title: Impact of hydrocortisone on adult height in congenital adrenal hyperplasia-the Minnesota cohort.
abstract: OBJECTIVE
  To estimate the impact of the average daily dose of hydrocortisone (HC) on the amount of growth attained in children with congenital adrenal hyperplasia (CAH). The effect of glucocorticoid therapy on adult height (AH) in children with CAH has yet to be elucidated.
  
  
  METHODS
  Triple-logistic models estimating components of growth and maturation were fitted to longitudinal records of 104 patients with classic CAH from 3 pediatric medical centers in Minnesota between 1955 and 2012. A total of 3664 clinical encounters were examined. Random-effects longitudinal models with time-related covariates were used to estimate the effect of HC therapy on linear growth.
  
  
  RESULTS
  The predicted AH z-score (-0.7) was similar between the sexes and among CAH subtypes. The mean growth period HC dose was 18.9 ± 5.6 mg/m(2)/day. In the final regression model, HC dose was negatively associated with predicted AH, with each mg/m(2)/day increase in average growth period HC dose predicting a 0.37-cm decrease in AH (P < .004).
  
  
  CONCLUSIONS
  This study has quantified the fractional reduction in predicted final AH with an incremental increase in HC dose. These findings have important clinical implications in the decision making balance between HC replacement dose and adrenal androgen suppression in children with CAH.
authors.affiliation: Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN. Electronic address: saraf010@umn.edu.
authors.forename: Kyriakie
authors.initials: K
authors.lastname: Sarafoglou
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
authors.forename: O Yaw
authors.initials: OY
authors.lastname: Addo
authors.affiliation: Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN.
authors.forename: Lucie
authors.initials: L
authors.lastname: Turcotte
authors.affiliation: Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN.
authors.forename: Noelle
authors.initials: N
authors.lastname: Otten
authors.affiliation: Department of Pediatrics, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wickremasinghe
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Pittock
authors.affiliation: Division of Diabetes and Endocrinology, Children's Hospitals of Minnesota, Minneapolis, MN.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kyllo
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Aida N
authors.initials: AN
authors.lastname: Lteif
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
authors.forename: John H
authors.initials: JH
authors.lastname: Himes
authors.affiliation: Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000494:pharmacology* / Q000627:therapeutic use; D007223:Infant; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008910:Minnesota; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone