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Age-specific Contributions to Height in Boys with Klinefelter Syndrome: Analysis of Growth Using the QEPS Model
Anton Holmgren1,2,3, Aimon Niklasson1, Lars Gelander1
1Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 41685 Gothenburg, Sweden.
Context:
Increased height is a characteristic of Klinefelter syndrome (KS). Detailed evaluation of growth patterns in boys and adolescents carrying a 47,XXY karyotype is lacking.
Objective:
To delineate detailed growth patterns during the different growth phases and their contribution to the increased adult height in boys with KS.
Methods:
Longitudinal data on growth from 55 boys with KS were compared with a reference from the GrowUp1974Gothenburg cohort using a statistical growth model using 4 mathematical functions: the QEPS model. A subgroup of 35 boys out of whom 34 were on testosterone replacement therapy (TRT) reached final height.
Results:
The infant growth period was shorter with a lower height gain (Emax, 63.3 vs 65.1 cm, P < .001) in boys with KS. The boys gained more height during the childhood growth phase, (Qmax, 110.9 vs 104.1 cm, P < .001), and onset of pubertal growth was earlier as compared with the reference (11.3 vs 11.8 years, P < .001). The total pubertal height gain was higher (32.9 vs 30.6 cm, P < .001) due to more basic growth; the specific pubertal growth was equal, resulting in a taller adult height (184.6 vs 180.5 cm, P < .001).
Conclusion:
The boys with KS exhibited a different growth pattern as compared with a healthy reference population, with less and shorter growth in infant life and more basic growth during childhood and the pubertal years (the Q-function growth by the QEPS model), resulting in taller adult height.
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