ESPE Abstracts

Objective: To summarize the prevalence of compromised linear growth in 21OHD and its final adult height (FAH).

Methods: Clinical data of children with CAH 21OHD from pediatric endocrinology clinics at the First Affiliated Hospital of Sun Yat-Sen University from January 1990 to February 2023 were included. The prevalence and types of compromised linear growth in 21OHD and related factors were discussed. FAH and its related factors were also included.

Results: A total of 358 children with classic CAH 21OHD were included. 1) The prevalence of compromised linear growth: 221/358 (61.73%) were found with compromised linear growth classified into three types: HtSDSca<-2(Type A), HtSDSba<-2(Type B) and abnormally slowly growth (defined as a decrease in HtSDSca≥0.25 in 12 months) (Type C). The prevalence of compromised linear growth in SW form was lower than that in SV form (54.79% vs 69.41%, P <0.01); and in those with “early diagnosis” was lower than in "late diagnosis” (54.26% vs 70.00%, P <0.01). 2) The types of compromised linear growth in CAH 21OHD: 9.22%, 50.28% and 10.06% were found with type A, type B, and type C, respectively. 54.44% in CAH 21OHD with type B were found with initiated hypothalamic-pituitary-gonadal axis. 65.00% in CAH 21OHD with type C showed increased height growth rate accompanied by accelerated bone maturation. 3) Final adult height: 88/221 (39.82%) had reached their FAH with (-1.43±1.22) SD and FAHTht (FAH for target height) (-0.85±1.22) SD. The FAHTht were higher in females, SV and those with adjuvant treatment compared with males, SW and those without adjuvant treatment, respectively (female 0.54±0.99 vs males -1.19±1.39, P = 0.013; SV -0.61±1.13 vs SW -1.18±1.30, P = 0.033; with adjuvant treatment -0.69±1.07 vs without adjuvant treatment -1.60±1.70, P = 0.011).

Conclusion: 1) Compromised linear growth was common in classic CAH 21OHD, and the prevalence of various types (from high to low) were type B (HtSDSBA <-2), type A(HtSDSca<-2) and type C(abnormally slow growth). 2)The prevalence of compromised linear growth was lower in SW form than that in SV; lower in "early diagnosis" than that in "late diagnosis". 3) Consideration should be given to the bone age advancement when the growth rate appears to rebound (△HtSDSca>0) in slowly growing children. 4)The adult height of CAH 21OHD with compromised linear growth were higher in girls, SV and those with adjuvant treatment than in boys, SW and those without adjuvant treatment, respectively.