RESULTS@#A total of 10 studies were included, and the total sample size was 720 children, with 475 children in the GnRHa treatment group and 245 children in the control group. The Meta analysis showed that compared with the control group, the GnRHa treatment group had significantly better final adult height (@*CONCLUSIONS@#GnRHa treatment is safe and effective in improving the final adult height of children over 6 years of age with CPP or EFP.

Clinical significance of skeletal age assessment in children / 国际儿科学杂志

Bone development is influenced by a number of factors,including nutrition,hormonal secretions,and genetics.Skeletal age assessment(SAA) is a clinical procedure,which is used in determining the skeletal age(SA) of children and adolescents.The selection of evaluation methods,the difference of evaluation techniques,and the influence of disease can affect the accuracy of SAA.Currently,the main clinical methods for SAA are the Greulich-Pyle(GP) and Tanner-Whitehouse(TW)methods.The GP method has the advantage of being quick and easy to use.The method of TW,however,seems to be more reliable than the GP method.In China,the CHN method is also used.With the development of technology,the computer automatic SAA and ultrasonic SAA are gradually applied in clinical practice.The SAA plays an important role in the diagnosis and treatment of endocrine diseases,such as short stature and precocious puberty,and also in the children's growth and development.In order to improve the accuracy of SAA,this article reviews the related methods,techniques and clinical applications.

Observation of body mass index and final adult height of triptorelin on idiopathic central precocious puberty / 中国基层医药

Objective To observe the gonadotropin analogue ( GnRHa) Triptorelin of idiopathic central pre-cocious puberty(ICPP) girls′body mass index(BMI) and final adult height(FAH).Methods 120 patients with idi-opathic central precocious puberty cases were summarized and track the return visit ,which.of 62 cases with ICPP girls Triptorelin treatment,6,12,18,24,36 months of observation and treatment of bone age (BA),the growth rate(GV), BMI,predicted height ( PAH) ,and life-long high and up to lifelong high BMI .The untreated group was also observed the relevant indicators such as BMI ,and lifelong.Results After treatment,the increase in BA was less than that in age.The PAH has improved with the growth of the treatment regimens .After treatment PAH 12,18,24,36 months PAH respectively[(153.4 ±7.1)cm,(154.6 ±6.2)cm,(155.7 ±4.7)cm,(156.9 ±5.9) cm], both were statisti-cally significant(t=2.23,2.67,3.01,2.88,all P0.05).Lifelong treatment and control groups,respectively[(158.2 ±3.9)cm,(153.7 ±2.8) cm],and between the two there is a statistically significant (t=3.04,P0.05). Conclusion Triptorelin can effectively suppress idiopathic central precocious sexual characteristics and bone age growth and improve adult height .There is no significant effect on the BMI .

Final adult height of girls with central precocious puberty or early and fast puberty could be improved by treatment of gonadotropin-releasing hormone analogs / 中华内分泌代谢杂志

Objective To assess the efficacy and impact factors of treatment with Gonadotropin-releasing hormone analogs (GnRHa) in central precocious puberty (CPP) or early and fast puberty (EFP) girls in a retrospective unicenter study.Methods One hundred and two girls (75 CPP and 27 EFP) were treated with GnRHa alone and were followed up to their final adult hight (FAH).Results FAH was (158.0 ± 4.8) cm,being significantly higher than pretreatment predicted adult height [(151.1 ±5.1) cm,P＜0.01].There was no significant difference between CPP [(7.3 ± 4.4) cm] and EFP [(5.5 ± 4.5) cm] in net height gain.There was no significant improvement in FAH and pretreatment PAH for the patients who had menarche before treatment or whose growth velocity was less than 4 cm during the first year.Conclusion GnRHa treatment improves FAH efficiently for both CPP and EFP girls.Nevertheless,those who had menarche before treatment or whose growth velocity was less than 4 cm during the first year can hardly improve FAH by GnRHa treatment alone.

