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Comparison of height for age and height for bone age with and without adjustment for target height in pediatric

Janna W Woestenenk1, Tiny Hoekstra, Carola Hesseling

  • 1Julius Centre for Health, Sciences and Primary Care, Department of Dietetics and Nutritional Science, University Medical Centre Utrecht, GA Utrecht, The Netherlands. J.W.Woestenenk@umcutrecht.nl

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|April 5, 2011
PubMed

Insights

Height assessment in cystic fibrosis (CF) is crucial. Using height-for-age (HFA) alone may misclassify short stature; incorporating bone age and target height provides a more accurate evaluation for CF patients.

Area of Science:

  • Pediatric endocrinology
  • Pulmonology
  • Genetics

Background:

  • Height is a critical prognostic indicator in cystic fibrosis (CF).
  • Current height-for-age (HFA) assessments may not fully capture growth potential due to unconsidered bone age (BA) and genetic factors.
  • This can lead to misclassification of short stature in children with CF.

Purpose of the Study:

  • To evaluate the impact of different height assessment methods on classifying stature in children with CF.
  • To determine if incorporating bone age (BA) and target height (TH) improves the accuracy of short stature classification compared to standard height-for-age (HFA).

Main Methods:

  • Assessed height, bone age (BA), and target height (TH) in 169 children with CF.
  • Calculated four height metrics: HFA, height-for-bone-age (HBA), HFA adjusted for TH (HFA/TH), and HBA adjusted for TH (HBA/TH).
  • Categorized children based on these four methods to identify short stature (z-score <-2 SD).

Main Results:

  • Mean z-scores varied across methods, ranging from -0.1 ± 0.8 (HBA/TH) to -0.5 ± 1.0 (HFA).
  • Height-for-age (HFA) identified a higher prevalence of short stature (8%) compared to HBA, HFA/TH (both 5%), and HBA/TH (1%).
  • Significant differences in short stature classification were observed based on the method employed.

Conclusions:

  • The choice of height classification method significantly impacts group-level and individual patient outcomes in CF.
  • Integrating bone age (BA) and target height (TH) offers added value for accurate height interpretation in pediatric CF patients.
  • These factors are essential for a comprehensive understanding of growth and prognosis in cystic fibrosis.
Abstract

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