Adult height in children with short stature and idiopathic delayed puberty after different management

Stefano Zucchini, Malgorzata Wasniewska, Mariangela Cisternino, Mariacarolina Salerno, Lorenzo Iughetti, Mohamad Maghnie, Maria Elisabeth Street, Manuela Caruso-Nicoletti, Stefano Cianfarani

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Abstract

By retrospectively collecting data from nine Italian centres of pediatric endocrinology, we assessed the different management and final outcome of children with short stature and idiopathic delayed puberty. Data were obtained in 77 patients (54 males, 23 females) diagnosed and followed-up in the various centres during the last 15 years. Inclusion criteria were short stature at initial observation and idiopathic delayed puberty diagnosed during follow-up. At first observation, age was 13.8 ± 1.0 years and height standard deviation score (SDS) was -2.6 ± 0.6 in males. In females age was 13.1 ± 0.9 years and height SDS -2.6 ± 0.4. Local diagnostic and therapeutic protocols included testing for growth-hormone deficiency (six centres) and treatment in case of deficiency or, in the remaining centres, testosterone or no treatment in males, and no treatment in females. At diagnosis, both in males and in females, the auxological features (height SDS, target height SDS and bone age delay) were similar in the patients treated with growth hormone, testosterone or not treated. Overall 32 patients received growth hormone (25 males, 7 females), 33 no treatment (17 males, 16 females) and 12 testosterone. There was no difference in the adult height of males and females in the different treatment groups. In males there were no differences between adult and target height SDSs (growth hormone-treated 0.31 ± 0.79, untreated 0.10 ± 0.82, testosterone-treated 0.05 ± 0.95), between adult and initial height SDSs (growth hormone-treated 1.70 ± 0.93, untreated 1.55 ± 0.92, testosterone-treated 1.53 ± 1.43) and percentage of subjects with adult height above target height. In females, there were no differences between adult and target height SDSs (growth hormone-treated -0.49 ± 1.13; untreated 0.10 ± 0.97) and between adult and initial height SDSs (growth hormone-treated 1.76 ± 0.92; untreated 1.77 ± 0.98), whereas a significantly higher percentage of patients remained below target height in the growth hormone-treated group (6/7, 85.7% vs 5/11, 31.3%) (P = 0.02). In conclusion, the diagnostic and therapeutic management of the patients with short stature and delayed puberty is different among Italian pediatric endocrinologists. Our data do not support the usefulness of growth-hormone therapy in improving adult height in subjects with short stature and delayed puberty, particularly in the female sex.

Original languageEnglish
Pages (from-to)677-681
Number of pages5
JournalEuropean Journal of Pediatrics
Volume167
Issue number6
DOIs
Publication statusPublished - Jun 2008

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Keywords

  • Adult height
  • Delayed puberty
  • GH therapy
  • Short stature
  • Testosterone

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Zucchini, S., Wasniewska, M., Cisternino, M., Salerno, M., Iughetti, L., Maghnie, M., Street, M. E., Caruso-Nicoletti, M., & Cianfarani, S. (2008). Adult height in children with short stature and idiopathic delayed puberty after different management. European Journal of Pediatrics, 167(6), 677-681. https://doi.org/10.1007/s00431-007-0576-y