[Precocious puberty, Gh deficiency and obesity can affect final height in patients with myelomeningocele: comparison of males and females].
Patients with myelomeningocele show an increased incidence of endocrinological disorders during their childhood. These disorders can ulteriorly affect the adult height of these patients who are already extremely short. In the present study we determined the final height in 21 patients (11 females aged 20.55 +/- 3.54 years; 10 males aged 20.99 +/- 2.94 years) with myelomeningocele. The endocrinological implications were investigated by clinical and laboratory assessment at control and an accurate retrospective evaluation of individual clinical history. Auxological data indicated that in male patients mean final height was significantly less (P < 0.05) than target height, but in females the difference between final height and target height was even more marked (P < 0.001). Comparison of SDS for adult height between males (-2.04 +/- 1.89) and females (-4.36 +/- 2.24) evidenced a statistically significant difference (P < 0.05). The analysis of endocrinological data showed that 7 females had had precocious puberty not treated; no case of precocious puberty was evidenced in males. In 4 females we observed plasmatic IGF-1 and IGFBP-3 concentrations significantly reduced either for chronological age and pubertal stage; this finding emerged in only 1 male. Plasmatic thyroid hormone and adrenal steroid concentrations resulted normal in both groups. Finally, obesity, considered as BMI > 90%, resulted present since childhood in 4 females and 2 males. Our data show that females with myelomeningocele have a statistically greater decrease of their adult stature respect to males. This difference is probably due to a more significant incidence in females of endocrinological diseases. Thus, we believe that a better statural prognosis may be joined in these patients (particularly in girls), through a careful endocrinological follow-up, performed from their births, in order to ensure a prompt identification and treatment of the cases of precocious puberty, impaired GH secretion or obesity.
Galluzzi
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Clinica Pediatrica II, Università di Firenze, Italia.
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D000293:Adolescent; D000328:Adult; D001827:Body Height; D005260:Female; D006130:Growth Disorders / Q000209:etiology; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000503:physiopathology; D009765:Obesity / Q000150:complications*; D011629:Puberty, Precocious / Q000150:complications / Q000209:etiology*; D012744:Sex Ratio
D019382:Human Growth Hormone