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Spontaneous growth in idiopathic short stature. European Study Group
L T Rekers-Mombarg1, J M Wit, G G Massa
1Bureau of the Dutch Growth Foundation, Leiden, The Netherlands.
Insights
Growth curves for children with idiopathic short stature (ISS) were established using data from 229 untreated European children. These specific data provide a more accurate reference for evaluating growth-promoting treatments in children with ISS.
Area of Science:
- Pediatric Endocrinology
- Growth and Development
- Genetics and Rare Diseases
Background:
- Idiopathic Short Stature (ISS) affects children's growth, necessitating accurate reference data for treatment evaluation.
- Existing growth charts may not precisely reflect the natural progression of ISS, potentially impacting treatment efficacy assessment.
Purpose of the Study:
- To document the spontaneous growth patterns of children with Idiopathic Short Stature (ISS).
- To create specific growth curves for untreated children with ISS to aid in evaluating growth-promoting therapies.
Main Methods:
- Construction of growth curves using data from 229 untreated children (145 boys, 84 girls) with ISS from nine European countries.
- Subdivision of children based on target height range and pubertal onset.
- Evaluation of growth using Standard Deviation Scores (SDS) and final height measurements.
Main Results:
- Children with ISS exhibited shorter stature at birth (boys -0.8 SDS, girls -1.3 SDS) and a progressive decrease in height SDS through adolescence.
- Final mean adult height was below target height (boys -1.5 SDS, girls -1.6 SDS).
- Delayed onset of puberty was observed in both boys and girls with ISS.
Conclusions:
- The constructed growth curves for ISS provide a specific reference dataset for this condition.
- These ISS-specific growth data are potentially more suitable for assessing the effects of growth-promoting treatments compared to general population references.
- Understanding the natural growth trajectory in ISS is crucial for personalized treatment strategies.
Abstract:
Documenting the spontaneous growth pattern of children with idiopathic short stature (ISS) should be helpful in evaluating the effects of growth promoting treatments. Growth curves for children with ISS were constructed, based on 229 untreated children (145 boys and 84 girls) from nine European countries. The children were subdivided according to target range and onset of puberty, and the growth of these subgroups was evaluated from standard deviation scores (SDS). At birth, children with ISS were already shorter than normal (means; boys -0.8 SDS, girls -1.3 SDS). Height slowly decreased from -1.7 SDS at the age of 2 years to -2.7 SDS at the age of 16 years in boys and 13 years in girls. Final height was -1.5 SDS in boys and -1.6 SDS in girls (mean (SD): boys 164.8 (6.1) cm, girls 152.7 (5.3) cm)), which was 5-6 cm below their target height. The onset of puberty was delayed (boys 13.8 (1.3) years, girls 12.9 (1.1) years). Subclassification resulted in similar growth curves. These specific growth data may be more suitable for evaluating the effects of growth promoting treatments than population based references.