Final adult height in children with congenital adrenal hyperplasia treated with growth hormone.

CONTEXT

Patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency typically reach a final adult height well below their mid-parental target height.

OBJECTIVE

The objective of this study was to examine whether GH alone or in combination with an LHRH analog (LHRHa) improved the final adult height in patients with CAH.

DESIGN

The study was a nonrandomized prospective study.

SETTING

The study was conducted at two university hospitals in New York City, NY.

PARTICIPANTS

Thirty-four patients with CAH treated with GH participated in this study. Nineteen males and 15 females who were predicted to be more than 2 SD below their mid-parental target height or more than 2 SD below the population mean received GH until reaching final adult height. In addition to GH, 27 patients (16 males, 11 females) were also treated with an LHRHa.

INTERVENTION

The mean duration of GH treatment was 5.6 ± 1.8 yr in males and 4.5 ± 1.6 yr in females. The mean duration of LHRHa therapy was 3.7 ± 1.7 yr for both sexes.

MAIN OUTCOME MEASURES

The primary endpoint variables were final adult height, final height discrepancy, and gain in height.

RESULTS

Males reached a significantly higher final adult height (172.0 ± 4.8 cm) than their initial predicted height (162.8 ± 7.7 cm) (P < 0.00001). Females also reached a significantly higher final adult height (162.2 ± 5.3 cm) than initially predicted (151.7 ± 5.2 cm) (P < 0.0000001). Mean gain in height was 9.2 ± 6.7 cm in males and 10.5 ± 3.7 cm in females.

CONCLUSION

Our results indicate that GH alone or in combination with LHRHa improves final adult height in patients with CAH.