Effects of recombinant human growth hormone on final adult height in children with Turner′s syndrome and analysis of the influencing factors / 中华内分泌代谢杂志

Objective To observe the final adult height (FAH) outcome and influencing factors in Turner′s Syndrome(TS) children treated with recombinant human growth hormone ( rhGH ).Methods Thirty TS children treated with rhGH were compared with 16 TS children without rhGH treatment and were followed up to achieve their FAH.Comparisons were made regarding predicted adult height (PAH),height standard deviation score for chronological age( HtSDScA ),height SDS for BA( HtSDSRA ),and growth velocity ( GV ) between rhGH treatment and without treatment groups and between the onset and by the end of rhGH treatment group.The factors determining FAH were also evaluated.Results FAH in rhGH treatment group was obviously improved as compared with untreatment group[ ( 149.5±6.3 vs 142.4±5.2) cm,P＜0.01 ].FAH in treatment group was positively correlated with height standard deviation score for chronological age ( Ht0 SDSCA ),Hto SDS for BA ( Hto SDSBA ),height age ( HA0 ) at preliminary diagnosis,and correlated with duration of rhGH therapy,duration of estrogen-free rhGH therapy,and PAH0SDS at preliminary diagnosis.Stepwise regression analysis indicated that duration of estrogen-free rhGH therapy and PAH0 SDS were the variables with the greatest identified influence on FAH (F =11.56 and F =86.91,P＜ 0.01 ).FAH in the 45,XO group was significantly different from the mosaicism group (45,XO/46,XX ) [ ( 147.2 ± 6.3 vs 153.3±6.4) cm,P =0.038].Conclusion rhGH treatment is efficacious in improving FAH of TS children,but a variability in the magnitude of the response to rhGH is recognized.Duration of estrogen-free rhGH therapy and PAH0SDS are the variables with the greatest identified influence on FAH,and karyotype may be one of the influence factors.rhGH treatment should be initiated as early as possible and sufficient course of estrogen-free rhGH therapy is needed to yield a satisfactory FAH.

Comparison of final adult height in boys with idiopathic short stature accepted growth hormone treatment or not / 中国基层医药

Objective In order to understand whether recombinant human growth hormone(r-hGH) can improve the idiopathic short stature(ISS) boys' final adult height(FAH).Methods We measured 16 cases diagnosed as ISS boys FAH, divided into 2 groups, of which 9 cases were not given r-hGH treatment, treatment group ,7 patients received r-hGH treatment, a dose of 0.1 ～ 0.13 U· kg-1·d-1, before going to sleep subcutaneous injection, duration of treatment was 6 ～ 20 months ( 11.9 ± 5.2 months).Results The treatment group compared with the average FAH FAH observation group had significantly improved the average(t =2.219,P<0.05).Conclusion r-hGH can improve the ISS boys FAH, but early treatment, the longer the course the more obvious effects.

Long-term follow up of childhood-onset primary growth hormone deficiency: clinical analysis of 80 cases / 中华内分泌代谢杂志

Objectives To evaluate final adult height(FAH), lipid profile, sexual development, and quality of life in individuals with childhood-onset growth hormone deficiency (CO-GHD) during the transition from childhood to adulthood, to reassess the function of GH-IGF-I axis, and to explore effective managements for different types of GHD in each period. Methods Totally 80 CO-GHD patients were divided into 2 groups; 22 patients with isolated growth hormone deficiency ( IGHD) and 58 patients with multiple pituitary hormone deficiencies (MPHD); 62 male (age ≥18 years) and 18 female ( age ≥ 16 years) patients. The clinical and biochemical parameters, education and occupation, rhGH, and other hormones therapy in the past were followed up. Results rhGH replacement improved FAH of patients with GHD. The incidences of either hyperlipidemia (39.0% , 47.4%) or fatty liver disease (26.8%, 31.6%) showed no statistically significant changes between 2 groups with and without rhGH replacement. Mean value of IGF-I SDS was significantly higher in IGHD group than that in MPHD group (-1.43±0. 31,-3. 01 ±0. 66) ,and also IGFBP3(-2. 10±0. 33,-3. 17±0. 19,all P< 0.05 ). Patients with IGHD had normal sexual development, but the incidence of sexual dysfunction accounted for 79.7% in MPHD group. Conclusions rhGH improves FAH of individuals with CO-GHD. Patients with CO-GHD should be followed during the transition period; GHD patients carry a high risk of metabolic abnormalities in the adulthood; IGHD female can give birth to offsprings; patients with MPHD have gonadotrophin deficiency of varying degrees.

