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

Area of Science:

• Pediatric Endocrinology
• Growth Disorders
• Medical Statistics

Background:

• Assessing the accuracy of adult height prediction is crucial for managing children with idiopathic growth hormone deficiency (IGHD).
• The precision of bone age determination methods for predicting final height in IGHD patients remains unclear.

Purpose of the Study:

• To evaluate the accuracy of adult height prediction using the Bayley-Pinneau (BP) and Tanner-Whitehouse 2 (TW2) methods in children with IGHD.
• To compare the predictive accuracy of these methods at different stages of growth hormone (GH) treatment.

Main Methods:

• Retrospective analysis of near adult height (NAH) from the KIGS database for patients with IGHD.
• Comparison of NAH with adult height predictions derived from bone age assessments using BP (Greulich-Pyle) and TW2 methods.
• Statistical analysis using multiple linear regression, adjusting for key treatment and patient variables.

Main Results:

• Both BP and TW2 methods significantly underestimated adult height at baseline in IGHD patients.
• Prediction accuracy improved after one year of GH treatment, with BP showing less underestimation than TW2.
• By the final bone age assessment, both methods overestimated adult height, with BP overestimating more in boys and TW2 overestimating in both sexes.

Conclusions:

• Height prediction by BP and TW2 methods underestimates adult height in prepubertal IGHD children at the onset of GH treatment.
• After approximately 6 years of GH treatment, these prediction methods tend to overestimate adult height in IGHD patients.