Relationship between the timing of the physical changes of puberty and total pubertal growth in healthy adolescents: new insights which can provide helpful clinical guidance

Georgina Yan; Anton Holmgren; Kerstin Albertsson-Wikland; Gary Butler

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ESPE Abstracts (2024) 98 FC13.4

ESPE2024 Free Communications Pituitary, Neuroendocrinology and Puberty 2 (6 abstracts)

Relationship between the timing of the physical changes of puberty and total pubertal growth in healthy adolescents: new insights which can provide helpful clinical guidance

Georgina Yan ^1,2 , Anton Holmgren ^3,4,5 , Kerstin Albertsson-Wikland ⁶ & Gary Butler ^1,7

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¹University College London Great Ormond Street Institute of Child Health, London, United Kingdom. ²Paediatric ED, Royal London Hospital, London, United Kingdom. ³Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. ⁴Department of Paediatrics, Halland Hospital, Halmstad, Sweden. ⁵Department of Research and Development, Region Halland, Halmstad, Sweden. ⁶Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. ⁷University College London Hospital, London, United Kingdom

Introduction: In healthy adolescents, there is significant inter-individual variation in the timing of peak height velocity (PHV) and the total growth achieved during puberty. The relationship between physical changes of puberty and pubertal growth has been studied previously, but further detail is needed for use in clinical practice, especially where there are worries that early or late pubertal onset will curtail the magnitude of the pubertal growth spurt. Our aim was to explore this relationship through an analysis of data from a pure longitudinal growth study.

Methods: The Edinburgh longitudinal growth study included healthy children born as singletons between 1972-1976 with a birth weight of >2.5 kg (1). Anthropometric measurements and Tanner staging were undertaken twice a year. Pubertal growth was quantified using the QEPS-growth-model, which generates an individual growth curve from birth-length to adult height (AH) and has been previously validated in this cohort (2). The QEPS-model calculates the individual height gain and duration of pubertal growth, the total growth during puberty from both specific pubertal growth and basic growth (3).

Results: 157 adolescents were included in analysis (89 boys, 68 girls). In girls, variation in reaching B3 ranged between 9.78 and 15.27 years. Age at B3 was negatively correlated with total pubertal growth and contribution of pubertal growth to AH (Pearson coefficients -0.64, P <0.01 and -0.67, P <0.01, respectively). There was no correlation between age at B3 and AH (0.15, P = 0.24). In boys, variation in reaching G4 ranged between 11.51 and 16.55 years. Age at G4 was negatively correlated with total pubertal growth (coefficient -0.24, P <0.04) and contribution of pubertal growth to AH (-0.27, P = 0.02). However, there was no correlation between age at G4 and AH (0.02, P = 0.86).

Discussion: Our results reveal how the shape and size of the pubertal growth spurt are associated with age at reaching mid-puberty as Tanner stage B3 in girls and G4 in boys, but there were no consequential effects of the variation in the timing of these landmarks on adult height. This new knowledge can provide reassurance in the clinical setting for children with no underlying health issues, in that starting pubertal growth earlier or later than their peers will not curtail their expected adult height.

References:

1. Ratcliffe SG et al Birth Defects Orig Artic Ser. 1990;26(4):1–44.

2. Holmgren A et al Pediatr Res. 2022 Aug;92(2):592-601. doi: 10.1038/s41390-021-01790-2.

3. Nierop AFM et al J Theor Biol. 2016 Oct 7:406:143-65. doi: 10.1016/j.jtbi.2016.06.007.