Final Adult Height of Children with Normal Endocrine Function after Hematopoietic Stem Cell Transplantation / 대한소아내분비학회지

PURPOSE: We analyzed the final adult height of patients without endocrine dysfunction who underwent hematopoietic stem cell transplantation (HSCT) during the childhood. METHODS: We evaluated the final height of 28 long term survivors (13 males, 15 females) who underwent HSCT at the mean age of 12.3 years. Patients who had solid tumors, inherited diseases and endocrine dysfunction before or after HSCT were excluded. The mean age at last visit was 18.8 years. Height values were expressed in standard deviation score (SDS). Height at HSCT was compared with final height as well as mid-parental height. We analyzed the risk factors for affecting final adult height of patients. RESULTS: There was a decrease in final height SDS compared to pre-transplantation height SDS (P= 0.003). All patients except one reached an adult height above -2.0 SDS of normal population. The difference between the height SDS at HSCT and the final height was -0.98+/-0.5 SDS in boys and -0.10+/-0.6 SDS in girls (P<0.01, and P=0.53 respectively). A significant decrease in height SDS was found in male (Mann-Whitney U test, P=0.001). The type of primary diseases, age at HSCT, total body irradiation, acute graft-versus-host disease did not influence the final height. CONCLUSION: Despite the decrease in final height SDS after HSCT during childhood, the majority of patients without endocrine dysfunction spontaneously reached on a normal adult height range (above -2.0 SDS). Therefore, careful monitoring of growth after HSCT during childhood is warranted to detect the growth velocity decrease.

Factors affecting the final adult height in survivors of childhood brain tumors / 소아과

PURPOSE: Short stature is an important complication that impairs the quality of life in survivors of childhood brain tumors. We studied their final adult height (FAH) to evaluate risk factors for short stature. METHODS: We reviewed the medical data of 95 survivors of childhood brain tumors (64 males and 31 females) who had been followed up from 1982 to 2006, reached FAH, and had a more than five year-disease-free survival. RESULTS: Final adult height standard deviation score (FAHTSDS: mean+/-SD) of the patients was lower than those of general population (-1.15+/-1.72), HTSDS at diagnosis (-0.13+/-1.57), and target HTSDS (-0.49+/-0.69). FAHTSDS of craniopharyngioma patients did not decrease (0.57+/-1.17), but those of germ cell tumor and medulloblastoma patients were significantly reduced (-1.20+/-1.45, -2.70+/-1.46; P<0.05). The patients treated with craniospinal radiation or chemotherapy had lower FAHTSDS (-1.93+/-1.58, -2.27+/-1.44; P<0.01). In the spinal irradiation group, the younger the age at diagnosis was, the more the loss of FAH (r=0.442, P<0.01). Growth hormone replacement (GHR) didn't improve FAHTSDS, but starting GHR under 12 years was an independent factor for improving FAH once treatment methods were taken into account (P=0.01). CONCLUSION: The younger age at diagnosis, spinal radiation and chemotherapy were all important risk factors of height loss, and height gain was expected in patients who received GHR under the age of 12 years. Therefore, regular check-ups of growth and early intervention with growth hormones are needed for high risk groups to improv

Final Adult Height and Its Influencing Factors in Patients with Congenital Adrenal Hyperplasia Caused by 21-Hydroxylase Deficiency / 대한소아내분비학회지

