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因身材矮小接受评估的韩国儿童接近最终身高:身高预测方法的临床实用性和分析有效性

Near final height in Korean children referred for evaluation of short stature: clinical utility and analytical validity of height prediction methods.

作者信息

Jeong Seung Woo, Cho Ja Hyang, Jung Hae Woon, Shim Kye Shik

机构信息

Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

Department of Pediatrics, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.

出版信息

Ann Pediatr Endocrinol Metab. 2018 Mar;23(1):28-32. doi: 10.6065/apem.2018.23.1.28. Epub 2018 Mar 22.

Abstract

PURPOSE

Predicted adult height (PAH) is often crucial to decision-making about treatment with human growth hormone (GH) or gonadotropin-releasing hormone agonist in children with short stature. This study compares final adult height (FAH) with different methods used to determine PAH and assesses the clinical utility and analytical validity of height prediction for children not treated with GH.

METHODS

Clinical findings were retrospectively analyzed, and the heights of 44 children (22 males and 22 females) who visited our clinic between August 2006 and June 2017 and reached near final adult height (NFAH) were evaluated. Children treated with GH were excluded. We compared measured NFAH to PAH using the Bayley-Pinneau (BP), Tanner-Whitehouse Mark 2, and Roche-Wainer-Thissen (RWT) methods.

RESULTS

Pearson correlation between all 3 prediction methods and NFAH showed high positive correlations in males and females (<0.05). The average difference between PAH and NFAH for the BP method (0.4±3.9 cm) was significantly lower than those for the RWT and TW 2 methods in females (=0.000, analysis of variance). Furthermore, only PAH by the BP method in females was very close to measured NFAH (paired -test). A Bland-Altman plot verified that 95% of the differences between the PAH and NFAH exist between limits of agreement (mean±1.96 standard deviation).

CONCLUSIONS

The BP method is more useful to predict NFAH in females than other methods. Careful attention is still required when using such tools because PAH can be inaccurate. Therefore, a more accurate FAH prediction model for Korean children is needed.

摘要

目的

预测成人身高(PAH)对于身材矮小儿童使用生长激素(GH)或促性腺激素释放激素激动剂治疗的决策通常至关重要。本研究比较了最终成人身高(FAH)与用于确定PAH的不同方法,并评估了未接受GH治疗儿童身高预测的临床实用性和分析效度。

方法

对临床发现进行回顾性分析,并评估了2006年8月至2017年6月期间来我院就诊且达到接近最终成人身高(NFAH)的44名儿童(22名男性和22名女性)的身高。排除接受GH治疗的儿童。我们使用贝利-平诺(BP)法、坦纳-怀特豪斯2型法和罗氏-韦纳-蒂森(RWT)法将测量的NFAH与PAH进行比较。

结果

所有3种预测方法与NFAH之间的皮尔逊相关性在男性和女性中均显示出高度正相关(<0.05)。BP法的PAH与NFAH的平均差异(0.4±3.9厘米)在女性中显著低于RWT法和TW 2法(方差分析,=0.000)。此外,仅女性中BP法的PAH非常接近测量的NFAH(配对检验)。布兰德-奥特曼图验证了PAH与NFAH之间95%的差异存在于一致性界限内(均值±1.96标准差)。

结论

BP法在预测女性NFAH方面比其他方法更有用。使用此类工具时仍需谨慎,因为PAH可能不准确。因此,需要一个更准确的韩国儿童FAH预测模型。

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