What is The Most Effective Method for Predicting Adult Height in Boys with Constitutional Delay of Growth and Puberty?

62nd Annual ESPE (ESPE 2024), Liverpool, İngiltere, 16 - 18 Kasım 2024, ss.412, (Özet Bildiri)

Background: Predicted adult height (PAH) can be calculated

using methods such as Bayley-Pinneau (BP), Roche-Wainer-

Thissen (RWT), and BoneXpert based on bone age (BA) assessment.

Since these methods were developed for healthy children,

conflicting results have been reported regarding their effectiveness

in different patient groups.

Objective: This study aimed to determine the most accurate

method for PAH by comparing the BP, RWT, and BoneXpert

methods in boys with constitutional delay of growth and puberty

(CDGP).

Subjects and Methods: We included 62 male patients diagnosed

with CDGP who reached their final height (FH). The clinical

findings were retrospectively analyzed. Two researchers assessed

the left-hand and wrist radiographs taken at the time of diagnosis

using the Greulich-Pyle (GP) atlas and manually determined the

BA. Among the methods used for PAH, the GP atlas was used for

BP and RWT, while for the BoneXpert method, we used its

software.

Results: The mean age at diagnosis of the patients was 14.2 ±

0.8 years, and 58.1% (n=36) had a similar family history. The mean

height SD score was -2.1 ± 0.9, and 24.2% (n=15) of patients

received low-dose testosterone induction therapy. The median

BAs of the patients were 12.5 (11.5–13.0) years using the GP atlas

and 12.6 (11.8–13.4) years with BoneXpert (p<0.001). Boys who

were treated or not treated with testosterone had similar ages,

Heights, and median BAs with both methods. The mean target

height and FH SD scores were -0.6 ± 0.6 and -0.6 ± 0.9, respectively

(p=0.8). Almost all of the patients (n=60, 97%) achieved adult

height within the target range, and there was no significant difference

in the FH SD score between boys who received testosterone

and those who did not (p=0.1). There was no significant difference

between the FH and PAH when estimated by the BP and RWT

methods (p=0.2 and p=0.6, respectively), while the BoneXpert

method underestimated the FH (p<0.001) (Table 1). The BP and

RWT methods gave better predictions in patients with BA ≤ 2

years compared to BoneXpert (p=0.3 and p=0.4 vs. p<0.001,

respectively). On the other hand, RWT and BoneXpert methods

were more accurate in PAH in boys with delayed BA >2 years

(p=0.1 and p=0.1, respectively), while the BP method resulted in

overestimation (p=0.003).

Conclusion: The RWT method was found to be a better predictor

of FH than the BP or BoneXpert methods in boys with delayed

BA ≤ 2 years and >2 years.