Division of Pediatric Endocrinology, Health Sciences University, Istanbul Haseki Training and Research Hospital, Istanbul, Turkey.
Department of Radiology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey.
Endocrine. 2024 Oct;86(1):349-357. doi: 10.1007/s12020-024-03951-9. Epub 2024 Jul 5.
Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV based on CA, HA, or BA in the patients with GHD.
Fifty-seven patients with severe and 40 patients with partial GHD and 39 patients with ISS assigned to the study. For defining the most accurate diagnosis of pituitary hypoplasia, PH and PV were evaluated based on CA, BA and HA. The relationship of each method with clinical features was examined.
The mean PV was significantly larger in patients with ISS compared to the GH-deficient patients. PV was more correlated with clinical features including height SDS, stimulated GH concentration, IGF-1 and IGFBP-3 SDS, height velocity before and after rGH therapy. We found BA-based PV could discriminate GHD from ISS (Sensitivity: 17%, specificity: 98%, positive predictive value: 94%, negative predictive value: 39%), compared to the other methods based on PH or PV respect to CA and HA. 3% of patients with ISS, 17% of patients with GHD had pituitary hypoplasia based on PV-BA.
PV based on BA, has the most accurate diagnostic value for defining pituitary hypoplasia. But it should be kept in mind that there might be still misdiagnosed patients by this method. PV is also a significant predictor for the rGH response.
身高年龄（HA）和骨龄（BA）延迟在身材矮小的患者中是众所周知的。因此，根据实际年龄（CA）评估垂体发育不全可能导致垂体发育不全的过度诊断。我们旨在研究基于 CA、HA 或 BA 的 PH 和 PV 在 GHD 患者中的诊断和预后价值。
将 57 例严重 GHD 患者、40 例部分 GHD 患者和 39 例 ISS 患者纳入研究。为了更准确地诊断垂体发育不全，我们根据 CA、BA 和 HA 评估 PH 和 PV。检查了每种方法与临床特征的关系。
与 GH 缺乏患者相比，ISS 患者的平均 PV 显著更大。PV 与身高 SDS、刺激 GH 浓度、IGF-1 和 IGFBP-3 SDS、rhGH 治疗前后的身高增长速度等临床特征更相关。我们发现，与基于 PH 或 PV 相对于 CA 和 HA 的其他方法相比，BA 为基础的 PV 能够将 GHD 与 ISS 区分开来（灵敏度：17%，特异性：98%，阳性预测值：94%，阴性预测值：39%）。3%的 ISS 患者和 17%的 GHD 患者根据 PV-BA 存在垂体发育不全。
基于 BA 的 PV 对定义垂体发育不全具有最准确的诊断价值。但应记住，通过这种方法仍可能存在误诊患者。PV 也是 rhGH 反应的重要预测指标。