PURPOSE: We evaluated adult final height and factors influencing adult height outcome in patients with congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency. METHOD: We retrospectively reviewed medical records of 20 male and 22 female patients with 21- hydroxylase deficiency who reached adult final height from 1980 to 2004. We obtained final adult height and analysed possible factors influencing final adult height such as urine 17-ketosteroid (17- KS), plasma 17-OH-progesterone (17-OHP), plasma renin activity, pubertal initiaton age, glucocorticoid dose, age at diagnosis and effect of growth hormone or gonadotropin releasing hormone analogue. RESULT: Mean FH (final height) SDS-MPH (midparental height) SDS were -1.89+/-1.0 in male simple virilization (SV) and -0.83+/-0.8 in female SV patients, -2.27+/-1.3 in male salt wasting (SW) and -1.12+/-1.1 in female SW patients. Mean final adult height and mean FH SDS-MPH SDS were not different between SV and SW patients, but mean FH SDS-MPH SDS in males was significantly lower than that of females (-2.12+/-1.2 vs 0.95+/-0.9, P<0.05). In SW mean FH SDS-MPH SDS were correlated positively with pubertal height gain (r=0.484. P<0.05) and correlated negatively with pubertal initiation age (r=-0.334, P<0.05). but mean FH SDS-MPH SDS were not correlated with age at diagnosis, glucocorticoid dose, urine 17-KS level, plasma 17-OHP level, plasma renin activity, treatment with growth hormone or gonadotropin releasing hormone analogue in both SW and SV. CONCLUSION: Mean final height and mean FH SDS-MPH SDS in 21-hydroxylase deficiency were below the mean for the general population. In SW, adult final height was correlated with pubertal initiation age and pubertal height gain. Therefore it should be important to control early onset of puberty and make improvement pubertal height gain during puberty.

Factors Affecting Final Adult Height in Patients with Turner Syndrome / 소아과

PURPOSE: Short stature is one of the characteristic features of Turner syndrome. We investigated the factors affecting final adult height(FAH) in patients with Turner syndrome. METHODS: The study group was comprised of 60 patients who were diagnosed with Turner syndrome by chromosomal study and clinical phenotypes and attained FAH. Data were obtained from retrospective review of the medical records. We analyzed the factors influencing FAH in growth hormone(GH) treated and GH untreated groups. RESULTS: Sixty patients were enrolled; 48 patients received GH treatment, and 12 patients did not. Mean duration of GH treatment was 35.8 months(range 4 to 120 months), and mean dosage of GH was 0.8+/-0.2 IU/kg/wk in GH treated group. Mean growth velocity was 5.6+/-2.0 cm/yr, which was significantly higher than that during pretreatment period. In the GH treated group, mean chronological age, bone age, mean height, and height standard deviation(SD) score at GH treatment were 12.2+/-2.7 yr, 10.3+/-2.5 yr, 127.5+/-10.1 cm and -3.1+/-1.1, respectively. In the GH treated group, the mean FAH and SD score of FAH were 146.9+/-5.8 cm and -2.7+/-1.2, respectively, which showed significant differences compared with those of the GH untreated group. Analyzing the factors affecting FAH in GH-treated patients, only the SD score of height at the time of treatment was significantly related to FAH. CONCLUSION: GH treatment leads to an increment in FAH in patients with Turner syndrome. Average FAH gain was as much as 5.8 cm. SD score of height at the time of GH treatment was the only factor influencing FAH.

Factors Affecting on Final Adult Height and Total Height Gain in Children with Idiopathic and Organic Growth Hormone Deficiency after Growth Hormone Treatment

