Adult height prediction by bone age determination in children with isolated growth hormone deficiency

Abstract

Background: The precision of adult height prediction by bone age determination in children with idiopathic growth hormone deficiency (IGHD) is unk nown. Methods: The near adult height (NAH) of patients with IGHD in the KIGS database was compared retrospectively to adult height prediction calculated by the Bayley–Pinneau (BP) prediction based on bone age by Greulich–Pyle (GP) in 315 children and based on the Tanner-Whitehouse 2 (TW2) method in 121 children. Multip le linear regression analyses adjusted for age at GH start, age at puberty, mean dose and years of of GH treatment, and maximum GH peak in stimulation test were calcula ted. Results: The mean underestimation of adult height based on the BP metho d was at baseline 4.1 ± 0.7 cm in girls and 6.1 ± 0.6 cm in boys, at 1 year of GH treatment 2.5 ± 0.5 cm in girls and 0.9 ± 0.4 cm in boys, while at last b one age determination adult height was overestimated in mean by 0.4 ± 0.6 cm in girls and 3 .8 ± 0.5 cm in boys. The mean underestimation of adult height based on the TW2 metho d was at baseline 5.3 ± 2.0 cm in girls and 7.9 ± 0.8 cm in boys, at 1 year of GH treatment adult height was overestimated in girls 0.1 ± 0.6 cm in girls and underestimated 4.1 ± 0.4 cm in boys, while at last bone age determination adult height was overestimated i n mean by 3.1 ± 1.5 cm in girls and 3.6 ± 0.8 cm in boys. Conclusions: Height prediction by BP and TW2 at onset of GH treatment underestimates adult height in prepubertal IGHD children, while in mean 6 year s after onset of GH treatment these prediction methods overestimated adult height.

Keywords

• growth prediction
• greulich and pyle
• bayley–pinneau
• tanner whitehouse
• bone age
• growth hormone deficiency
• growth hormone