Height and Weight Dynamics in Preschool Boys with Constitutional Delay of Growth and Puberty

Thomas Reinehr; Elisa Hoffmann; Juliane Rothermel; Thersia Lehrian; Gerhard Binder

Background: Constitutional delay of growth and puberty (CDGP) is one of the most frequent norm variants in children presenting with short stature. Knowing the height, growth, and weight pattern of CDGP in the first years of life is important to distinguish CDGP from growth hormone deficiency (GHD) or other diseases.

Methods: We studied height and weight in the first 5 years of life in 54 boys with CDGP including measurements of adult height and weight at the age of >20 years.

Results: Height-SDS and BMI-SDS decreased between birth and chronological age of 2 years and increased between puberty and final observation. While at 1 year of age 7.7% of the boys were underweight, 26% of boys with CDGP were underweight at 2 years. In contrast, at adult age 77.8% of the boys had a BMI in the normal range and 16.7% were underweight.

Table: Height, height-SDS, qeight, BMI, and BMI-SDS over time
Time point	Height [cm]	Height-SDS	Weight [kg]	BMI [kg/m²]	BMI-SDS	p-value height-SDS compared to previous observation	p-value BMI-SDS compared to previous observation
birth	51 (49-53)	-0.36 (-1.03- 0.30)	3.18 (2.84 - 3.42)	12.0 (11.0 - 13.0)	-0.37 (-1.36 – 0.33)	-	-
6 months	68 (65-69)	-0.70 (-1.18- -0.12	7.67 (7.09 – 8.20)	17.0 (15.7 - 17.7)	0.07 (-0.84 – 0.87)	0.004	n.s.
12 months	73 (71-75)	-1.16 (-15.4- -0.42)	8-93 (8.35 – 9.52)	16.6 (16.0 - 17.3)	-0.08 (-0.76 – 0.53)	<0.001	n.s.
2 years	84 (82-87)	-1.39 (-2.02- -0.47)	11.1 (10.5 - 12.4)	15.5 (14.6 - 17.0)	-0.68 (-1.45 - 0.50)	0.035	0.031
4 years	99.0 (96.1-102.0)	-1.32 (-1.89- -0.37)	14.4 (13.6 - 16.0)	14.9 (14.1 - 15.6)	-0.66 (-1.44 - -0.02)	n.s.	n.s.
5 years	106.3 (103.0-110.0)	-1.11 (-1.89- -0.21)	16.4 (15.5 - 18.2)	14.5 (14.0 - 15.5)	-0.82 (-1.35 – 0.06)	n.s.	n.s.
visit clinic [~14 years]	147.6 (142.8-154.5)	-2.24 (-2.68- -1.39)	36.0 (31.9 - 45.0)	16.8 (15.3-18.6)	-1.35 (-1.91- -0.48)	<0.001	<0.001
Last observation [~22 years]	174.6 (170.8-179.0)	-0.66 (-1.21-0.01)	66.5 (60.0 - 73.7)	21.9 (19.9 - 23.9)	-0.14 (-0.92 - 0.40)	<0.001	<0.001
Data as median and interquartile range, n.s.: not significant

Conclusion: Height and weight deflection in CDGP occurs already during the first two years of life. Leanness is a typical feature of CDGP during childhood, while boys with CDGP frequently have a healthy weight status as adults. This characteristic pattern of growth and weight changes might be helpful to distinguish CDGP from other diseases with short stature.

ESPE Abstracts

P1-231