ESPE2024 Poster Category 2 Growth and Syndromes (39 abstracts)
What is The Most Effective Method for Predicting Adult Height in Boys with Constitutional Delay of Growth and Puberty?
Gözde Akın Kağızmanlı 1 , Deniz Özalp Kızılay 2 , Reyhan Deveci Sevim 3 , Kübra Yüksek Acinikli 1 , Fulya Mete Kalaycı 2 , Ayşegül Tekneci 3 , Korcan Demir 1 , Ece Böber 1 , Ahmet Anık 3 , Samim Özen 2 & Ayhan Abacı 1
1Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey. 2Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey. 3Aydın Adnan Menderes University Faculty of Medicine, Department of Pediatric Endocrinology, Aydın, Turkey
Background: Predicted adult height (PAH) can be calculated using methods such as Bayley-Pinneau (BP), Roche-Wainer-Thissen (RWT), and BoneXpert based on bone age (BA) assessment. Since these methods were developed for healthy children, conflicting results have been reported regarding their effectiveness in different patient groups.
Objective: This study aim ed to determine the most accurate method for PAH by comparing the BP, RWT, and BoneXpert methods in boys with constitutional delay of growth and puberty (CDGP).
Subjects and Methods: We included 62 male patients diagnosed with CDGP who reached their final height (FH). The clinical findings were retrospectively analyzed. Two researchers assessed the left-hand and wrist radiographs taken at the time of diagnosis using the Greulich-Pyle (GP) atlas and manually determined the BA. Among the methods used for PAH, the GP atlas was used for BP and RWT, while for the BoneXpert method, we used its software.
Results: The mean age at diagnosis of the patients was 14.2 ± 0.8 years, and 58.1% (n =36) had a similar family history. The mean height SD score was -2.1 ± 0.9, and 24.2% (n =15) of patients received low-dose testosterone induction therapy. The median BAs of the patients were 12.5 (11.5–13.0) years using the GP atlas and 12.6 (11.8–13.4) years with BoneXpert (P <0.001). Boys who were treated or not treated with testosterone had similar ages, heights, and median BAs with both methods. The mean target height and FH SD scores were -0.6 ± 0.6 and -0.6 ± 0.9, respectively (P =0.8). Almost all of the patients (n =60, 97%) achieved adult height within the target range, and there was no significant difference in the FH SD score between boys who received testosterone and those who did not (P =0.1). There was no significant difference between the FH and PAH when estimated by the BP and RWT methods (P =0.2 and P =0.6, respectively), while the BoneXpert method underestimated the FH (P <0.001) (Table 1). The BP and RWT methods gave better predictions in patients with BA ≤ 2 years compared to BoneXpert (P =0.3 and P =0.4 vs. P <0.001, respectively). On the other hand, RWT and BoneXpert methods were more accurate in PAH in boys with delayed BA >2 years (P =0.1 and P =0.1, respectively), while the BP method resulted in overestimation (P =0.003).
Conclusion: The RWT method was found to be a better predictor of FH than the BP or BoneXpert methods in boys with delayed BA ≤ 2 years and >2 years.
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