ESPE2022 Poster Category 1 Adrenals and HPA Axis (52 abstracts)
Objective: Patients with congenital adrenal hyperplasia (CAH) seldom achieve their target height. Early adrenarche may accelerate bone age maturation and affect adult height. The QEPS-growth-model have been used for developing growth references and investigating healthy/pathological growth, however, not before used in individuals with endocrine disorders. This study aimed to evaluate growth patterns in CAH-patients with the QEPS-model.
Methods: Longitudinal growth-data were collected from 25 CAH-patients (13 girls) at Lithuanian University of Health Sciences Hospital1. The QEPS-model2 was used, and the model’s growth-functions and estimates were compared with the GrowUp1974Gothenburg cohort, used for both Swedish growth reference and when developing the QEPS-growth model.
Results: The CAH-patients were similar with the GrowUp1974cohort in birth characteristics and parental heights, except CAH-patients being longer at birth. The CAH-patients had faster tempo of growth as shown by both shorter E-timescale (E-growth function in QEPS-model representing mainly foetal/infancy growth) and earlier onset of pubertal growth. The specific pubertal height gain was lower in CAH-patients and their adult height was lower than expected from parental heights, details in Table1.
|Variable||Mean CAH girls (n13)||Mean Gothenburg girls (n1165)||P-value||Mean CAH boys (n12)||Mean Gothenburg boys (n1174)||P-value|
|Gestational age (weeks)||39.08||39.78||0.221||39.42||39.68||0.258|
|Birth length (cm)||51.50||49.95||0.005||53.45||50.53||< 0.001|
|Birth weight (kg)||3.238||3.410||0.096||3.659||3.515||0.164|
|Mother’s height (cm)||166.6||166.1||0.386||166.9||166.8||0.473|
|Father’s height (cm)||179.9||180.1||0.456||179.8||179.5||0. 437|
|Etimescale1||0.89||1.01||< 0.001||0.80||1.01||< 0.001|
|Emax (cm)||61.26||62.85||<.0.036||60.14||65.07||< 0.001|
|Age P5%3(years)||8.60||9.87||< 0.001||9.97||11.82||< 0.001|
|Age at peak height velocity (years)||10.39||11.84||< 0.001||11.92||13.69||< 0.001|
|Pmax4 (cm)||8.87||12.80||< 0.001||10.86||17.38||< 0.001|
|Tmax5 (cm)||158.10||167.26||< 0.001||169.43||180.53||< 0.001|
|1=Tempo of the exponential (E) growth function. 2=Quadratic growth function from before birth until adult height. 3=Age at 5% (onset) of pubertal growth. 4=Specific pubertal height gain. 5=Calculated total/adult height.|
Conclusion: The QEPS-model has now for the first time been used and proven to characterize growth patterns in patients with CAH. CAH-patients had distinct different growth patterns when compared with a healthy reference population, including faster tempo of growth during infancy/early childhood and puberty with earlier onset, lower specific pubertal gain, resulting in shorter adult height.
1. Navardauskaitė, R, et. al. Medicina(Kaunas). 2021 Sep 29; 57(10):1035
2. Nierop, AF, et. al. J. Theor. Biol. 2016;406:143-65
15 Sep 2022 - 17 Sep 2022