Reinehr Thomas, Carlsson Martin, Chrysis Dionisios, Camacho-Hübner Cecilia
Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Children's Hospital, University of Witten/Herdecke, Datteln, Germany.
Endocrine Care, Pfizer Inc, New York, New York, USA.
Endocr Connect. 2020 May;9(5):370-378. doi: 10.1530/EC-20-0090.
The precision of adult height prediction by bone age determination in children with idiopathic growth hormone deficiency (IGHD) is unknown.
The near adult height (NAH) of patients with IGHD in the KIGS database was compared retrospectively to adult height prediction calculated by the Bayley-Pinneau (BP) prediction based on bone age by Greulich-Pyle (GP) in 315 children and based on the Tanner-Whitehouse 2 (TW2) method in 121 children. Multiple linear regression analyses adjusted for age at GH start, age at puberty, mean dose and years of of GH treatment, and maximum GH peak in stimulation test were calculated.
The mean underestimation of adult height based on the BP method was at baseline 4.1 ± 0.7 cm in girls and 6.1 ± 0.6 cm in boys, at 1 year of GH treatment 2.5 ± 0.5 cm in girls and 0.9 ± 0.4 cm in boys, while at last bone age determination adult height was overestimated in mean by 0.4 ± 0.6 cm in girls and 3.8 ± 0.5 cm in boys. The mean underestimation of adult height based on the TW2 method was at baseline 5.3 ± 2.0 cm in girls and 7.9 ± 0.8 cm in boys, at 1 year of GH treatment adult height was overestimated in girls 0.1 ± 0.6 cm in girls and underestimated 4.1 ± 0.4 cm in boys, while at last bone age determination adult height was overestimated in mean by 3.1 ± 1.5 cm in girls and 3.6 ± 0.8 cm in boys.
Height prediction by BP and TW2 at onset of GH treatment underestimates adult height in prepubertal IGHD children, while in mean 6 years after onset of GH treatment these prediction methods overestimated adult height.
特发性生长激素缺乏症（IGHD）患儿通过骨龄测定预测成人身高的准确性尚不清楚。
回顾性比较KIGS数据库中IGHD患者的接近成人身高（NAH）与根据贝利-皮诺（BP）预测法计算的成人身高预测值，其中315名儿童的骨龄基于格吕利希-派尔（GP）法，121名儿童的骨龄基于坦纳-怀特豪斯2（TW2）法。计算了针对开始使用生长激素时的年龄、青春期年龄、生长激素治疗的平均剂量和年限以及刺激试验中的最大生长激素峰值进行调整的多元线性回归分析。
基于BP法，在基线时女孩成人身高平均低估4.1±0.7厘米，男孩为6.1±0.6厘米；在生长激素治疗1年时，女孩为2.5±0.5厘米，男孩为0.9±0.4厘米；而在最后一次骨龄测定时，女孩成人身高平均高估0.4±0.6厘米，男孩为3.8±0.5厘米。基于TW2法，在基线时女孩成人身高平均低估5.3±2.0厘米，男孩为7.9±0.8厘米；在生长激素治疗1年时，女孩成人身高高估0.1±0.6厘米，男孩低估4.1±0.4厘米；而在最后一次骨龄测定时，女孩成人身高平均高估3.1±1.5厘米，男孩为3.6±0.8厘米。
生长激素治疗开始时用BP法和TW2法预测身高会低估青春期前IGHD儿童的成人身高，而在生长激素治疗开始约6年后，这些预测方法会高估成人身高。
