Background/Aims: Boys with constitutional delay of growth and puberty (CDGP) with early reduction in relative height before the onset of puberty will have adult height (AH) clearly below their target height (TH). Characteristics of growth in girls with CDGP are poorly known. We examined whether girls with CDGP attain their TH and whether early reduction in height SDS influences their AH. We also investigated effects of low-dose estrogen on AH. Methods: We investigated growth of 39 women (7 treated with low-dose estrogen) with CDGP history. We compared AH between estrogen-treated and untreated subjects, and used multiple linear regression to investigate the influence of various growth characteristics, e.g. height SDS changes between different ages in childhood, on AH. Results: AH was similar in estrogen-treated and untreated subjects. Reduction of height SDS between 3 and 8 years was significantly associated with the difference between AH and TH (regression coefficient 0.8, 95% confidence interval 0.1–1.5). Overall, 49% of subjects had AH >0.50 SDS below TH. Conclusion: A proportion of CDGP girls do not attain AH consistent with their TH. Reduction in height SDS in childhood predicts smaller AH. Low-dose estrogen treatment does not seem to influence AH in girls with CDGP.

Keywords:
Pubertal growth, Pubertal delay, Constitutional delay of puberty, Adult height, Low-dose estrogen treatment, Estrogen
1.
Crowne EC, Shalet SM, Wallace WH, Eminson DM, Price DA: Final height in girls with untreated constitutional delay in growth and puberty. Eur J Pediatr 1991;150:708–712.
2.
Sedlmeyer IL, Palmert MR: Delayed puberty: analysis of a large case series from an academic center. J Clin Endocrinol Metab 2002;87:1613–1620.
3.
Sedlmeyer IL, Hirschhorn JN, Palmert MR: Pedigree analysis of constitutional delay of growth and maturation: determination of familial aggregation and inheritance patterns. J Clin Endocrinol Metab 2002;87:5581–5586.
4.
Wehkalampi K, Widén E, Laine T, Palotie A, Dunkel L: Patterns of inheritance of constitutional delay of growth and puberty in families of adolescent girls and boys referred to specialist pediatric care. J Clin Endocrinol Metab 2008;93:723–728.
5.
Du Caju MV, Op De Beeck L, Sys SU, Hagendorens MM, Rooman RP: Progressive deceleration in growth as an early sign of delayed puberty in boys. Horm Res 2000;54:126–130.
6.
Rensonnet C, Kanen F, Coremans C, Ernould C, Albert A, Bourguignon JP: Pubertal growth as a determinant of adult height in boys with constitutional delay of growth and puberty. Horm Res 1999;51:223–229.
7.
Bramswig JH, Fasse M, Holthoff ML, von Lengerke HJ, von Petrykowski W, Schellong G: Adult height in boys and girls with untreated short stature and constitutional delay of growth and puberty: accuracy of five different methods of height prediction. J Pediatr 1990;117:886–891.
8.
Crowne EC, Shalet SM, Wallace WH, Eminson DM, Price DA: Final height in boys with untreated constitutional delay in growth and puberty. Arch Dis Child 1990;65:1109–1112.
9.
LaFranchi S, Hanna CE, Mandel SH: Constitutional delay of growth: expected versus final adult height. Pediatrics 1991;87:82–87.
10.
Albanese A, Stanhope R: Does constitutional delayed puberty cause segmental disproportion and short stature? Eur J Pediatr 1993;152:293–296.
11.
Albanese A, Stanhope R: Predictive factors in the determination of final height in boys with constitutional delay of growth and puberty. J Pediatr 1995;126:545–550.
12.
Wehkalampi K, Vangonen K, Laine T, Dunkel L: Progressive reduction of relative height in childhood predicts adult stature below target height in boys with constitutional delay of growth and puberty. Horm Res 2007;68:99–104.
13.
Cutler GB Jr: The role of estrogen in bone growth and maturation during childhood and adolescence. J Steroid Biochem Mol Biol 1997;61:141–144.
14.
Zachmann M, Studer S, Prader A: Short-term testosterone treatment at bone age of 12 to 13 years does not reduce adult height in boys with constitutional delay of growth and adolescence. Helv Paediatr Acta 1987;42:21–28.
15.
Wilson DM, Kei J, Hintz RL, Rosenfeld RG: Effects of testosterone therapy for pubertal delay. Am J Dis Child 1988;142:96–99.
16.
Kelly BP, Paterson WF, Donaldson MD: Final height outcome and value of height prediction in boys with constitutional delay in growth and adolescence treated with intramuscular testosterone 125 mg per month for 3 months. Clin Endocrinol (Oxf) 2003;58:267–272.
17.
Wehkalampi K, Widén E, Laine T, Palotie A, Dunkel L: Association of the timing of puberty with a chromosome 2 locus. J Clin Endocrinol Metab 2008;93:4833–4839.
18.
Pihkala J, Hakala T, Voutilainen P, Raivio K: Characteristic of recent fetal growth curves in Finland. Duodecim 1989;105:1540–1546.
19.
Karlberg J, Kwan CW, Gelander L, Albertsson-Wikland K: Pubertal growth assessment. Horm Res 2003;60(suppl 1):27–35.
20.
Liu YX, Wikland KA, Karlberg J: New reference for the age at childhood onset of growth and secular trend in the timing of puberty in Swedish. Acta Paediatr 2000;89:637–643.
21.
Marshall WA, Tanner JM: Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303.
22.
Greulich WW, Pyle JI (ed): Radiographic Atlas of Skeletal Development of Hand and Wrist, ed 2. Palo Alto, Stanford University Press, 1959.
23.
Sorva R, Lankinen S, Tolppanen EM, Perheentupa J: Variation of growth in height and weight of children. II. After infancy. Acta Paediatr Scand 1990;79:498–506.
24.
Sorva R, Tolppanen EM, Lankinen S, Perheentupa J: Growth evaluation: parent- and child-specific height standards. Arch Dis Child 1989;64:1483–1487.
25.
Volta C, Ghizzoni L, Buono T, Ferrari F, Virdis R, Bernasconi S: Final height in a group of untreated children with constitutional growth delay. Helv Paediatr Acta 1988;43:171–176.
26.
Arrigo T, Cisternino M, Luca De F, Saggese G, Messina MF, Pasquino AM, De Sanctis V: Final height outcome in both untreated and testosterone-treated boys with constitutional delay of growth and puberty. J Pediatr Endocrinol 1996;9:511–517.
27.
Sperlich M, Butenandt O, Schwarz HP: Final height and predicted height in boys with untreated constitutional growth delay. Eur J Pediatr 1995;154:627–632.
28.
Poyrazoglu S, Gunoz H, Darendeliler F, Saka N, Bundak R, Ba F: Constitutional delay of growth and puberty: from presentation to final height. J Pediatr Endocrinol 2005;18:171–179.
29.
Butenandt O, Bechtold S, Meidert A: Final height in patients with constitutional delay of growth and development from tall statured families. J Pediatr Endocrinol 2005;18:165–169.
30.
Brooks-Gunn J, Warren MP, Rosso J, Gargiulo J: Validity of self-report measures of girls’ pubertal status. Child Dev 1987;58:829–841.
31.
Pietiläinen KH, Rissanen A, Laamanen M, Lindholm AK, Markkula H, Yki-Järvinen H, Kaprio J: Growth patterns in young adult monozygotic twin pairs discordant and concordant for obesity. Twin Res 2004;7:421–429.
32.
Rowland ML: Self-reported weight and height. Am J Clin Nutr 1990;52:1125–1133.
33.
Tanner JM, Davies PS: Clinical longitudinal standards for height and height velocity for North American children. J Pediatr 1985;107:317–329.
34.
Tanner JM, Whitehouse RH, Marubini E, Resele LF: The adolescent growth spurt of boys and girls of the Harpenden growth study. Ann Hum Biol 1976;3:109–126.
35.
Mussen PH, Jones MC: Self-conceptions, motivations, and interpersonal attitudes of late- and early-maturing boys. Child Dev 1957;28:243–256.
36.
Jones MC, Mussen PH: Self-conceptions, motivations, and interpersonal attitudes of early- and late-maturing girls. Child Dev 1958;29:491–501.
37.
Alsaker FD: Annotation: The impact of puberty. J Child Psychol Psychiatry 1996;37:249–258.
38.
Graber JA, Seeley JR, Brooks-Gunn J, Lewinsohn PM: Is pubertal timing associated with psychopathology in young adulthood? J Am Acad Child Adol Psychiatry 2004;43:718–726.
39.
Johnston DI, Betts P, Dunger D, Barnes N, Swift PG, Buckler JM, Butler GE: A multicentre trial of recombinant growth hormone and low dose oestrogen in Turner syndrome: near final height analysis. Arch Dis Child 2001;84:76–81.
40.
Quigley CA, Crowe BJ, Anglin DG, Chipman JJ: Growth hormone and low dose estrogen in Turner syndrome: results of a United States multi-center trial to near-final height. J Clin Endocrinol Metab 2002;87:2033–2041.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.