PURPOSE: The purpose of this study was to evaluate the factors affecting the final adult height and total height gain in idiopathic and organic growth hormone deficient(GHD) children after growth hormone(GH) treatment. METHODS: Thirteen patients with idiopathic GHD and 22 patients with organic GHD who had been treated with GH and attained adult final height were included in this study. Factors which could affect the final adult height(FAH) and total height gain, were evaluated. RESULTS: Height SDS(standard deviation score) at initial GH treatment in idiopathic GHD was significantly shorter than that in organic GHD(-4.13+/-1.28 vs -1.66+/-1.06, P<0.001). Growth velocity during the first year of GH treatment was 9.69+/-3.19 cm(idiopathic GHD) and 7.87+/-3.65 cm(organic GHD). Height(SDS) at puberty in organic GHD was significantly greater than in idiopathic GHD (-0.55+/-1.25 vs -2.28+/-0.95, P<0.001). Final adult height(SDS) was significantly greater in organic GHD than in idiopathic GHD(0.22+/-1.06 vs -1.44+/-0.84, P<0.001). In idiopathic GHD, total height gain (SDS) was most significantly correlated with midparental height minus initial height(MPH-IH)(SDS) (r=0.886, P<0.001). Total height gain(SDS) was more significantly correlated with MPH-IH(SDS) and prepubertal height gain(SDS) in idiopathic GHD(r=0.640, P=0.01, r=0.801, P<0.001). CONCLUSION: Final adult height was greater in organic GHD than in idiopathic GHD patients. While total height gain(SDS) was more pronounced in children with lower initial height compared to MPH, absolute final adult height was influenced by height at puberty. To improve the final adult height in children with GHD, height at onset of puberty must be increased by early diagnosis and continuous treatment with optimal doses of GH. There results should be evaluated with more patients.

Effect of recombinant human growth hormone on final adult height in children with growth hormone deficiency / 中华内分泌代谢杂志

0.05).Conclusion GH improves FAH of children with GHD.Height at the initiation of puberty is the most significant determining factor for the long-term efficacy.Hence,it is important that the diagnosis should be made and treatment be initiated as early as possible to afford children with GHD the opportunity to make up much of their height deficit before puberty.Adequate dosage of GH should be used for the children taking initial treatment at puberty to attain satisfactory FAH.

Factors Affecting the Presence of Menarche and Final Adult Height in Adult Female Patients with Congenital Adrenal Hyperplasia of 21-Hydroxylase Deficiency

PURPOSE: Amenorrhea and short stature are serious complications in patients with congenital adrenal hyperplasia of 21-hydroxylase deficiency(CAH). We analysed several factors influencing the presence of menarche and final adult height in these patients. METHODS: We retrospectively reviewed medical records of 24 female patients with CAH. We analysed possible factors affecting the menarche and final adult height, such as clinical type, predicted adult height, age at treatment, age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP. RESULTS: The occurrence rate of menarche were significantly higher in patients with the simple virilizing form rather than the salt losing form(P<0.05). No significant differences were found in age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP between menarche group and amenorrhea group. The age at treatment was younger in amenorrhea group(P<0.05). There were no significant differences in the proportion of patients who attained predicted adult height between two clinical types. No significant differences were found in age at treatment, age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP between the group of patients who attained predicted adult height and the group of patients who didn't. Final adult height did not show any correlation with age at treatment, age at onset of puberty, BMI, and plasma levels of DHEA and 17-OHP but showed significant correlation with mid-parental height(r=0.426, P=0.01). CONCLUSION: Our data suggest that the presence of menarche in patients with CAH depends on the degree of prenatal exposure to adrenal androgen regardless of the degree of postnatal control and age at onset of puberty. Additionally, it seems likely that mid-parental height determines the final adult height.

Factors Affecting Final Adult Height in Patients with Congenital Hypothyroidism / 대한소아내분비학회지

