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Growth patterns in patients with congenital adrenal hyperplasia analyzed by the QEPS growth model

Ruta Navardauskaite1, Aimon Niklasson2, Andreas F M Nierop2,3

  • 1Department of Endocrinology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania.

Frontiers in Endocrinology
|June 22, 2026
PubMed

Insights

Congenital adrenal hyperplasia (CAH) patients show altered growth patterns. Salt-wasting CAH individuals experience reduced early and pubertal growth, leading to shorter adult height despite longer birth length.

Area of Science:

  • Pediatric Endocrinology
  • Growth and Development
  • Genetics and Inherited Diseases

Background:

  • Congenital adrenal hyperplasia (CAH) presents significant challenges to achieving target adult height in affected individuals.
  • The QEPS growth model offers a comprehensive framework for analyzing healthy and pathological growth trajectories but has not been previously applied to CAH patients.

Purpose of the Study:

  • To apply the QEPS growth model to evaluate growth patterns in patients with congenital adrenal hyperplasia (CAH).
  • To compare the growth characteristics of CAH patients with a healthy reference population.

Main Methods:

  • A retrospective longitudinal study design was employed, analyzing growth data from 1986 to 2008.
  • Twenty-five patients with CAH (subtyped into salt wasting [SW] and simple virilizing [SV]) were included, with growth data compared against a healthy cohort.
  • The QEPS model, assessing early life (E-function), childhood (Q-function), and pubertal (P-function) growth, was utilized. Final adult height was compared to reference and parental heights.

Main Results:

  • Patients with CAH-SW exhibited longer birth lengths but demonstrated reduced early-life and puberty-specific growth (lower Pmax), resulting in a mean adult height of -1.7 SDS.
  • CAH-SV girls showed an earlier onset of pubertal growth, also contributing to reduced adult height (mean -1.6 SDS).
  • Both CAH subtypes displayed comparable basic childhood growth patterns.

Conclusions:

  • Patients with CAH-SW present unique growth trajectories characterized by initial longer birth length followed by diminished early and pubertal growth, ultimately leading to shorter adult stature.
  • These findings highlight the importance of understanding specific growth patterns in CAH for potential therapeutic interventions.
Abstract

Keywords:
QEPS growth modeladult heightchildhood growthcongenital adrenal hyperplasiagrowth patternspubertal growth

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