Comparison of methods for final height assessment in adolescents with a normal variant short stature

Autores

  • Karla Cristina Malta Costa Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo
  • Inez Tomita
  • Marco Antonio Barbieri
  • Heloisa Bettiol
  • Luiz Antonio Del Ciampo

DOI:

https://doi.org/10.7322/jhgd.131259

Palavras-chave:

short stature, final height, bone age

Resumo

Introduction: patients with low stature normal variant growth have peculiar evolutionary patterns making it difficult to precisely define when final stature will be reached, since prediction methods are based on parameters of difficult quantification, such as bone age.

Objective: To assess the agreement between two methods for prediction of final height based on family target range regarding the final height reached by adolescents with a diagnosis of normal variant short stature.  

Methods: Thirty-three subjects were evaluated using height of parents for the calculation of family target range and Bayley-Pinneau and Tanner-Whitehouse methods for prediction of final height. Spearman correlation coefficient was calculated to correlate final height with the mean of the family target range, and the St. Laurent concordance coefficient was used to assess concordance between final stature and predictive methods.

Results:  87.9% (29/33) subjects kept short stature at the end of growth and 90.9% (30/33) had a final height within family target range. A very strong positive correlation (Cs = 0.77; p < 0.01) was observed between parental mean and final height. Bayley-Pinneau method showed a 0.47 concordance coefficient with final height (95% CI: 0.34; 0.57), and Tanner-Whitehouse 3 method showed a concordance coefficient of 0.58 (95% CI: 0.41; 0.75).

Conclusion: The strong positive correlation observed demonstrates the significant influence of parental height on final height. Neither method showed good concordance when used as a predictor of final height, with height values being overestimated.

Referências

Romani SAM, Lira PIC. Determinant factors of infant growth. Rev Bras Saúde Matern Infant. 2004;4(1):15-23. DOI: http://dx.doi.org/10.1590/S1519-38292004000100002

Weedon MN, Lettre G, Freathy RM, Lindgren CM, Woight BF, Perry JR, et al. A common variant of HMGA2 is associated with adult and childhood height in the general population. Nat Genet. 2007;39(1):1245-50. DOI: http://dx.doi.org/10.1038/ng2121

Barbieri MA, Bettiol H, Almeida LEA, Del Ciampo LA, Tomita I. Growth and nutritional status assessment. In: Dutra-de-Oliveira JE, Marchini JS. Nutritional Sciences. São Paulo: Sarvier, 2008. p.663-90.

Tanner JM. Use and abuse of growth standards. In: Falkner F, Tanner JM. Human growth: a comprehensive treatise. New York: Plenumm Press; 1986.

Cowell CT. Short stature. In: Brook CGD. Clinical paediatric endocrinology. Oxford: Blackwell Science; 1995. p.137-72.

Fox LA, Zeller WP. Evaluation of short stature. Comprehensive Ther. 1995; 21(3):115-21.

Reekers-Mombarg LTM, Cole TJ, Massa GG, Wit JM. Longitudinal analysis of growth in children with idiopathic short stature. Ann Hum Biol. 1997;24(6): 569-83. DOI: http://dx.doi.org/10.1080/03014469700005332

Ranke MB. Towards a consensus on the definition of idiopathic short stature. Horm Res. 1996;45(Suppl.2):64-6. DOI: http://dx.doi.org/10.1159/000184851

Hermanussen M, Abmann C, Groth D, Staub K. Final height, target and the community. Georgian Med News. 2014;(230):30-4.

Rios R, Bosch V, Santonja F, López JM, Garaulet M. The height target prediction by the Tanner method infra evaluates the final height in youths from the rural area of South East Spain. Nutr Hosp. 2014; 31(1):436-42. DOI: http://dx.doi.org/10.3305/nh.2015.31.1.7545

Longui CA. Previsão da estatura final — acertando no ''alvo''? Arq Bras Endocrinol Metab 2003;47(6): 636-7. DOI: http://dx.doi.org/10.1590/S0004-27302003000600002

Setian N, Kuperman H, Della Manna T, Daminai D, Dichtchekenian V. Critical analysis of final height prediction. Arq Bras Endocrinol Metab 2003;47(6):695-700. DOI: http://dx.doi.org/10.1590/S0004-27302003000600011

Tanner JM. Fetus into Man: physical growth from conception to maturity. Revised edition. Warvard University Press, 1990.

Marshal WA, Tanner JM. Variations in the patterns of pubertal changes in boys. Arch Dis Child. 1970;459239):13-23.

Bayley N, Pinneau SR. Tables for predicting adult height from skeletal age: revised for use with Greulich-Pyle hand standards. J Pediatr. 1952; 40(4):423-41. DOI: https://dx.doi.org/10.1016/S0022-3476(52)80205-7

Tanner JM. Assessment of skeletal maturity and prediction of adult height (TW3 method). 3. ed. London: Saunders, 2001.

Buckler JM. Skeletal age changes in puberty. Arch Dis Child. 1984;59(2): 115-9. DOI: http://dx.doi.org/10.1136/adc.59.2.115

Simm PJ, Werther GA. Child and adolescent growth disorders – an overview. Aust Fam Physician. 2005;34(9):731-6.

Tomita I. Maturação óssea e puberal em crianças com baixa estatura. Dissertação (Mestrado) - Faculde de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto: 2002.

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(10):1109-12.

Giacobbi V, Trivin C, Lawson-Body E, Fonseca M, Sourbebielle JC, Brauner R. Extremely short stature: Influence of each parent’s height on clinical-biological features. Horm Res. 2003;60(6): 272-6. DOI: http://dx.doi.org/10.1159/000074244

Kim HJ, Song HR, Shyam A, Heon SS, Unnikrishnan R, Song SY. Skeletal age in idiopathic short stature: An analytical study by the TW3 method, Greulich and Pyle method. Indian J Orthop. 2010;44(3):322-6. DOI: http://dx.doi.org/10.4103/0019-5413.65144

Volta V, 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(3):171-6.

Bueno LG, Ruibal FJL, Reverte BF, Casado FE. Accuracy of three methods of height prediction in a group of variant short stature children. An Esp Pediatr. 1998;49(1):27-32.

Christoforidis A, Badouraki M, Katzos G, Athanassiou-Metaxa M. Bone age estimation and prediction of final height in patients with β-thalassaemia major: a comparison between the two most common methods. Pediatr Radiol. 2007;37(12):1241-6. DOI: https://doi.org/10.1007/s00247-007-0656-1

Milner GR, Levick RK, Kay R. Assessment of bone age: a comparison of Greulich-Pyle and Tanner-Whitehouse methods. Clin Radiol. 1986; 37(2):119-21. DOI: https://dx.doi.org/10.1016/S0009-9260(86)80376-2

Ostojic SM. Prediction of adult height by Tanner-Whitehouse method in young Caucasian male athletes. QJM. 2013;106(4):341-5. DOI: https://dx.doi.org/10.1093/qjmed/hcs230

Brämswig JH, Fasse M, Holthoff ML, van Lengerke HJ, van 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(6):886-91.

Publicado

2017-12-18

Edição

Seção

Artigos Originais