PURPOSE: Thyroid hormone is essential for normal growth and development. The aim of this study was to evaluate the factors affecting final adult height in patients with congenital hypothyroidism. METHODS: The study group was comprised of 42 patients who were diagnosed as congenital hypothyroidism and attained final adult height. Retrospectively, we reviewed medical records as to clinical and laboratory data. We analyzed the influence of various factors on final adult height(FAH) in patients with congenital hypothyroidism. RESULTS: The mean chronologic age at initiation of treatment was 5.85+/-4.32 years and the FAH deviation score(SDS) was -1.21+/-1.14. The age at initiation of treatment, the chronologic age, the mean dose of L-thyroxine of current treatment, and the bone age delay at initiation of treatment were negatively related to the FAH SDS(P<0.05). The height SDS at initiation of treatment and the height SDS at initiation of puberty were positively related to the FAH SDS(P<0.05). Analyzing according to etiology, the FAH SDS of dyshormonogenesis, thyroid aplasia, thyroid ectopia, and thyroid hypoplasia were 0.16+/-0.27, -1.15+/-0.97, -1.45+/-1.07, and -2.70+/-1.70 respectively(P<0.05). CONCLUSION: The younger the age at initiation of treatment and the chronologic age, and the more the mean dose of L-thyroxine of current treatment and the bone age delay at initiation of treatment, The higher the final adult height SDS. The higher the height SDS at initiation of treatment and the height SDS at initiation of puberty, the final adult height SDS were the higher.

Factors affecting Final Adult Height in Turner Syndrome / 대한소아내분비학회지

Purpose : Shortness is the most frequent and quite disturbing characteristics of patients with Turner syndrome. The aim of this study was to evaluate the factors affecting final adult height(FAH) in these patients. METHODS : The study group was comprised of 19 patients who were diagnosed as Turner syndrome and attained FAH. We analyzed the influences of various factors on FAH in GH treated group with those in GH untreated group. Results : Nineteen patients were enrolled; thirteen received GH treatment and six did not. The mean duration of GH treatment was 24.3 months(range : 9 to 50 months), and the mean dosage of GH was 0.98+/-0.35IU/kg/wk in GH treated group. The mean growth velocity during GH treatment was 5.6+/-1.8 cm/yr, which was significantly higher than that during pretreatment period(P<0.05). In GH treated group, the mean chronological age, bone age, mean height, and height SD score at GH therapy were 13.7+/-1.7yr, 11.3+/-1.9yr, 129.7+/-7.9cm, and -4.1+/-1.1, respectively, which were not statistically different from those at diagnosis of GH untreated group. In GH treated group, the mean FAH and FAH SD score were 144.8+/-5.0cm, and -3.2+/-0.9, respectively, which showed no significant difference compared with those of GH untreated group. Analyzing the factor affecting FAH in all Turner girls of both groups together, parental height, chronological age, bone age, and bone age delay at diagnosis(or at the initiation of GH therapy) were not related to FAH. Height and height SD score at diagnosis(or at the initiation of therapy) were positively related to FAH(P<0.05, r=0.72). CONCLUSION : The results suggest that GH treatment dose not improve FAH in patients with Turner syndrome, despite increased growth velocity during GH treatment, which might come from intermittern GH therapy. This should be remained to be clarified with more Turner patients who attained FAH.

Growth Hormone Therapy in Girls with Turner Syndrome; Results of the Korean Turner Study Group / 대한소아내분비학회지

PURPOSE:Short stature relative to the familial height potential is a universial characteristics of patients with Turner syndrome. growth hormone(GH)therapy has been shown to improve adult height in Turner syndrome. this study was done to determine the effects of GH treatment. Objects and METHOD:178 patients were enrolled by investigators at multiple center. Diagnosis of Turner syndrome confirmed by karyotype analysis. Growth rate of 121 patients who were given Recombinant human GH(0.6-1.0IU/kg/Week) by subcutaneous injection for 1-3 years were analized. Final adult height was defined by the growth rate which was less than 1cm/year. RESULTS:Height velocity increased significantly during GH treatment, particularly in the first year. mean height velocity of our Turner patients was 6.3(+/-.39)cm/year during the first year(121 patients), 5.3(+/-.72)cm/year during second year(92 patients), 4.6(+/-.62)cm/year during third year(72 patients) after GH treatment. Mean height velocity of our Turner patients without GH treatment was 3.8(+/-.47)cm/year. the final adult height of our Turner patients with GH trearment was 143.0(+/-.6)cm. the final adult height without GH trearment was 139.6(+/-.9)cm. CONCLUSION: Our data demonstrate that GH treatment seems effective in accelerating growth velocity and in improving final height in Turner syndrome. the final height of our Turner patients is not to be considered the best result, as most of them was received GH therapy late age.

