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Constitutional delay in growth and puberty: a comparison of final height achieved between treated and untreated
A Ferrández Longás1, E Mayayo, A Valle
1Children's Hospital Miguel Servet, Division of Endocrinology, Zaragoza, Spain.
Insights
Constitutional delay in growth and puberty (CDGP) often leads to short stature. While most reach their predicted height, therapies like hGH don't improve final height and should be used cautiously.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Constitutional delay in growth and puberty (CDGP) is a common reason for pediatric short stature consultations.
- Familial short stature frequently coexists with CDGP.
- Negative prognostic factors for final height include poor pubertal growth and maternal height/growth delay.
Purpose of the Study:
- To evaluate factors influencing final height in children with CDGP.
- To assess the efficacy of growth hormone (hGH) and oxandrolone therapies on final height outcomes.
- To determine optimal treatment strategies considering psychosocial factors.
Main Methods:
- Review of clinical data for children diagnosed with CDGP.
- Analysis of growth velocity and final height following various therapeutic interventions.
- Assessment of psychosocial status and its impact on treatment decisions.
Main Results:
- hGH and oxandrolone therapies increase growth velocity but do not improve final height in CDGP.
- Transient diminished GH secretion in prepubertal children often normalizes during puberty.
- Psychosocial well-being is a primary indication for treatments like testosterone, estrogens, or oxandrolone.
Conclusions:
- Routine hGH administration is not recommended for CDGP due to lack of final height improvement.
- The benefits of hGH therapy in specific CDGP subgroups require further investigation.
- Treatment decisions should prioritize psychosocial aspects and evidence-based final height outcomes.
Abstract:
Constitutional delay in growth and puberty (CDGP) is one of the principal causes of consultation due to short height. Frequently familial short stature is associated with the CDGP. The predicted final height is reached in the majority of the cases but some individuals do not achieve their target height. Poor growth, especially during the pubertal years, as well as a short or growth delayed mother are some of the negative factors for final outcome. Some prepubertal children show a transient diminished GH secretion that normalizes during puberty. Therapy with hGH or oxandrolone increases growth velocity but does not ameliorate final height. The psychosocial situation of the children is the most important condition to treat with testosterone, estrogens or oxandrolone. In view of the results hGH should not be administered routinely to these cases. It remains open which children could benefit from hGH therapy.