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Ahead of print
Original paper
Published online: 2021-04-13
Submitted: 2021-03-05
Accepted: 2021-03-20
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Validity of Bayley-Pinneau in Predicting Final Adult Height at the Onset of Puberty in Patients with Classic Congenital Adrenal Hyperplasia

Nora Badawi, Lubna Fawaz, Ahmed Amin, Abdelkarim Kamel, Noha Arafa
DOI: 10.5603/EP.a2021.0039

open access

Ahead of print
Original Paper
Published online: 2021-04-13
Submitted: 2021-03-05
Accepted: 2021-03-20

Abstract

Introduction: Final adult height (FAH) in patients with congenital adrenal hyperplasia (CAH) is often lower than predicted adult height (PAH) using Bayley-Pinneau (B&P). The aim of the current work was to test the validity of B&P in predicting FAH from a bone age (BA) performed at onset of puberty. Material and Methods: This was a retrospective longitudinal observational convenience single-center study. The study included 54 patients (male and female) with classic CAH whether salt-wasting (SW) or simple virilising (SV) who had reached FAH. Results of auxological measurements and hormonal data around the time of puberty were retrieved from files. Predicted adult height (PAH) was calculated from a BA taken at onset of puberty and compared with FAH. Results: The median PAH SDS at the onset of puberty (-1.5) was significantly greater than median FAH SDS (-2.2) (p<0.001). The median target height SDS (-0.8) was significantly higher than median FAH SDS (-2.2) (p<0.001). FAH and FAH SDS were significantly worse in females (150.36 ± 7.23; -2.05+1.13) than their male counterparts (162.86 ± 3.30; -1.53+0.51) (p value < 0.001; 0.048). In patients with good control, there was no difference between PAH SDS (-1.7) and FAH SDS (-1.5) (p value=0.37). In patients with poor control (over or under-treated) FAH SDS (-2.1) was significantly lower than PAH SDS (-1.4) (P value<0.001). Conclusion: B&P method was able to accurately predict FAH in children with classic CAH who were medically well controlled (based on 17-hydroxyprogesterone levels) but overestimated it by a significant 0.7SD in poorly-controlled patients.

Abstract

Introduction: Final adult height (FAH) in patients with congenital adrenal hyperplasia (CAH) is often lower than predicted adult height (PAH) using Bayley-Pinneau (B&P). The aim of the current work was to test the validity of B&P in predicting FAH from a bone age (BA) performed at onset of puberty. Material and Methods: This was a retrospective longitudinal observational convenience single-center study. The study included 54 patients (male and female) with classic CAH whether salt-wasting (SW) or simple virilising (SV) who had reached FAH. Results of auxological measurements and hormonal data around the time of puberty were retrieved from files. Predicted adult height (PAH) was calculated from a BA taken at onset of puberty and compared with FAH. Results: The median PAH SDS at the onset of puberty (-1.5) was significantly greater than median FAH SDS (-2.2) (p<0.001). The median target height SDS (-0.8) was significantly higher than median FAH SDS (-2.2) (p<0.001). FAH and FAH SDS were significantly worse in females (150.36 ± 7.23; -2.05+1.13) than their male counterparts (162.86 ± 3.30; -1.53+0.51) (p value < 0.001; 0.048). In patients with good control, there was no difference between PAH SDS (-1.7) and FAH SDS (-1.5) (p value=0.37). In patients with poor control (over or under-treated) FAH SDS (-2.1) was significantly lower than PAH SDS (-1.4) (P value<0.001). Conclusion: B&P method was able to accurately predict FAH in children with classic CAH who were medically well controlled (based on 17-hydroxyprogesterone levels) but overestimated it by a significant 0.7SD in poorly-controlled patients.

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Keywords

Classic congenital adrenal hyperplasia; Bayley-Pinneau method; predicted adult height; final adult height; bone age

About this article
Title

Validity of Bayley-Pinneau in Predicting Final Adult Height at the Onset of Puberty in Patients with Classic Congenital Adrenal Hyperplasia

Journal

Endokrynologia Polska

Issue

Ahead of print

Article type

Original paper

Published online

2021-04-13

DOI

10.5603/EP.a2021.0039

Keywords

Classic congenital adrenal hyperplasia
Bayley-Pinneau method
predicted adult height
final adult height
bone age

Authors

Nora Badawi
Lubna Fawaz
Ahmed Amin
Abdelkarim Kamel
Noha Arafa

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