Growth Promoting Factors Which Affect Final Adult Height / 대한소아내분비학회지

PURPOSE:Factors influencing postnatal growth are innumerable. It is known that genetic factors such as parental height and environmental factors such as nutrition, economic status and hormonal effects are important factors. The purpose of this study was to examine the factors affecting final adult height in normal children. METHODS:753 high school students (513 boys, 240 girls) who live in Seoul were studied. Height and body weight were measured and questionaires about sexual development were examined. We included the subjects who reached fianl adult height. The criteria of final adult height was as following: ages over 17 years in the boys and over 15 years in the girls and growth velocity was less than 1 cm per year. They had no systemic diseases and height standard deviation scores were more than -2.5. RESULTS: 1)Final adult heights were 173.1+/-.1cm in boys and 160.9+/-.7cm in girls. 2)Final adult height significantly correlated with father height(r=0.13, p<0.01), mother height(r=0.25, p<0.01), midparental height(r=0.25 p<0.01) and birth weight (r=0.16, p<0.01). 3)In short final adult height groups, birth weight and midparental height were significantly lower(p<0.05), but puberty onset age, body mass index and economic status were similar to normal stature groups. 4)Final adult height significantly correlated with target height.(r=0.43, p<0.01). In boys, the final adult height was 1.7cm taller than target height on the average. In girls, final adult height was 1.6cm taller than target height on the average. 5)In the group in which final adult height is less than target height, birth weights were significantly lower than those of the groups in which final height is greater than target height. CONCLUSIONS:Among factors affecting final adult height, parent height and birth weight were important. To predict final adult height, target height can be used simply and target height showed significant correlation with final adult height. In the case of showing differences between final adult height and target height, many factors including birth weight will influence the outcome.

Final Adult Height in Patients with Turner Syndrome / 대한소아내분비학회지

PURPOSE: Short stature is the most constant finding in Turner syndrome. Short stature in Turner syndrome has lately received considerable attention, mostly because of recent attemp to improve growth by hormonal treatments; growth hormone, oxandrolone, estrogen. The aim of this study was to find out whether growth promoting treatment would improve final height in girls with Turner syndrome. METHODS:Seventy-one girls with the clinical chracteristics Turner syndrome verified by karyotype analysis were entered into this study. The following selection criteria for final adult height were used; Chronological age of more than 14years old, bone age of more than 15years old and growth velocity of less than 0.5cm per 6months. Analysis was performed by means of multiple regression analysis between descriptive data; modality of treatment with oxandrolone and/or estrigen, parental height, karyotype and final adult height. RESULTS: 1) The final adult height of untreated Turner syndrome was 138.9+/-3.9cm. 2)The final adult height in 29 GH treated Turner girls was 143.9+/-6.5cm, significant higher value than 42 GH untreated Turner girls height, 139.8+/-5.2cm(p<0.01). 3) The final height in GH only group and combined group were 141.2+/-6.0cm, 146.2+/-6.2cm, respectively. The combined therapy was more effective than GH therapy(p<0.01). 4) The final height in 32 patients with karyotype of 45,X was 141.6+/-5.6cm, and that of 31 structural aberration group was 140.3+/-6.2cm. There was no significant difference between two groups. But in mosaicism, only numeric abnormalities, the final height 145.9+/-6.1cm was much more higher than other two groups(p<0.05). 5) The final adult height in Turner syndrome was in good correlation with target height. Final adult height(cm)= 1.01*Target height(cm)- 4.97 r=0.51, p<0.05. 6) There was positive correlation between final adult height and height SDS at start GH treatment and negative correlation with age at start GH treatment. The delta height (final height - height at start treatment) correlate with GH treatment duration. CONCLUSIONS:The final adult height in Turner syndrome in a given ethinic or national population varies in the same way as adult height in normal women. Growth hormone therapy may increase final height in Turner syndrome irrespective of ethinic or national difference. Further growth was observed in GH combined with estrogen or oxandrolone.