Clinically Optimized Adult Height Prediction From Key Bone and Pubertal Stages: Prospective Validation to Adult...

Area of Science:

• Pediatric Endocrinology
• Radiology
• Growth and Development

Background:

• Accurate adult height prediction is crucial in pediatric endocrinology but challenging.
• Traditional bone age (BA) methods are unreliable, time-consuming, and ignore pubertal progression's impact on growth potential.

Purpose of the Study:

• To develop a clinically optimized adult height prediction model.
• To replace traditional bone age assessment with key bone grades and pubertal stages.
• To establish a direct mapping between skeletal maturity and height growth potential.

Main Methods:

• Cross-sectional study in Beijing (2022-2023) using Tanner-Whitehouse 3/radius-ulna-short bone grading and pubertal staging.
• Spearman analysis to identify key bone combinations correlated with BA and height.
• Development and validation of an integrated bone-puberty model.

Main Results:

• Radius, ulna, and metacarpal I grading strongly correlated with BA (ρ = 0.94-0.96).
• Bone combinations (radius + ulna, radius + metacarpal I, radius + ulna + metacarpal I) integrated with pubertal stages showed high predictive performance.
• The proposed radius + metacarpal I bone combination with puberty stages model reduced mean prediction error from 0.71 cm to 0.02 cm, increasing accurate predictions (≤3cm error) from 66.9% to 73.5%.

Conclusions:

• The integrated bone-puberty model significantly enhances adult height prediction accuracy.
• This model incorporates skeletal maturity and pubertal dynamics for improved clinical decision-making.
• A streamlined 2-bone protocol (radius + metacarpal I) offers a practical tool for growth monitoring.